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2019, Número 3

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Cir Cir 2019; 87 (3)


Comparativa entre la resección anatómica y la no anatómica en el tratamiento del hepatocarcinoma: método de emparejamiento por análisis de propensión

Molina-Romero FX, Palma-Zamora E, Morales-Soriano R, Rodríguez-Pino JC, González-Argente FX, Morón-Canis JM

Idioma: Español
Referencias bibliográficas: 50
Paginas: 328-336
Archivo PDF: 263.22 Kb.


RESUMEN

Objetivo: Evaluar el pronóstico de la resección anatómica (RA) y la resección no anatómica (RNA) de los pacientes sometidos a cirugía de carcinoma hepatocelular. Método: Estudio retrospectivo sobre una base de datos prospectiva entre mayo de 2002 y diciembre de 2016. Para evitar posibles sesgos de confusión, se realizó un estudio de emparejamiento por análisis de propensión (EAP). Resultados: Se incluyeron 86 pacientes, divididos en dos grupos: 39 RA y 47 RNA. Tras el EAP, quedaron 17 en cada grupo. No hubo diferencias en las variables demográficas ni del tumor. La supervivencia global (SG) tras el EAP fue del 93.9 y el 55.9% al año y los 5 años, y la supervivencia libre de enfermedad (SLE) global fue del 91 y el 45.7%, respectivamente. No se observaron diferencias entre los grupos (p = 0.47 y p = 0.31). El análisis de regresión no halló relación de los grupos con la SG (p = 0.47) ni con la SLE (p = 0.31). Respecto a la recidiva, no hubo diferencias. La RNA presenta mayor tendencia a la recidiva. Tampoco se encontraron diferencias en cuanto al tiempo de aparición de la recidiva. Conclusiones: El tipo de resección hepática en el tratamiento del hepatocarcinoma no influye en los resultados a largo plazo ni en la aparición de recidiva.


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