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Organo Oficial de la Sociedad Mexicana de Urología

2012, Número 4

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Rev Mex Urol 2012; 72 (4)


Resultados del tratamiento quirúrgico del cáncer de células renales. Análisis de una cohorte de 370 casos

Basilio-de Leo CI, Castillejos-Molina R, Uribe-Uribe N, Sotomayor-Zavaleta M, Feria-Bernal G, Gabilondo-Navarro F, Rodríguez-Covarrubias F

Idioma: Español
Referencias bibliográficas: 48
Paginas: 151-156
Archivo PDF: 387.09 Kb.


RESUMEN

Objetivo: Evaluar el papel pronóstico de variables clínico-patológicas en pacientes con cáncer de células renales (CCR) tratados quirúrgicamente.
Material y métodos: Analizamos retrospectivamente la base de datos de 440 pacientes con tumores renales. Se analizaron variables tanto clínicas como histopatológicas. El desenlace principal fue la supervivencia cáncer específica (SCE), evaluada con el método de Kaplan-Meier. Se realizó análisis univariado y multivariado para determinar los factores pronósticos.
Resultados: Se identificaron 370 pacientes con CCR entre marzo de 1980 y julio de 2011, el seguimiento promedio fue de 55.4 meses. Fallecieron 23.2% a causa del cáncer, se encontraron tumores más grandes (p‹0.0001), de mayor grado (p‹0.0001) y con mayor frecuencia de invasión linfovascular (p‹0.0001). La SCE a cinco y 10 años fue de 97.2% y 97.2% en estadio I, 77.8% y 68.1% en estadio II, 62.7% y 49.4% en estadio III, 18.4% y 6.0% en estadio IV (p‹0.0001). Todas las variables se asociaron con la SCE en el análisis univariado, y en el multivariado, el grado nuclear, la invasión ganglionar, el diámetro tumoral y la presencia de metástasis mantuvieron una asociación independiente con la supervivencia.
Conclusiones: Corroboramos el potencial pronóstico del grado nuclear, diámetro tumoral, ECOG (por sus siglas en inglés, Eastern Cooperative Oncology Group), invasión linfática y la presencia de metástasis.


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