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Organo Oficial de la Sociedad Mexicana de Urología

2005, Número 5

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Rev Mex Urol 2005; 65 (5)


¿Pueden aplicarse los nomogramas diseñados en Estados Unidos de América en nuestra población? Validación del nomograma de Kattan

Rojas BL, Márquez HJC, Viveros EJM, Pacheco GC, Morales MJG, Pérez OR, Calderón FF

Idioma: Español
Referencias bibliográficas: 27
Paginas: 322-327
Archivo PDF: 56.74 Kb.


RESUMEN

Antecedentes. El nomograma de Kattan es una herramienta que predice qué pacientes tendrán recurrencia en los primeros cinco años del postoperatorio, fue diseñado en Estados Unidos de Norteamérica. Sin embargo, no hay hasta el momento estudios que validen dicho nomograma en nuestra población. Métodos. Se consideraron 77 pacientes sometidos a prostatectomía radical en el hospital General Dr. Manuel Gea González, de 1991 a 2004, con información preoperatoria suficiente y en el postoperatorio un adecuado seguimiento del antígeno mínimo de 60 meses. La recurrencia de la enfermedad se definió como dos elevaciones consecutivas del antígeno igual o mayor a 0.4 ng/mL. El nomograma se calculó para cada paciente y posteriormente fueron estratificados en seis grupos para su análisis. Resultados. De 77 pacientes 39 (50.6%) presentaron recurrencia en un tiempo promedio de 20.45 meses. El nomograma obtenido por paciente fue de 13 a 95% (promedio 70.66%), el comportamiento actuarial de las curvas de recurrencia de Kaplan-Meier es similar al reportado en las grandes series que validan dicho nomograma. Conclusión. La probabilidad de enfermedad libre a cinco años, es sobreestimada por el nomograma de Kattan, no obstante es claro que la recurrencia bioquímica se presenta de acuerdo con las distintas categorías, según el mismo autor.


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