Fernando Martínez-Regueira

Publications (10)10.78 Total impact

• Article: Transthoracic oesophagectomy with lymphadenectomy in 100 oesophageal cancer patients. Multidisciplinary approach

  Víctor Valentí, José Luis Hernández-Lizoain, Fernando Martínez-Regueira, Manuel Bellver, Javier Rodríguez, Juan Antonio Díaz González, Wenceslao Torres, Jesus Javier Sola, Javier Álvarez-Cienfuegos
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  ABSTRACT: ObjetivesAnalysis of the results on the treatment of esophageal cancer by transthoracic esophagectomy by a multidisciplinary team of surgeons and oncologists. MethodsBetween January 1990 and December 2009, 100 consecutive patients underwent transthoracic esophagectomy. Data were collected prospectively and clinical, pathological and histological features of the tumors were analyzed as well as the results of postoperative morbidity and mortality. ResultsThe average patient age was 55 years (range 31–83 years). In 59 cases the tumor was located in the lower third and in 41 cases in the middle third. Forty-six patients had adenocarcinoma and 54 squamous cell carcinoma. In 54 cases radio-chemotherapy was planned preoperatively. Classification according to pathological tumor stage was: stage 0 in 21 patients, stage I in 10 patients, stage IIa in 28, stage IIb in 9, stage III in 21 and stage IV in 11. The mean number of lymph nodes examined was 14 (range 0–28). Hospital mortality occurred in 4 cases and postoperative complications in 29 patients (33%). The most frequent postoperative complication was pulmonary complications in 17 cases. The average hospital stay was 15.2 days (range 10–40 days) ConclusionsThe results of esophageal cancer have been improved in recent years due to the formation of multidisciplinary teams in this pathology. In our study we have shown that the results obtained with the transthoracic technique for cancer of the esophagus are within the ranges reported in the literature for teams with high prevalence of the disease. KeywordsOesophagectomy–Preoperative chemoradiothe rapy–Postoperative complications
  Clinical and Translational Oncology 05/2012; 13(12):899-903. · 1.33 Impact Factor
• Article: Patterns of response after preoperative treatment in gastric cancer.

  Juan A Díaz-González, Javier Rodríguez, José L Hernández-Lizoain, Raquel Ciérvide, Miren Gaztañaga, Iñigo San Miguel, Leire Arbea, J Javier Aristu, Ana Chopitea, Fernando Martínez-Regueira, Víctor Valentí, Jesús García-Foncillas, Rafael Martínez-Monge, Jesús J Sola
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  ABSTRACT: To analyze the rate of pathologic response in patients with locally advanced gastric cancer treated with preoperative chemotherapy with and without chemoradiation at our institution. From 2000 to 2007 patients were retrospectively identified who received preoperative treatment for gastric cancer (cT3-4/ N+) with induction chemotherapy (Ch) or with Ch followed by concurrent chemoradiotherapy (45 Gy in 5 weeks) (ChRT). Surgery was planned 4-6 weeks after the completion of neoadjuvant treatment. Pathologic assessment was used to investigate the patterns of pathologic response after neoadjuvant treatment. Sixty-one patients were analyzed. Of 61 patients, 58 (95%) underwent surgery. The R0 resection rate was 87%. Pathologic complete response was achieved in 12% of the patients. A major pathologic response (<10% of residual tumor) was observed in 53% of patients, and T downstaging was observed in 75%. Median follow-up was 38.7 months. Median disease-free survival (DFS) was 36.5 months. The only patient-, tumor-, and treatment-related factor associated with pathologic response was the use of preoperative ChRT. Patients achieving major pathologic response had a 3-year actuarial DFS rate of 63%. The patterns of pathologic response after preoperative ChRT suggest encouraging intervals of DFS. Such a strategy may be of interest to be explored in gastric cancer.
  International journal of radiation oncology, biology, physics 07/2011; 80(3):698-704. · 4.59 Impact Factor
• Article: [Analysis of postoperative morbidity in patients with gastric adenocarcinoma treated using a protocol of preoperative chemoradiotherapy and surgery].

  Víctor Valentí, José Luis Hernández-Lizoain, Fernando Martínez Regueira, Aurora Gil, Pablo Martí, Gabriel Zozaya, Alvaro Bueno, Nicolás Pedano, Jorge Arredondo, M Carmen Beorlegui, Javier Alvarez-Cienfuegos
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  ABSTRACT: The impact of neoadjuvant treatment on the postoperative complications in stomach cancer is a subject of controversy. The aim of this study is to analyse the post-surgical morbidity and mortality in a group of patients who were treated using a chemoradiotherapy protocol before surgery, as well as to identify the possible risk factors that may be associated with the development of complications. Patients diagnosed with locally advanced gastric adenocarcinoma between June 2005 and June 2008 were operated on in our Centre after having followed a preoperative chemoradiotherapy protocol. Data on postoperative morbidity and mortality were collected retrospectively and the dependent variables associated with the patients, the type of intervention and the tumour characteristics were analysed. A total of 40 patients were evaluated. The overall morbidity and mortality was 32.5% (13 patients) and 2.5% (1 patient), respectively. The most frequent complications were pneumonia in 12.9% and sepsis due to the catheter in 9.7% of the patients. The risk factors for the development of complications were the body mass index (BMI 25 kg/m(2)) and the inclusion of the pancreas and/or spleen in the resection. Preoperative treatment with chemoradiotherapy in patients with locally advanced stomach cancer does not increase the incidence of post-surgical complication. The preoperative condition of the patient (BMI) and extending the surgery to the spleen and pancreas are prognostic factors of early postoperative complications.
  Cirugía Española 10/2009; 86(6):351-7. · 0.87 Impact Factor
• Article: Early breast cancer treated with conservative surgery, adjuvant chemotherapy, and delayed accelerated partial breast irradiation with high-dose-rate brachytherapy.

  Alfonso Gómez-Iturriaga, Luis Pina, Mauricio Cambeiro, Fernando Martínez-Regueira, José Manuel Aramendía, Oscar Fernández-Hidalgo, Rafael Martínez-Monge
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  ABSTRACT: To evaluate the feasibility and intermediate-term results of conservative surgery, adjuvant chemotherapy, and delayed accelerated partial breast irradiation (APBI) with high-dose-rate brachytherapy. Between 2000 and 2007, a total of 26 patients with a median age of 54 years were treated with conservative surgery followed by adjuvant chemotherapy and exclusive high-dose-rate brachytherapy. Inclusion criteria followed the Radiation Therapy Oncology Group 95-17 trial guidelines. The tumor bed was marked at the time of surgery (n = 2) or before brachytherapy (n = 24). The brachytherapy procedure was performed at a median of 22 weeks after surgery. A median of 14 brachytherapy catheters were placed in three to four parallel planes. A dose of 34.0 Gy in 10 b.i.d. fractions given over 5 consecutive days was prescribed to the clinical target volume (CTV90). After a median followup of 53 months (range, 6.8-81), Radiation Therapy Oncology Group Grade 1-2 events and Grade 3 events were observed in 10 (38.4%) patients and 3 (11.5%) patients, respectively. No Grade 4-5 events were observed. Patients rated their cosmetic result as excellent (37.5%), good (50.0%), fair (8%), or poor (4%) based on the Wazer's Criteria. The 6-year actuarial local, elsewhere in the breast, and distant control rates were 100%, 96.2%, and 96.2%, respectively. Six-year disease-free survival and overall survival were 92.3% and 96.2%, respectively. Patients undergoing surgery and adjuvant chemotherapy can still be candidates for APBI. Optimal visualization of the internal lumpectomy scar before implantation is mandatory. Cosmetic results may be slightly worse due to the interaction between chemotherapy and APBI, and technical refinements may be needed in this group of patients.
  Brachytherapy 10/2008; 7(4):310-5. · 1.47 Impact Factor
• Article: [Sequelae after illegal injection of liquid silicone for breast augmentation: report of two cases].

  María Cervera, Fernando Martínez-Regueira, Josu Sola, Víctor Valentí, Carlos Pastor, Ignacio Poveda, Pablo Martí, Gerardo Zornoza
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  ABSTRACT: The use of liquid silicone for breast augmentation was widespread in the 1960s but was abandoned at the end of the decade due to numerous studies describing the development of a large number of local complications, as well as remote migration of small amounts of silicone. The use of liquid silicone also leads to enormous difficulty in the early diagnosis of breast cancer; these patients are precluded from routine screening programs and must undergo exhaustive periodic examinations. Magnetic resonance imaging has become the most effective test for the early detection of breast cancer in these patients. Indications for subcutaneous mastectomy are the presence of local complications, suspicion of a malignant lesion, or the patient's desire to prevent both these potential problems.
  Cirugía Española 11/2006; 80(4):227-9. · 0.87 Impact Factor
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  Article: Stereotactic-guided excisional biopsy: a new technique for very thin breasts.

  Maria L Diaz, Jose J Noguera, Alberto Alonso-Burgos, Pablo Dominguez, Luis J Pina, Gerardo Zornoza, Fernando Martínez-Regueira
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  ABSTRACT: Stereotactic biopsies are widely used for the diagnosis of breast lesions. Most biopsy devices require breast thickness of at least 25-30 mm with compression. We describe an alternative technique in order to perform excisional stereotactic-guided biopsies for very thin breasts using the prone stereotactic table. In the outpatient setting and with local anesthesia, this procedure can be performed by a radiologist, a surgeon, and a nurse. After conventional stereotactic localization, a fine needle is placed at the site of the lesion. Once the point is marked with a skin marker, a 25G x 16 mm needle is introduced. Then, a couple of stereotactic views are taken to confirm the correct position of the needle. Later, the surgeon excises the lesion guided by the needle. Additional radiographs of the specimen and the remaining breast tissue are obtained to ensure the accuracy of the procedure.
  The Breast Journal 12(6):566-8. · 1.64 Impact Factor
• Article: [Breast cancer].

  Manuel García Manero, Fernando Martínez Regueira
  Revista de medicina de la Universidad de Navarra 52(1):3.
• Article: Estado actual de la cirugía laparoscópica esofágica

  Fernando Martínez-Regueira, Fernando Rotellar Sastre, J Baixauli, Víctor Valentí Azcarate, Aurora Gil Rendo, José Luis Hernández-Lizoain
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  ABSTRACT: La cirugía laparoscópica ha cambiado el abordaje terapéutico de las enfermedades esofágicas más frecuentes. Con los excelentes resultados en el control de síntomas y con la baja morbilidad asociada el tratamiento quirúrgico se indica cada vez más en la patología esofágica benigna como una alternativa superior a un tratamiento médico crónico y menos eficaz. Para la hernia de hiato y el reflujo gastroesofágico la funduplicatura de Nissen por laparoscopia es la técnica de elección. Los mejores resultados en el tratamiento de la acalasia se consiguen con la miotomia de Heller laparoscópica. Esta experiencia creciente incluye la resección de tumores de esófago combinando toracoscopia y laparoscopia con resultados similares a los de cirugía abierta.
  Anales del sistema sanitario de Navarra, ISSN 1137-6627, Nº. 3, 2005 (Ejemplar dedicado a: Cirugía mínimamente invasiva), pags. 11-19.
• Article: Cáncer de mama

  M. García Manero, Fernando Martínez Regueira
  Revista de medicina, Vol. 52, Nº. 1, 2008, pag. 3.
• Article: Analisis de la morbilidad postoperatoria en pacientes con adenocarcinoma gastrico tratados segun protocolo de quimiorradioterapia preoperatoria y cirugõ´a

  Victor Valenti, JoseLuis Hernandez-Lizoain, Fernando Martinez Regueira, Aurora Gil, Pablo Marti, Gabriel Zozaya, Alvaro Bueno, Nicolas Pedano, Jorge Arredondo, M. Carmen Beorlegui, Javier Alvarez-Cienfuegos, CIRUGIA ESPANOLA