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Sarcomas de cabeza y cuello. Nuestra experiencia
Head and neck sarcomas. Our experience
Zenaida Piñeiro Aguína,
Autor para correspondencia
Zenaida1979@gmail.com

Autor para correspondencia.
, Xavier León Vintróa, Jacinto García Lorenzoa, Francisco J. Sanchob, Antonio López Pousac, Miquel Quer Agustía
a Servicio de Otorrinolaringología, Hospital de la Santa Creu i Sant Pau, Barcelona, España
b Servicio de Anatomía Patológica, Hospital de la Santa Creu i Sant Pau, Barcelona, España
c Servicio de Oncología Médica, Hospital de la Santa Creu i Sant Pau, Barcelona, España
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por lo que su comportamiento var&#237;a desde tumores que tienden a la recurrencia local con m&#237;nimo potencial metast&#225;sico&#44; hasta una diseminaci&#243;n sist&#233;mica r&#225;pida a pesar de la aplicaci&#243;n de tratamientos agresivos<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#8211;4</span></a>&#46; De forma caracter&#237;stica&#44; los tejidos normales en la periferia de los sarcomas sufren una compresi&#243;n como consecuencia de la expansi&#243;n tumoral formando una pseudoc&#225;psula&#46; Esta pseudoc&#225;psula suele estar invadida por c&#233;lulas malignas que pueden atravesar los planos fasciales&#44; el m&#250;sculo&#44; los vasos y nervios&#46; Como consecuencia&#44; los sarcomas pueden invadir &#225;reas de dif&#237;cil acceso quir&#250;rgico dificultando una resecci&#243;n con m&#225;rgenes adecuados<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">Los sarcomas representan un grupo de tumores con caracter&#237;sticas epidemiol&#243;gicas&#44; histol&#243;gicas y cl&#237;nicas diferentes de los carcinomas de cabeza y cuello<a class="elsevierStyleCrossRef" href="#bib0010"><span class="elsevierStyleSup">2</span></a>&#46; En la mayor&#237;a de los casos est&#225;n ausentes los cl&#225;sicos factores de riesgo presentes en los carcinomas como son el tabaco y el alcohol&#46; En la mayor&#237;a de series publicadas en la literatura se describe un cierto predominio masculino&#44; alcanz&#225;ndose ratios hombre&#47;mujer de hasta 2 a 1<a class="elsevierStyleCrossRef" href="#bib0025"><span class="elsevierStyleSup">5</span></a>&#44; si bien existen series en las que el predominio corresponde al sexo femenino<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a>&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">El mecanismo etiopatog&#233;nico de los sarcomas es desconocido&#46; Solo en un 3&#37; de los casos se reconoce el antecedente de irradiaci&#243;n previa<a class="elsevierStyleCrossRef" href="#bib0030"><span class="elsevierStyleSup">6</span></a>&#46; Los avances en biolog&#237;a molecular permiten en ocasiones obtener un diagn&#243;stico de certeza&#44; tal como sucede con la translocaci&#243;n t &#40;X&#59;18&#41;&#44; que se produce en el 100&#37; de los sarcomas sinoviales<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#46;</p><p id="par0025" class="elsevierStylePara elsevierViewall">Existe una gran variedad de abordajes terap&#233;uticos utilizados en el manejo de estos tumores&#46; Cl&#225;sicamente se ha considerado la cirug&#237;a como el tratamiento de elecci&#243;n&#46; Recientemente&#44; y debido al alto &#237;ndice de recurrencia de estos tumores despu&#233;s de la cirug&#237;a&#44; se han a&#241;adido la radioterapia y la quimioterapia como estrategias terap&#233;uticas complementarias con la finalidad de mejorar el control y la supervivencia de la enfermedad&#46; El uso combinado de tratamientos ha mejorado de forma significativa el pron&#243;stico de alguna de las formas de sarcoma&#44; tal como sucede con los rabdomiosarcomas durante la edad pedi&#225;trica&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">El objetivo de nuestro estudio es llevar a cabo una revisi&#243;n de los resultados obtenidos en nuestro centro con los pacientes diagnosticados y tratados por un sarcoma localizado a nivel de cabeza y cuello durante un per&#237;odo de 25 a&#241;os&#44; compar&#225;ndolos con los resultados presentados en la literatura&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="par0035" class="elsevierStylePara elsevierViewall">El presente estudio se efectu&#243; de forma retrospectiva a partir de una base de datos que recoge de forma prospectiva informaci&#243;n de los pacientes con tumores malignos de cabeza y cuello diagnosticados en nuestro centro desde el a&#241;o 1985&#46; Se incluyeron los pacientes con diagn&#243;stico de sarcoma localizado en cabeza y cuello&#46; Se excluyeron del estudio los sarcomas de localizaci&#243;n intracraneal y &#243;rbita&#44; as&#237; como los hemangiopericitomas&#44; dado que desde la &#250;ltima clasificaci&#243;n histol&#243;gica de la OMS son considerados como tumores mesenquimales benignos<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a>&#46;</p><p id="par0040" class="elsevierStylePara elsevierViewall">Todos los pacientes tuvieron un seguimiento m&#237;nimo de dos a&#241;os&#44; con una mediana en el seguimiento de 4&#44;9 a&#241;os&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">La clasificaci&#243;n histol&#243;gica se realiz&#243; en base a propuesta por la OMS&#44; dividiendo los tumores en tres grados&#44; alto&#44; intermedio&#44; y bajo&#44; seg&#250;n el grado de diferenciaci&#243;n del tejido tumoral&#46; El diagn&#243;stico se obtuvo del primer estudio anatomopatol&#243;gico&#44; no realiz&#225;ndose una revisi&#243;n histol&#243;gica espec&#237;fica de los casos para este estudio&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Ninguno de nuestros pacientes present&#243; historia previa de irradiaci&#243;n&#46; Todos los pacientes incluidos en el estudio contaban con una exploraci&#243;n ORL completa&#44; una prueba de imagen &#40;TC y&#47;o RNM&#41; y un estudio de extensi&#243;n&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">La supervivencia se analiz&#243; mediante el sistema de c&#225;lculo actuarial de Kaplan-Meier&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Caracter&#237;sticas del tumor</span><p id="par0060" class="elsevierStylePara elsevierViewall">Durante el per&#237;odo de estudio se diagnosticaron en nuestro centro un total de 25 pacientes con sarcomas localizados en cabeza y cuello&#44; 16 varones &#40;64&#37;&#41; y 9 mujeres &#40;34&#37;&#41;&#46; La edad de aparici&#243;n del tumor fue muy variable&#44; oscilando entre el primer a&#241;o de vida y los 78 a&#241;os&#46; Siete pacientes &#40;28&#37;&#41; ten&#237;an menos de 20 a&#241;os en el momento del diagn&#243;stico&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">La localizaci&#243;n anat&#243;mica de los sarcomas de la esfera ORL presenta una heterogeneidad marcada en todas las series publicadas&#46; En nuestra serie las localizaciones m&#225;s frecuente fueron las fosas nasales y senos &#40;32&#37;&#41; y el &#225;rea cervical&#44; excluyendo las v&#237;as aerodigestivas &#40;32&#37;&#41;&#46; La mayor&#237;a de los casos debutaron como una masa asintom&#225;tica &#40;36&#37;&#41;&#44; apareciendo como s&#237;ntoma inicial la epistaxis&#44; obstrucci&#243;n nasal&#44; disfon&#237;a o disfagia en otros casos en funci&#243;n de la localizaci&#243;n del tumor&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">De acuerdo con la histolog&#237;a&#44; el tumor que apareci&#243; con una mayor frecuencia en nuestra serie fue el sarcoma sinovial &#40;6 casos&#41;&#44; seguido por el fibrohistiocitoma maligno &#40;4 casos&#41; y el rabdomiosarcoma &#40;4 casos&#41;&#46; La gran mayor&#237;a de los pacientes present&#243; tumores de alto grado &#40;80&#37;&#41;&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">El volumen tumoral de estos tumores en el momento del diagn&#243;stico suele ser importante&#46; Un 56&#37; de los casos de nuestra serie contaban con un tama&#241;o en el momento del diagn&#243;stico superior a los 5<span class="elsevierStyleHsp" style=""></span>cm&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> muestra la distribuci&#243;n de los pacientes con sarcomas de cabeza y cuello diagnosticados en nuestro centro de acuerdo con variables como el sexo&#44; la edad&#44; la localizaci&#243;n anat&#243;mica del tumor&#44; el tipo histol&#243;gico&#44; y el tama&#241;o tumoral en el momento del diagn&#243;stico&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Tratamiento</span><p id="par0085" class="elsevierStylePara elsevierViewall">En un 80&#37; de los pacientes &#40;20&#47;25&#41; el tratamiento incluy&#243; una resecci&#243;n quir&#250;rgica del tumor&#46; El an&#225;lisis de la pieza de resecci&#243;n mostr&#243; la existencia de l&#237;mites libres de tumor en un 55&#37; de los casos &#40;11 pacientes&#41;&#44; en tanto que los l&#237;mites se encontraban cercanos o afectos en el 45&#37; restante&#46; La cirug&#237;a se asoci&#243; a un tratamiento adyuvante en la mayor&#237;a de las ocasiones&#58; se complement&#243; con radioterapia en 15 casos &#40;75&#37;&#41; y con quimioterapia en 11 &#40;55&#37;&#41;&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">En 5 ocasiones no se utiliz&#243; tratamiento quir&#250;rgico&#58; dos pacientes con rabdomiosarcoma tratados con quimioterapia y radioterapia con intenci&#243;n radical&#44; y tres casos en los que el tratamiento con quimioterapia &#40;un caso&#41;&#44; radioterapia &#40;un caso&#41; o medidas de soporte &#40;un caso&#41; pueden ser considerados como tratamientos paliativos&#46; Las pautas de QT empleadas fueron muy variadas&#44; siendo CYVADIC &#40;ciclofosfamida&#44; vincristina&#44; afriamicina y dacarbacina&#41; la m&#225;s frecuente en adultos&#44; e IVA &#40;ifosfamida&#44; vincristina y adriamicina&#41; en el caso de los ni&#241;os&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a> detalla las secuencias terap&#233;uticas empleadas en los 25 pacientes con sarcomas de cabeza y cuello&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Control de la enfermedad y supervivencia</span><p id="par0100" class="elsevierStylePara elsevierViewall">Solo se consigui&#243; el control de la enfermedad en un caso de los cinco en que la secuencia terap&#233;utica no incluy&#243; la cirug&#237;a&#46; Se trataba de una ni&#241;a de 5 a&#241;os de edad afecta de un rabdomiosarcoma del pe&#241;asco del temporal&#44; tratada con quimioterapia y radioterapia y que se encuentra libre de enfermedad a m&#225;s de 10 a&#241;os de completar el tratamiento&#46; Los otros 4 pacientes que no siguieron tratamiento quir&#250;rgico fallecieron como consecuencia de la evoluci&#243;n de la enfermedad&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Se consigui&#243; un control local de la enfermedad con la maniobra quir&#250;rgica inicial en el 45&#37; de los casos &#40;9&#47;20&#41; de los pacientes intervenidos quir&#250;rgicamente&#46; El porcentaje de pacientes en los que se consigui&#243; el control local de la enfermedad fue superior para el grupo de pacientes en los que se consiguieron l&#237;mites libres &#40;55&#37;&#41; que en aquellos en los cuales los l&#237;mites de resecci&#243;n se encontraron afectos o cercanos &#40;33&#37;&#41;&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">Se intent&#243; un rescate quir&#250;rgico&#44; en ocasiones complementado con quimioterapia y&#47;o radioterapia&#44; en 8 de los 11 pacientes con recidiva local de la enfermedad&#44; consiguiendo el control final de la neoplasia en tres de las ocasiones&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">El porcentaje de control local final de la enfermedad&#44; independientemente de la maniobra terap&#233;utica utilizada fue del 52&#37; &#40;13&#47;25&#41; de los pacientes&#46; En tres de los pacientes en los que se consigui&#243; el control local de la enfermedad aparecieron met&#225;stasis ganglionares &#40;dos casos&#41; o a distancia &#40;un caso&#41; durante el seguimiento&#46; No se logr&#243; el control de la enfermedad en ninguno de estos casos&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#fig0005">figura 1</a> muestra la curva de supervivencia actuarial ajustada correspondiente a los pacientes incluidos en el presente estudio&#46; La supervivencia ajustada a los 5 a&#241;os fue del 51&#44;2&#37; &#40;IC 95&#37;&#58; 30&#44;5-71&#44;9&#37;&#41;&#46; Cabe destacar la aparici&#243;n de dos casos de recidiva tumoral tard&#237;a&#44; un paciente con un rabdomiosarcoma y otro con un sarcoma sinovial&#44; que no pudieron ser rescatados y que justifican una ca&#237;da de la supervivencia a los 12 a&#241;os al 32&#37;&#44; tal como aparece en la figura&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia></span></span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p id="par0125" class="elsevierStylePara elsevierViewall">En nuestro &#225;mbito geogr&#225;fico&#44; un pa&#237;s del sur de Europa con una incidencia elevada de carcinomas escamosos relacionados con los consumos de tabaco y alcohol&#44; los sarcomas representan una proporci&#243;n muy peque&#241;a de los pacientes con tumores malignos de cabeza y cuello&#46; Del total de 5&#46;216 tumores malignos de cabeza y cuello diagnosticados y tratados en nuestro centro entre los a&#241;os 1985-2010&#44; tan solo un 0&#44;5&#37; correspondieron a sarcomas&#46; El objetivo de nuestro estudio fue llevar a cabo una revisi&#243;n de las caracter&#237;sticas cl&#237;nicas y los resultados en este grupo de pacientes&#46;</p><p id="par0130" class="elsevierStylePara elsevierViewall">Uno de los problemas en la evaluaci&#243;n de los pacientes con sarcomas localizados en cabeza y cuello reside en la ausencia de un sistema de clasificaci&#243;n v&#225;lido para este tipo de tumores&#46; De acuerdo con la clasificaci&#243;n TNM de los sarcomas&#44; la categor&#237;a T se define en base al tama&#241;o tumoral&#44; superior o inferior a los 5<span class="elsevierStyleHsp" style=""></span>cm&#44; y en que se trate de un tumor superficial o profundo&#46; Si bien este m&#233;todo de clasificaci&#243;n puede ser de utilidad a nivel de las extremidades&#44; es evidente que su aplicaci&#243;n cuenta con mayores dificultades a nivel de cabeza y cuello&#46; Por un lado&#44; la gran densidad de &#243;rganos y estructuras nobles existentes en las &#225;reas de cabeza y cuello hacen complicada la resecci&#243;n adecuada con m&#225;rgenes amplios incluso de tumores no voluminosos&#46; Por el otro&#44; dada la disposici&#243;n de las estructuras fasciales en cabeza y cuello&#44; la gran mayor&#237;a de lesiones tumorales afectan la fascia superficial o aparecen en los espacios profundos&#44; de manera que este criterio contar&#237;a igualmente con una escasa capacidad pron&#243;stica&#46;</p><p id="par0135" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a> resume las caracter&#237;sticas de los sarcomas localizados en cabeza y cuello comunicados por diversos autores&#46; Tal como puede observarse&#44; existe una notable disparidad en los resultados presentados en las diversas series publicadas&#46; En general&#44; la edad media de los pacientes oscila entre los 50 y 60 a&#241;os&#44; con un predominio en el sexo masculino&#44; una distribuci&#243;n muy heterog&#233;nea en cuanto a la localizaci&#243;n y la histolog&#237;a de los tumores en funci&#243;n de las series estudiadas&#44; con una tendencia al diagn&#243;stico de tumores de alto grado&#44; y un predominio de tumores con vol&#250;menes inferiores a los 5<span class="elsevierStyleHsp" style=""></span>cm&#46; En relaci&#243;n a los datos existentes en la literatura&#44; los datos de nuestra serie presentan una menor edad media y una mayor proporci&#243;n en el diagn&#243;stico de tumores voluminosos&#46; Las diferencias en cuanto a la edad media de los pacientes podr&#237;an justificarse por el hecho de que algunas de las series publicadas excluyen los rabdomiosarcomas embrionarios por tratarse de tumores con una historia natural diferente al resto de sarcomas&#44; siendo tumores que afectan preferentemente a la poblaci&#243;n pedi&#225;trica&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0140" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a> muestra un resumen del tipo de tratamiento utilizado y los resultados conseguidos en diferentes series que han analizado pacientes con sarcomas localizados en cabeza y cuello&#46; En general&#44; el tipo de tratamiento empleado con mayor frecuencia fue la cirug&#237;a&#44; habitualmente complementada con radioterapia&#46; La radioterapia adyuvante se recomienda como tratamiento complementario en tumores de gran tama&#241;o&#44; alto grado histol&#243;gico&#44; con m&#225;rgenes positivos tras la ex&#233;resis y para ciertas variantes histol&#243;gicas<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;3&#44;9&#8211;17</span></a>&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0145" class="elsevierStylePara elsevierViewall">Se ha demostrado que la recidiva local en los sarcomas de cabeza y cuello es mayor que en el retroperitoneo y en las extremidades<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6&#44;9&#44;18&#44;19</span></a>&#44; posiblemente consecuencia del hecho de que conseguir m&#225;rgenes negativos en la ex&#233;resis quir&#250;rgica es m&#225;s complejo en el caso de los sarcomas localizados en cabeza y cuello&#46; Independientemente de la localizaci&#243;n y el tama&#241;o del tumor&#44; uno de los factores pron&#243;sticos de mayor trascendencia en el caso de los sarcomas hace referencia al grado histol&#243;gico del tumor<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">16&#44;20&#8211;24</span></a>&#46;</p><p id="par0150" class="elsevierStylePara elsevierViewall">De acuerdo con los resultados obtenidos por los diferentes autores&#44; los porcentajes de control local de la enfermedad oscilaron entre el 60 y 70&#37;&#46; Barker et al&#46;<a class="elsevierStyleCrossRef" href="#bib0125"><span class="elsevierStyleSup">25</span></a>&#46; comunicaron que en 14 de los 19 pacientes que sufrieron una recidiva locorregional &#40;74&#37;&#41; de la enfermedad fueron considerados candidatos a un tratamiento de rescate&#44; que consiguieron el control final de la enfermedad en 9 de los pacientes &#40;47&#37;&#41;&#46; De acuerdo con nuestros resultados el porcentaje de pacientes que sufrieron una recidiva local de la enfermedad y que pudieron ser controlados con tratamiento de rescate fue del 27&#37;&#46;</p><p id="par0155" class="elsevierStylePara elsevierViewall">La supervivencia ajustada publicada en la literatura oscil&#243; entre el 60 y el 72&#37;&#44; con unos niveles de supervivencia observada muy similares&#44; lo que viene a indicar que la mortalidad en este tipo de pacientes depende mayoritariamente del fracaso en el control de la enfermedad oncol&#243;gica&#46;</p><p id="par0160" class="elsevierStylePara elsevierViewall">Con un per&#237;odo medio de seguimiento de 4&#44;9 a&#241;os&#44; la supervivencia actuarial ajustada a los 5 a&#241;os de los pacientes incluidos en nuestra serie fue del 51&#37;&#46; Existen autores &#40;Kraus<a class="elsevierStyleCrossRef" href="#bib0130"><span class="elsevierStyleSup">26</span></a>&#41; que han se&#241;alado que una gran mayor&#237;a de los fracasos tras el tratamiento de los sarcomas aparecieron durante los tres primeros a&#241;os de seguimiento&#44; de manera que los datos a 5 a&#241;os pueden ser considerados como maduros en este tipo de tumores&#46; Sin embargo&#44; en nuestro caso cabe destacar la aparici&#243;n de dos casos de recidiva local tard&#237;a del tumor que condicionaron una disminuci&#243;n notable de la supervivencia ajustada a largo plazo&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conclusiones</span><p id="par0165" class="elsevierStylePara elsevierViewall">Los sarcomas de cabeza y cuello son un grupo heterog&#233;neo de tumores malignos con una alta variabilidad en la presentaci&#243;n cl&#237;nica&#44; en su clasificaci&#243;n histopatol&#243;gica y sus caracter&#237;sticas biol&#243;gicas&#46; El tratamiento de elecci&#243;n para la mayor&#237;a de sarcomas incluye una resecci&#243;n quir&#250;rgica&#44; complementada con tratamiento adyuvante con radioterapia y quimioterapia en funci&#243;n de la extensi&#243;n&#44; los m&#225;rgenes de resecci&#243;n conseguidos por la cirug&#237;a y el grado histol&#243;gico del tumor&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">La supervivencia ajustada conseguida en un grupo de 25 pacientes con sarcomas de cabeza y cuello tratados en nuestro centro a lo largo de un per&#237;odo de 25 a&#241;os alcanz&#243; el 51&#37; a los 5 a&#241;os&#44; disminuyendo hasta el 32&#37; a los 12 a&#241;os como consecuencia de recidivas tard&#237;as de la enfermedad&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicto de intereses</span><p id="par0175" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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          "identificador" => "xpalclavsec81404"
          "palabras" => array:4 [
            0 => "Sarcoma"
            1 => "Head and neck tumour"
            2 => "Malignant grade"
            3 => "Survival"
          ]
        ]
      ]
    ]
    "tieneResumen" => true
    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Los sarcomas de cabeza y cuello son un grupo heterog&#233;neo de tumores malignos con una alta variabilidad en la presentaci&#243;n cl&#237;nica&#44; en su clasificaci&#243;n histopatol&#243;gica y sus caracter&#237;sticas biol&#243;gicas&#46;</p> <span class="elsevierStyleSectionTitle">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Estudio retrospectivo de los pacientes con un sarcoma localizado en cabeza y cuello tratado en nuestro centro a lo largo de un per&#237;odo de 25 a&#241;os&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Durante el per&#237;odo de estudio fueron diagnosticados un total de 25 pacientes con sarcomas localizados en cabeza y cuello&#44; que representaron un 0&#44;5&#37; del total de tumores malignos a dicho nivel&#46; El tratamiento m&#225;s habitual incluy&#243; la resecci&#243;n quir&#250;rgica del tumor&#44; habitualmente complementado con un tratamiento de radioterapia y&#47;o quimioterapia adyuvante&#46; El control local final&#44; incluyendo los tratamientos de rescate&#44; fue del 52&#37;&#44; con una supervivencia ajustada a los 5 a&#241;os del 51&#37; y a los 12 a&#241;os del 32&#37;&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El tratamiento quir&#250;rgico de los pacientes con sarcomas de cabeza y cuello consigue unos resultados aceptables de control local y supervivencia&#46;</p>"
      ]
      "en" => array:2 [
        "titulo" => "Abstract"
        "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Head and neck sarcomas are a heterogeneous group of malignant tumours that vary greatly in clinical presentation&#44; with different histopathological and biological characteristics&#46;</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">This was a retrospective study of patients with sarcoma located in the head and neck treated in our centre over a period of 25 years&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">During the study period&#44; a total of 25 patients were diagnosed with sarcomas in the head and neck&#44; accounting for 0&#46;5&#37; of all malignancies at this level&#46; The most common treatments included surgical resection of the tumour&#44; often supplemented with radiotherapy and&#47;or adjuvant chemotherapy&#46; The final local control&#44; including the salvage&#44; was 52&#37;&#44; with an adjusted survival of 51&#37; at 5 years and 32&#37; at 12 years&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">Surgical treatment of patients with head and neck sarcomas achieves acceptable results of local control and survival&#46;</p>"
      ]
    ]
    "multimedia" => array:5 [
      0 => array:7 [
        "identificador" => "fig0005"
        "etiqueta" => "Figura 1"
        "tipo" => "MULTIMEDIAFIGURA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "figura" => array:1 [
          0 => array:4 [
            "imagen" => "gr1.jpeg"
            "Alto" => 1201
            "Ancho" => 1604
            "Tamanyo" => 30529
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        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">Supervivencia actuarial ajustada para los 25 pacientes con sarcomas de cabeza y cuello tratados en nuestro centro&#46;</p>"
        ]
      ]
      1 => array:7 [
        "identificador" => "tbl0005"
        "etiqueta" => "Tabla 1"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Masculino&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>1-20 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7 &#40;28&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>21-40 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5 &#40;20&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>41-60 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#62; 60 a&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">9 &#40;36&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">7 &#40;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cervical&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">7 &#40;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Laringe&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3 &#40;14&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Orofaringe&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cavidad oral&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>O&#237;do medio&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="2" align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">6 &#40;24&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fibrohistiocitoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">4 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Rabdomiosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4 &#40;16&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Condrosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Leiomiosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Liposarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sarcoma de Kaposi&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sarcoma neurog&#233;nico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sin tipificar&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Grado de malignidad</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Alto &#40;III&#47;III&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20 &#40;80&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Medio &#40;II&#47;III&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="char" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">1 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="2" align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">14 &#40;56&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60; 5 cm&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">8 &#40;32&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">3 &#40;12&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>QT &#43;RT&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="char" valign="\n
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                  \t\t\t\t">2 &#40;8&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">1 &#40;4&#37;&#41;&nbsp;\t\t\t\t\t\t\n
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
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                  \t\t\t\t\ttop\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Barker JL et al&#46; U&#46; Iowa&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Dudath SB et al&#46; TMH&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Kraus DH et al&#46; MSKCC&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Le Vay J et al&#46; PMH&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Le QT et al&#46; UCSF&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Grager JA et al&#46; U&#46; Illinois&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Dijkstra MD et al&#46; NCI&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">De Bree&#44; R et al&#46; VUUMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Hubert et al&#46; Alberta&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1957-1993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1970-2000&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1981-1995&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1980-1988&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1961-1993&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1961-1993&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1969-1983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1983-2004&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">1974-1999&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">N&#46;&#176; pacientes</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">57&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">44&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">52&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">58&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">38&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sin datos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sin datos&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="11" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="11" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Histolog&#237;a &#40;&#37;&#41;</span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>MHF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">34&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">18&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">37&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Angiosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">20&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sarcoma neurog&#233;nico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">49&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">21&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Dermatofibrosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Fibrosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">26&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;1&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Leiomiosarcoma&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">14&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">16&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">10&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">7&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sarcoma Sinovial&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">5&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Liposarcoma&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">7&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">2&#44;6&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sarcoma epiteloide&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Tumor desmoide&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">3&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Otros&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">13&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">17&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">19&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">12&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">23&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">13&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
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          "es" => "<p id="spar0065" class="elsevierStyleSimplePara elsevierViewall">Caracter&#237;sticas cl&#237;nicas de los pacientes con sarcomas de cabeza y cuello en diferentes series publicadas</p>"
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          "leyenda" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Mx&#58; met&#225;stasis a distancia&#59; QT&#58; quimioterapia&#59; RT&#58; radioterapia&#59; Sv&#58; supervivencia&#46;</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Autor&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Willers H et al&#46; MGH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Barker JL et al&#46; U&#46; Iowa&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Dudath SB et al&#46; TMH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Kraus DH et al&#46; MSKCC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Le Vay J et al&#46; PMH&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Le QT et al&#46; UCSF&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Grager JA et al&#46; U&#46; Illinois&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Dijkstra MD et al&#46; NCI&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">De Bree&#44; R et al&#46; VUUMC&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" style="border-bottom: 2px solid black">Hubert et al&#46; Alberta&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Per&#237;odo de estudio</span>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1957-1993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1970-2000&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1981-1995&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1980-1988&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1961-1993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1961-1993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1969-1983&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1963-1993&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1989-1999&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">22&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">4&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Control local&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">60&#37; 5 a&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sv global&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">66&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">61&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">60&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">71&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">56&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">&#8211;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">60&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">58&#44;16&#37;&#42;&nbsp;\t\t\t\t\t\t\n
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Información del artículo
ISSN: 00016519
Idioma original: Español
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2024 Mayo 3 0 3
2024 Enero 1 2 3
2023 Diciembre 1 2 3
2023 Noviembre 1 0 1
2023 Septiembre 1 2 3
2023 Abril 1 2 3
2023 Marzo 16 0 16
2023 Enero 1 0 1
2022 Septiembre 3 2 5
2022 Abril 7 2 9
2022 Marzo 1 0 1
2022 Febrero 1 2 3
2021 Marzo 0 7 7
2021 Febrero 0 6 6
2021 Enero 1 4 5
2020 Diciembre 0 8 8
2020 Noviembre 0 12 12
2020 Octubre 0 8 8
2020 Septiembre 0 5 5
2020 Agosto 0 1 1
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2020 Junio 7 6 13
2020 Mayo 0 4 4
2020 Abril 0 1 1
2020 Marzo 107 13 120
2020 Febrero 221 11 232
2020 Enero 263 18 281
2019 Diciembre 228 26 254
2019 Noviembre 244 19 263
2019 Octubre 390 19 409
2019 Septiembre 294 12 306
2019 Agosto 185 12 197
2019 Julio 259 29 288
2019 Junio 218 62 280
2019 Mayo 254 24 278
2019 Abril 306 41 347
2019 Marzo 186 14 200
2019 Febrero 179 11 190
2019 Enero 173 12 185
2018 Diciembre 134 10 144
2018 Noviembre 184 18 202
2018 Octubre 224 24 248
2018 Mayo 5 3 8
2018 Abril 166 46 212
2018 Marzo 130 18 148
2018 Febrero 108 21 129
2018 Enero 111 20 131
2017 Diciembre 93 26 119
2017 Noviembre 119 25 144
2017 Octubre 125 15 140
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2017 Agosto 142 15 157
2017 Julio 121 31 152
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2017 Mayo 162 35 197
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2017 Enero 172 14 186
2016 Diciembre 127 17 144
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2016 Octubre 161 22 183
2016 Septiembre 191 14 205
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2016 Julio 105 5 110
2016 Junio 77 39 116
2016 Mayo 72 34 106
2016 Abril 99 28 127
2016 Marzo 88 13 101
2016 Febrero 99 13 112
2016 Enero 95 9 104
2015 Diciembre 81 13 94
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2015 Octubre 80 20 100
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2015 Mayo 81 10 91
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2014 Diciembre 98 28 126
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2014 Abril 41 5 46
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