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2009, Número 1

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Gac Med Mex 2009; 145 (1)


Supervivencia en relación con la edad en cáncer pulmonar de células no pequeñas

Serrano-Olvera A, Gersonc R

Idioma: Español
Referencias bibliográficas: 52
Paginas: 27-36
Archivo PDF: 108.58 Kb.


RESUMEN

Antecedentes: El cáncer pulmonar es la principal causa de muerte por cáncer en el mundo; el de células no pequeñas (NSCLC por sus siglas en inglés) representa 70% de los casos. El comportamiento clínico y la supervivencia pueden variar en función de la edad.Objetivo: Determinar el comportamiento epidemiológico y supervivencia global en NSCLC en relación con la edad. Métodos: Estudio retrospectivo del periodo de enero de 1993 a diciembre de 2007, en pacientes con NSCLC confirmado. Se designaron tres grupos: 1, edad menor o igual a 49 años; 2, 50 a 69 años de edad; 3, 70 años o más. Analizamos edad, ECOG (escala para medir calidad de vida del Eastern Cooperative Oncologic Group), comorbilidad, historia familiar, tabaquismo, etapa clínica, sitios metastásicos, tipo histológico, tratamiento, supervivencia global. Para el análisis se emplearon métodos descriptivos y las pruebas de Kruskal-Wallis, ANOVA, χ2, t de Student y Kaplan-Meier. Resultados: Se estudiaron 183 pacientes, 23 (12.6%) del grupo 1,108 (59%) del grupo 2 y 52 (28.4%) del grupo 3. Mediana de edad: 43.2, 61.2 y 75.6 años, respectivamente (p‹0.05). Las mujeres predominaron en el grupo 1 (p=0.036). Comorbilidad: 17.4, 55.5 y 76.9% (p=0.000). Tabaquismo positivo: 52.5, 87 y 69.2% (p=0.009). Síntomas: tos (38.9, 25 y 43.6%), dolor torácico (33.3, 41.3, 30.8%) y disnea (33.3, 16.3, 38.5%), p›0.05. El adenocarcinoma fue el tipo más frecuente (78.2, 63.9 y 54.5%). Etapa IIIB (17.4, 23.1, 23.1%) y etapa IV (52.2, 44.4, 50%). Supervivencia global en etapas I y II: 21 meses versus 18 meses en la etapa IIIA (p›0.05); en las etapas IIIB a IV fue 11, 8.5 y 4 meses, respectivamente (p=0.034). Conclusiones: Los jóvenes cursan con enfermedad más agresiva y los mayores de 70 años tienen mayor frecuencia de comorbilidad y ECOG 2. La supervivencia es mayor entre los jóvenes.


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