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Colegio de Medicos y Cirujanos República de Costa Rica

2010, Número 593

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Rev Med Cos Cen 2010; 67 (593)


Factores pronósticos en la cirugía de metástasis pulmonares

Dixon PTr, Alvarado AEM

Idioma: Español
Referencias bibliográficas: 33
Paginas: 311-316
Archivo PDF: 300.03 Kb.


RESUMEN

La resección quirúrgica de las metástasis pulmonares es una herramienta terapéutica eficaz en ciertos tumores. Aunque la vía hematógena es la forma más común de metástasis, ya que hay otras formas de la moda linfático, retrógrada de los ganglios linfáticos mediastínicos y biliares, alcanzar el pulmón. En la actualidad la cirugía de exéresis completa de metástasis pulmonares se considera una técnica estándar en pacientes seleccionados con una baja morbilidad y un aumento de la supervivencia de éstos. Los factores pronósticos que determinan la supervivencia son: localización y el estadio del tumor primario, intervalo libre de enfermedad, la resecabilidad, el grado de los ganglios linfáticos, el número de operaciones, el número de metástasis y la bilateralidad, el tamaño de la metástasis mayor resecada, tipo de resección, tiempo de duplicación tumoral y tipo histológico. Los tipos histológicos que causan con mayor frecuencia metástasis pulmonar son: cáncer colorectal, cáncer de mama, sarcomas blandos y osteogènicos, tumores de células renales, tumores ginecológicos y los tumores de cabeza y cuello. De estos los tumores germinales son los de mejor pronóstico y los melanomas, los de peor.


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