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array:24 [ "pii" => "S0210480609741397" "issn" => "02104806" "doi" => "10.1016/S0210-4806(09)74139-7" "estado" => "S300" "fechaPublicacion" => "2009-01-01" "aid" => "74139" "copyright" => "Asociación Española de Urología (AEU)" "copyrightAnyo" => "2009" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2009;33:258-69" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1538 "formatos" => array:3 [ "EPUB" => 8 "HTML" => 889 "PDF" => 641 ] ] "itemSiguiente" => array:18 [ "pii" => "S0210480609741403" "issn" => "02104806" "doi" => "10.1016/S0210-4806(09)74140-3" "estado" => "S300" "fechaPublicacion" => "2009-01-01" "aid" => "74140" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "rev" "cita" => "Actas Urol Esp. 2009;33:270-9" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1861 "formatos" => array:3 [ "EPUB" => 7 "HTML" => 1005 "PDF" => 849 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Guía del carcinoma de células renales" "tienePdf" => array:2 [ 0 => "es" 1 => "en" ] "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "270" "paginaFinal" => "279" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Renal cell carcinoma guideline" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:2 [ "es" => true "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Börje Ljungberg, C. Damian Hanbury, A. Marcus Kuczyk, S. Axel Merseburger, F.A. Peter Mulders, Jean-Jacques Patard, C. Ioanel Sinescuf" "autores" => array:8 [ 0 => array:1 [ "colaborador" => "Traducción del artículo european urology 51 (2007) 1502-1510: gonzalo garcía fadrique Servicio de Urología. Hospital Universitario La Fe. Valencia, España" ] 1 => array:2 [ "nombre" => "Börje" "apellidos" => "Ljungberg" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Damian Hanbury" ] 3 => array:2 [ "nombre" => "A." "apellidos" => "Marcus Kuczyk" ] 4 => array:2 [ "nombre" => "S." "apellidos" => "Axel Merseburger" ] 5 => array:2 [ "nombre" => "F.A." "apellidos" => "Peter Mulders" ] 6 => array:2 [ "nombre" => "Jean-Jacques" "apellidos" => "Patard" ] 7 => array:2 [ "nombre" => "C." "apellidos" => "Ioanel Sinescuf" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480609741403?idApp=UINPBA00004N" "url" => "/02104806/0000003300000003/v1_201304251925/S0210480609741403/v1_201304251925/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0210480609741385" "issn" => "02104806" "doi" => "10.1016/S0210-4806(09)74138-5" "estado" => "S300" "fechaPublicacion" => "2009-01-01" "aid" => "74138" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2009;33:249-57" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1392 "formatos" => array:3 [ "EPUB" => 6 "HTML" => 794 "PDF" => 592 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Factores pronósticos en la supervivencia de los pacientes con carcinoma transicional de vejiga tratados con cistectomía radical" "tienePdf" => array:2 [ 0 => "es" 1 => "en" ] "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "249" "paginaFinal" => "257" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Prognostic factors for survival in patients with transitional baldder cancer treated with radical cystectomy" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:2 [ "es" => true "en" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "Juan I. Monzó Gardiner, Felipe Herranz Amo, José M. Díez Cordero, Ramiro Cabello Benavente, Ángel Silmi Moyano, Carlos Hernández Fernández" "autores" => array:6 [ 0 => array:2 [ "nombre" => "Juan I." "apellidos" => "Monzó Gardiner" ] 1 => array:2 [ "nombre" => "Felipe" "apellidos" => "Herranz Amo" ] 2 => array:2 [ "nombre" => "José M." "apellidos" => "Díez Cordero" ] 3 => array:2 [ "nombre" => "Ramiro" "apellidos" => "Cabello Benavente" ] 4 => array:2 [ "nombre" => "Ángel" "apellidos" => "Silmi Moyano" ] 5 => array:2 [ "nombre" => "Carlos" "apellidos" => "Hernández Fernández" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480609741385?idApp=UINPBA00004N" "url" => "/02104806/0000003300000003/v1_201304251925/S0210480609741385/v1_201304251925/es/main.assets" ] "es" => array:14 [ "idiomaDefecto" => true "titulo" => "Factores predictivos de neoplasia vesical metacrónica tras nefroureterectomía" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "258" "paginaFinal" => "269" ] ] "autores" => array:1 [ 0 => array:4 [ "autoresLista" => "Andres Rodriguez Alonso, Alfonso Gonzalez Blanco, Alfonso Barbagelata Lopez, Salvador Pita Fernandez, Carlos Bonelli Martin, Miguel A. Cuerpo Perez" "autores" => array:6 [ 0 => array:4 [ "nombre" => "Andres" "apellidos" => "Rodriguez Alonso" "email" => array:1 [ 0 => "arodri68@gmail.com" ] "referencia" => array:2 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] 1 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0010" ] ] ] 1 => array:3 [ "nombre" => "Alfonso" "apellidos" => "Gonzalez Blanco" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0010" ] ] ] 2 => array:3 [ "nombre" => "Alfonso" "apellidos" => "Barbagelata Lopez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0010" ] ] ] 3 => array:3 [ "nombre" => "Salvador" "apellidos" => "Pita Fernandez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] 4 => array:3 [ "nombre" => "Carlos" "apellidos" => "Bonelli Martin" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0010" ] ] ] 5 => array:3 [ "nombre" => "Miguel A." "apellidos" => "Cuerpo Perez" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0010" ] ] ] ] "afiliaciones" => array:2 [ 0 => array:3 [ "entidad" => "Servicio de Urología, Hospital Arquitecto Marcide, Ferrol, La Coruña, España" "etiqueta" => "<span class="elsevierStyleSup">a</span>" "identificador" => "aff0010" ] 1 => array:3 [ "entidad" => "Unidad de Epidemiología Clínica y Bioestadística, Hospital Juan Canalejo. La Coruña, España" "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Correspondencia autor: Dr. Andres Rodriguez Alonso Servicio de Urologia. Hospital Arquitecto Marcide - Profesor Novoa Santos Ctra. San Pedro de Leixa s/n - 15405 Ferrol, La Coruna Tel.: 981 334 052" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Predictive factors of metachronous bladder neoplasm after nephroureterectomy" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2008-09-01" "fechaAceptado" => "2009-01-01" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec88902" "palabras" => array:6 [ 0 => "Neoplasia del tracto urinario superior" 1 => "Neoplasia vesical" 2 => "nefroureterectomia" 3 => "Recidiva" 4 => "Carcinoma de celulas transicionales" 5 => "Neoplasia vesical metacronica" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec88901" "palabras" => array:6 [ 0 => "Upper urinary tract neoplasm" 1 => "Bladder neoplasm" 2 => "Nephroureterectomy" 3 => "Recurrence" 4 => "Transitional cell carcinoma" 5 => "Metachronous bladder neoplasm" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">Determinar factores pronosticos de recidiva vesical en pacientes con carcinoma urotelial del tracto urinario superior (TUS), tratados mediante nefroureterectomia.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Pacientes (N=51) con carcinoma de celulas transicionales del TUS tratados mediante nefroureterectomia. Se realizo un estudio observacional de cohorte retrospectivo y prospectivo durante el periodo 1995-2007, en el Hospital Arquitecto Marcide, Area Sanitaria de Ferrol, La Coruna. Se analizaron las diferencias entre grupos con y sin recidiva vesical mediante test chi-cuadrado en variables cualitativas y test t-Student y U Mann-Whitney en variables cuantitativas. Se estudio la supervivencia libre de recidiva vesical (SLRV) mediante la metodologia de Kaplan-Meier, desarrollando un modelo multivariado de regresion de Cox para identificar variables asociadas a recidiva vesical.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">La media de edad fue 68,51-12,11 anos (24-86). La distribucion por grado histologico fue la siguiente: 7 g1 (13,72%), 20 g2 (39,21%), 23 g3 (45,10%) y 1 caso indeterminado (1,97%). En cuanto a la categoria pt, 19 casos eran pt1 (37,25%), 12 pt2 (23,53%), 19 pt3 (37,25%) y 1 caso indeterminado (1,97%). Durante el seguimiento se detecto recidiva vesical en 16 pacientes (31,37%). El 70,59% de las recidivas se identificaron durante los dos primeros anos de seguimiento. Entre los pacientes sin y con recidiva vesical se detectaron diferencias relacionadas con tiempo de seguimiento, existencia de uropatia obstructiva, morfologia microscopica y multifocalidad tumoral. La SLRV al cabo de 1, 2, 5 y 10 anos fue del 85,10%, 67,90%, 56,60% y 31,80%, respectivamente. La SLRV se modifico significativamente en funcion de la localizacion (p=0,019) y la multifocalidad (p=0,002) tumorales. En el analisis multivariado se observo que la multifocalidad tumoral predecia de forma independiente la recidiva vesical (rr=7,35;95%ic=1,57-34,45;p=0,011).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">El desarrollo de recidiva vesical tras nefroureterectomia se observa en el 31,37% del los pacientes de nuestro estudio, detectandose la mayoria de los episodios durante los dos primeros anos de seguimiento. La multifocalidad tumoral en el TUS es el factor de riesgo mas importante para el desarrollo de recidiva vesical.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Purpose</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">To determine prognostic factors of bladder recurrence in patients with upper urinary tract (UUT) urothelial carcinoma, who underwent nephroureterectomy.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Patients (N=51) with UUT transitional cell carcinoma who underwent nephroureterectomy. A Retrospective and prospective observational cohort study was made during the period 1995-2007, at Arquitecto Marcide Hospital, Ferrol Health Area, La Coruna. Differences between groups with and without recurrence were analized by means of chi-squared test in qualitative variables and t-Student and U Mann-Whitney test in quantitative variables. Kaplan-Meier methodology was used in order to predict bladder recurrence free survival (BRFS), developing a multivariate Cox regression model to identify variables related to bladder recurrence.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Mean age of patients was 68.51-12.11 (24-86). Histological grade distribution was as follows: 7 g1 (13.72%), 20 g2 (39.21%), 23 g3 (45.10%) and 1 undetermined case(1.97%). With regard to pT category, 19 cases were pt1(37.25%), 12 pt2 (23.53%), 19 pt3 (37.25%) y 1 case undetermined (1.97%). Bladder recurrence was detected in 16 patients during follow-up (31.37%). 70.59% of recurrences were identified during first two years of follow-up. Differences related to follow-up period, presence of obstructive uropathy, microscopic growth pattern and tumour multifocality, were observed between patients without and with bladder recurrence. BRFS rates at 1, 2, 5 and 10 years were 85.10%, 67.90%, 56.60% y 31.80%, respectively. BRFS was significantly modified by tumour location (p=0.019) and tumour multifocality (p=0.002). Multivariate analysis showed that tumour multifocality was an independent factor in the prediction of bladder recurrence (rr=7.35;95%ci=1.57-34.45;p=0.011).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The development of bladder recurrence after nephroureterectomy was observed in 31.37% of patients in our study, detecting most of events during the first two years of follow-up. Tumour multifocality in UUT constitutes the most important risk factor for the development of bladder recurrence.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:28 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nephroureterectomy: rationale in the management of transitional cell carcinoma of the upper urinary tract" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "K.B. Cummings" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Urol Clin N Am" "fecha" => "1980" "volumen" => "7" "numero" => "3" "paginaInicial" => "569" "paginaFinal" => "578" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." 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