Nuestros investigadores

Luis Chiva de Agustín

Clínica Universidad de Navarra. Clínica Universidad de Navarra
Líneas de investigación
Tratamiento de la Esterilidad sin manipulación embrionaria Naprotechnology (Natural Procreation Technology), Cirugía en cancer de ovario avanzado, Cancer hereditario de la mujer, Preservación de la fertilidad en cancer femenino, Modelos de docencia en Anatomia quirúrgica para ginecólogos
Índice H
14, (WoS, 04/06/2020)

Publicaciones científicas más recientes (desde 2010)

Autores: Suárez, Victor Manuel; et al.
ISSN 1048-891X  Vol. 29  Nº 4  2019  págs. 835 - 839
Autores: Vergote, I., (Autor de correspondencia); Harter, P. ; Chiva, Luis;
ISSN 0732-183X  Vol. 37  Nº 27  2019  págs. 2420 - +
Autores: Chiva, Luis, (Autor de correspondencia)
ISSN 1048-891X  Vol. 29  Nº 1  2019  págs. 221 - 222
Autores: Alcázar, Juan Luis, (Autor de correspondencia); Arraiza, María; et al.
ISSN 1048-891X  Vol. 29  Nº 2  2019  págs. 227 - 233
Objective: To compare the diagnostic performance of ultrasound and computed tomography (CT) for detecting pelvic and abdominal tumor spread in women with epithelial ovarian cancer. Methods: An observational cohort study of 93 patients (mean age 57.6 years) with an ultrasound diagnosis of adnexal mass suspected of malignancy and confirmed histologically as epithelial ovarian cancer was undertaken. In all cases, transvaginal and transabdominal ultrasound as well as CT scans were performed to assess the extent of the disease within the pelvis and abdomen prior to surgery. The exploration was systematic, analyzing 12 anatomical areas. All patients underwent surgical staging and/or cytoreductive surgery with an initial laparoscopy for assessing resectability. The surgical and pathological findings were considered as the 'reference standard'. Sensitivity and specificity of ultrasound and CT scanning were calculated for the different anatomical areas and compared using the McNemar test. Agreement between ultrasound and CT staging and the surgical stage was estimated using the weighted kappa index. Results: The tumorous stage was International Federation of Gynecology and Obstetrics (FIGO) stage I in 26 cases, stage II in 11 cases, stage III in 47 cases, and stage IV in nine cases. Excluding stages I and IIA cases (n=30), R0 (no macroscopic residual disease) was achieved in 36 women (62.2%), R1 (macroscopic residual disease <1cm) was achieved in 13 women (25.0%), and R2 (macroscopic residual disease >1cm) debulking surgery occurred in three women (5.8%). Eleven patients (11.8%) were considered not suitable for optimal debulking surgery during laparoscopic assessment. Overall sensitivity of ultrasound and CT for detecting disease was 70.3% and 60.1%, respectively, and specificity was 97.8% and 93.7%, respectively. The agreement between radiological stage and surgical stage for ultrasound (kappa index 0.69) and CT (kappa index 0.70) was good for both techniques. Overall accuracy to determine tumor stage was 71% for ultrasound and 75% for CT. Conclusion: Detailed ultrasound examination renders a similar diagnostic performance to CT for assessing pelvic/abdominal tumor spread in women with epithelial ovarian cancer.
Autores: Chiva, Luis, (Autor de correspondencia); Cibula, D. ; Querleu, D. ; et al.
ISSN 0028-4793  Vol. 380  Nº 8  2019  págs. 793 - 794
Autores: Fotopoulou, C. , (Autor de correspondencia); Sehouli, J.; Mahner, S.; et al.
ISSN 0923-7534  Vol. 29  Nº 8  2018  págs. 1610 - 1613
Autores: del Bas, B. F. ; Villayzan, J. G.; et al.
ISSN 1553-4650  Vol. 25  Nº 7  2018  págs. 1142 - 1143
Autores: Harter, P., (Autor de correspondencia); du Bois, A.; Sehouli, J. ; et al.
ISSN 0932-0067  Vol. 298  Nº 5  2018  págs. 859 - 860
Hyperthermic intraperitoneal chemotherapy (HIPEC) is promoted by some as a standard treatment for peritoneal carcinomatosis of epithelial ovarian cancer (EOC) and other tumor entities, despite lack of robust data supporting this. Publicly available evidence addressing the value of HIPEC in EOC is rather inconclusive, revealing contradictory and inconsistent results while some studies even report harm to the patients from a higher morbidity. On this ground, we cannot recommend the implementation and use of HIPEC outside of a randomized clinical trial setting.
Autores: del Bas, B. F.; Villayzan, J. G. ; et al.
ISSN 1699-048X  Vol. 20  Nº 11  2018  págs. 1455 - 1459
BackgroundOne aim of this study was to assess the efficacy and safety of laparoscopic paraaortic lymphadenectomy for paraaortic lymph node staging in locally advanced cervical carcinoma. The second aim was to identify prognostic factors in the evolution of this disease and to evaluate how the results of the surgery modify the oncological treatment of patients.Materials and methodsWe analyzed 59 patients diagnosed with locally advanced cervical cancer International Federation of Gynecology and Obstetrics stage IB2-IVA who underwent laparoscopic paraaortic lymphadenectomy at our hospital between 2009 and 2015. Depending on the results of the paraaortic lymphadenectomy, treatment consisted of pelvic- or extended-field chemoradiotherapy.ResultsThe mean age at diagnosis was 52.3years. The median operative time was 180min. The mean hospital stay was 1.7days. The mean number of paraaortic lymph nodes excised was 16.4. Eight patients (13.5%) had positive paraaortic lymph nodes. Thirteen patients (22%) underwent surgery via the transperitoneal route, and 46 (78%) underwent surgery via the retroperitoneal route. The sensitivity and specificity of computerized axial tomography (CT) scanning for detecting paraaortic lymph node involvement was 75 and 86%, respectively. The statistically significant prognostic factors that affected survival were surgical paraaortic lymph node involvement, radiological pelvic lymph node involvement, and radiological tumor size as assessed with nuclear magnetic resonance. The rate of serious complications was 1.7%.ConclusionsPretherapeutic laparoscopic paraaortic lymphadenectomy for locally advanced cervical carcinoma allows the adaption of radiotherapy fields to avoid false-positive and false-negative imaging results.
Autores: Vergote, I. , (Autor de correspondencia); Chiva, Luis; du Bois, A.;
ISSN 0028-4793  Vol. 378  Nº 14  2018  págs. 1362 - 1363
Autores: Fotopoulou, C.; Sehouli, J.; Aletti, G.; et al.
ISSN 0732-183X  Vol. 35  Nº 6  2017  págs. 587 - 590
Autores: Querleu, D.; Planchamp, F.; Chiva, Luis; et al.
ISSN 1048-891X  Vol. 27  Nº 7  2017  págs. 1534 - 1542
Objective The aim of this study was to develop clinically relevant and evidence-based guidelines as part of European Society of Gynaecological Oncology's mission to improve the quality of care for women with gynecological cancers across Europe. Methods The European Society of Gynaecological Oncology council nominated an international multidisciplinary development group made of practicing clinicians who have demonstrated leadership and interest in the care of ovarian cancer (20 experts across Europe). To ensure that the statements are evidence based, the current literature identified from a systematic search has been reviewed and critically appraised. In the absence of any clear scientific evidence, judgment was based on the professional experience and consensus of the development group (expert agreement). The guidelines are thus based on the best available evidence and expert agreement. Before publication, the guidelines were reviewed by 66 international reviewers independent from the development group including patients representatives. Results The guidelines cover preoperative workup, specialized multidisciplinary decision making, and surgical management of diagnosed epithelial ovarian, fallopian tube, and peritoneal cancers. The guidelines are also illustrated by algorithms.
Autores: Mota A.; Colás E.; García-Sanz P.; et al.
ISSN 0893-3952  Vol. 31  Nº 1  2017  págs. 134-145
Endometrial cancer is the most common cancer of the female genital tract in developed countries. Although the majority of endometrial cancers are diagnosed at early stages and the 5-year overall survival is around 80%, early detection of these tumors is crucial to improve the survival of patients given that the advanced tumors are associated with a poor outcome. Furthermore, correct assessment of the pre-clinical diagnosis is decisive to guide the surgical treatment and management of the patient. In this sense, the potential of targeted genetic sequencing of uterine aspirates has been assessed as a pre-operative tool to obtain reliable information regarding the mutational profile of a given tumor, even in samples that are not histologically classifiable. A total of 83 paired samples were sequenced (uterine aspirates and hysterectomy specimens), including 62 endometrioid and non-endometrioid tumors, 10 cases of atypical hyperplasia and 11 non-cancerous endometrial disorders. Even though diagnosing endometrial cancer based exclusively on genetic alterations is currently unfeasible, mutations were mainly found in uterine aspirates from malignant disorders, suggesting its potential in the near future for supporting the standard histologic diagnosis. Moreover, this approach provides the first evidence of the high intra-tumor genetic heterogeneity associated with endometrial cancer, evident when multiple regions of tumors are analyzed from an individual hysterectomy. Notably, the g
Autores: Chiva, Luis; Mínguez, José Ángel; Querleu D, ; et al.
ISSN 1048-891X  Vol. 27  Nº 4  2017  págs. 819-25
Specialists in gynecologic oncology that have obtained a formal accreditation received a significantly better surgical education than those that have not. The ESGO responders recognize that their society should lead the standardization of surgical training and promote ways of improving members' surgical skills.
Autores: Harter, P ; Reuss, A ; Sehouli, J ; et al.
ISSN 1048-891X  Vol. 27  Nº 2  2017  págs. 246-47
A published so-called phase 3 study regarding HIPEC in ovarian cancer raised multiple questions. This commentary focusses on the weakness of the publication and discusses this in detail
Autores: Chiva, Luis; Castellanos T,; Alonso S, ; et al.
ISSN 1048-891X  Vol. 26  Nº 5  2016  págs. 906-11
Patients with ovarian cancer with MMRD after primary surgery obtain a modest but significant advantage in survival (10 months) over suboptimal patients. Patients with macroscopic residual disease (0.1-0.5 cm) obtain a better survival (53 months) than those with more than 0.5 to 1 cm. We propose that they should be classified as a different prognostic group.
Autores: Querleu D.; Planchamp F, ; Chiva, Luis; et al.
ISSN 1048-891X  Vol. 26  Nº 7  2016  págs. 1354-63
The ESGO quality criteria can be used for self-assessment, for institutional or governmental quality assurance programs, and for the certification of centers. Quality indicators and corresponding targets give practitioners and health administrators a quantitative basis for improving care and organizational processes in the surgical management of advanced ovarian cancer
Autores: Ataseven B.; Chiva, Luis; Harter P.; et al.
ISSN 0090-8258  Vol. 142  Nº 3  2016  págs. 597-607
Epithelial ovarian, fallopian tube and peritoneal cancer (EOC) is the seventh most common cancer diagnosis among women worldwide and shows the highest mortality rate of all gynecologic tumors. Different histological and anatomic spread patterns as well as multiple gene-expression based studies have demonstrated that EOC is indeed a heterogeneous disease. The prognostic factors that best predict the survival in this disease include: age, performance status and patient's comorbidities at the time of diagnosis; tumor biology, histological type, amount of residual tumor after surgery and finally tumor stage as surrogate for pre-operative tumor burden and growth pattern. In the majority of patients, the disease is diagnosed in advanced stage, disseminated intra- and/or extra-abdominally. It is unclear whether this is a consequence of distinct tumor biology, absence of anatomic barriers between ovary and the abdominal cavity, delay of diagnosis and/or the lack of sufficient early detection methods. FIGO stage IV disease, defined as tumor spread outside the abdominal cavity (including malignant pleural effusion) and/or visceral metastases, will be present in 12-33% of the patients at initial diagnosis. Overall, median survival for patients with stage IV disease ranges from 15 to 29months, with an estimated 5-year survival of approximately 20%. Unfortunately, over the past decades the overall survival gain compared to stage III remains disappointing. The current review aims to summar
Autores: Chiva, Luis; et al.
ISSN 1534-4681  Vol. 23  Nº 5  2016  págs. 1666-1673
Complete cytoreduction after IDS yields a inferior outcome in terms of median survival than PDS of almost 2 years. Despite the higher rate of complete resection, IDS apparently fails to improve the results obtained by primary debulking.
Autores: Ruiz, V.; Alonso ,S.; Castellanos,T.; et al.
ISSN 0304-5013  Vol. 58  2015  págs. 417-21
El cáncer de cérvix constituye una enfermedad muy frecuente y presenta una elevada mortalidad a nivel mundial a pesar de la instauración de diversas modalidades terapéuticas. Presentamos el caso de una paciente de 47 años con un cáncer de cérvix con metástasis a distancia en el momento del diagnóstico (estadio IVB de la FIGO), que recibió tratamiento multimodal con quimioterapia basada en carboplatino y cirugía. Presentó una respuesta completa al tratamiento y mantiene una supervivencia libre de enfermedad hasta el momento actual de 53 meses.
Autores: Alonso S.; Castellanos T.; Lapuente F; et al.
ISSN 1754-6605  Vol. 3  Nº 9  2015  págs. 505
Endometrial cancer is the most common gynaecologic malignancy, usually diagnosed in postmenopausal women. However, an incidence rate of 2-14% of cases consisting of women under the age of 45 years old has been reported. Multiple reports have described the conservative treatment of this tumour in selected patients with the objective of preserving fertility. In this article, we review the literature to evaluate the results of conservative treatment of endometrial cancer with hysteroscopic resection.
Autores: Chiva, Luis; González-Martín, A.;
ISSN 0090-8258  Vol. 136  Nº 1  2015  págs. 130-35
Although randomized trials are ongoing, the recently published retrospective data regarding the use of HIPEC for primary advanced and for recurrent ovarian cancer do not indicate any apparent advantage of this treatment in terms of the survival outcomes in these patients. Therefore, HIPEC cannot be considered a standard treatment and should not be offered outside of clinical trials.
Autores: Mota, Alba; Carlos Trivino, Juan; Rojo-Sebastian, Alejandro; et al.
ISSN 1471-2407  Vol. 15  2015  págs. 940
Altogether, our results shed light on the clonal evolution of the distinct tumor regions identifying the most aggressive subpopulations and at least some of the genes that may be implicated in its progression and recurrence, and highlights the importance of considering intra-tumor heterogeneity when carrying out genetic and genomic studies, especially when these are aimed to diagnostic procedures or to uncover possible therapeutic strategies
Autores: Mota A.; Triviño JC; Rojo-Sebastian A.; et al.
ISSN 1471-2407  Vol. 30  Nº 15  2015  págs. 940
Altogether, our results shed light on the clonal evolution of the distinct tumor regions identifying the most aggressive subpopulations and at least some of the genes that may be implicated in its progression and recurrence, and highlights the importance of considering intra-tumor heterogeneity when carrying out genetic and genomic studies, especially when these are aimed to diagnostic procedures or to uncover possible therapeutic strategies.
Autores:  Alonso-Alconada,L; Muinelo-Romay,L; Madissoo K,; et al.
ISSN 1476-4598  Vol. 27  Nº 13  2014  págs. 223
Our results associate the presence of CTC with high-risk EC. Gene-expression profiling characterized a CTC-plasticity phenotype with stemness and EMT features. We finally recapitulated this CTC-phenotype by over-expressing ETV5 in the EC cell line Hec1A and demonstrated an advantage in the promotion of metastasis in an in vivo mouse model of CTC dissemination and homing.
Autores: González-Martín A.; Sánchez-Lorenzo L,; Bratos R, M.; et al.
Revista: DRUGS
ISSN 0012-6667  Vol. 74  Nº 8  2014  págs. 879-89
Paclitaxel and carboplatin combination chemotherapy has remained the standard of care in the frontline therapy of advanced epithelial ovarian carcinoma during the last decade. Maintenance chemotherapy or immunotherapy has not been proven to impact on overall survival and only one clinical trial that explored the administration of monthly paclitaxel for 1 year showed a benefit in terms of progression-free survival (PFS), but at the cost of maintained alopecia and increased peripheral neuropathy. This scenario may be changing with the incorporation of targeted therapy to the frontline therapy of ovarian cancer. In particular, anti-angiogenic therapy has been identified as the most promising targeted therapy, and the addition of bevacizumab to first-line chemotherapy followed by a maintenance period of bevacizumab in monotherapy has shown to prolong PFS. This was considered the proof of concept of the value of anti-angiogenic therapy in the frontline of ovarian cancer, and the results of two additional clinical trials with anti-angiogenic tyrosine-kinase inhibitors have shown results in the same direction
Autores: Peiró V.; Chiva, Luis; González, Antonio José; et al.
ISSN 2253-654X  Vol. 33  Nº 2  2014  págs. 87-92
PET/CT is postulated as a useful imaging test for the management of vulvar cancer, mainly in the identification of nodal metastases. It may affect both surgical planning and clinical management. Larger series are needed to confirm our findings.
Autores: González Martín A.; Bratos R, ; Márquez R, ; et al.
ISSN 1473-7140  Vol. 13  Nº 2  2013  págs. 123-29
Ovarian cancer is the leading cause of death due to gynecological tumors. Despite the progress made during the last two decades in the surgery and chemotherapy of ovarian cancer, more than 70% of patients with advanced ovarian cancer will recur and die. Improvements in this field are coming from a better knowledge of the biology and the development of new-targeted agents. Bevacizumab, is a monoclonal antibody against VEGF that has shown activity as a monotherapy in recurrent ovarian cancer. The addition of bevacizumab to the front-line therapy of ovarian cancer has produced a benefit in progression-free survival in two randomized Phase III trials. This benefit seems to be greater in patients with more advanced disease. However, several questions remain to be clarified in the future, specially the optimal patient selection based on predictive biomarkers and the duration of therapy. Nevertheless, for the first time, the addition of a biologically targeted agent has shown an improvement in progression-free survival in the front-line treatment of advanced ovarian cancer and it is a proof of concept of the potential value of antiangiogenic therapy in ovarian cance
Autores: Gonzalez-Martin, A.; Chiva, Luis;
ISSN 1523-3790  Vol. 15  Nº 1  2013  págs. 4-6
Autores: Chiva, Luis; Lapuente F,; Alonso S.;
ISSN 0090-8258  Vol. 131  Nº 1  2013  págs. 213
Autores: Diaz-Padilla I.; Malpica, AL.; Minig, L,; et al.
ISSN 0090-8258  Vol. 126  Nº 2  2012  págs. 279-285
Ovarian low-grade serous ovarian carcinoma (OvLGSCa) comprises a minority within the heterogeneous group of ovarian carcinomas. Despite biological differences with their high-grade serous counterparts, current treatment guidelines do not distinguish between these two entities. OvLGSCas are characterized by an indolent clinical course. They usually develop from serous tumors of low malignant potential, although they can also arise de novo. When compared with patients with ovarian high grade serous carcinoma (OvHGSCa) patients with OvLGSCa are younger and have better survival outcomes. Current clinical and treatment data available for OvLGSCa come from retrospective studies, suggesting that optimal cytoreductive surgery remains the cornerstone in treatment, whereas chemotherapy has a limited role. Molecular studies have revealed the preponderance of the RAS-RAF-MAPK signaling pathway in the pathogenesis of OvLGSCa, thereby representing an attractive therapeutic target for patients affected by this disease. Improved clinical trial designs and international collaboration are required to optimally address the unmet medical treatment needs of patients affected by this disease.
Autores: Oaknin, Ana; Roda, Desamparado; González, Antonio José; et al.
ISSN 1048-891X  Vol. 21  Nº 6  2011  págs. 1048-1055
The GEICO outpatient modified regimen resulted in a lesser toxicity and a greater rate of treatment completion than previously reported. The accurate selection of patients and the administration following well-defined guidelines can increase the feasibility of IP chemotherapy administration.
Autores: González, Antonio José; Toledo G,; Chiva, Luis;
ISSN 1699-048X  Vol. 12  Nº 6  2010  págs. 418-30
Epithelial ovarian carcinoma is still the most common cause of death from gynaecological cancer in USA and western Europe. The optimal therapy of epithelial ovarian carcinoma requires participation of a multidisciplinary team - from diagnosis through the entire natural history of each individual patient. Only 20-30% of patients are diagnosed at the initial stage, when appropriate staging surgery in combination with adjuvant chemotherapy for high-risk patients can be curative. Treating patients with advanced disease consists of a staging surgery with maximum cytoreductive effort, followed by chemotherapy with a combination of taxane and carboplatin. Unfortunately, the majority of patients with advanced disease will relapse and become candidates for therapy that comprises individualised chemotherapy, and surgery in selected cases. For this reason, there is still a need for new treatments and strategies in the first-line setting.