Análisis de supervivencia de los carcinomas de células renales órgano-confinados. Valor pronóstico de la clasificación TNM 1997
Survival analysis for localized renal cell carcinoma.prognostic value of 1997 tnm classification.
M. García Torrelles1
, M. Sánchez Sanchís, J.R. Beltrán Armada, J. Vidal Moreno, C. Sanjuán de Laorden
Autor para correspondencia
garcia_martor@gva.es
Dra. M. García Torrelles Servicio de Urología. Hospital Dr. Peset Av. Gaspar Aguilar, 90 - 46017 Valencia
Dra. M. García Torrelles Servicio de Urología. Hospital Dr. Peset Av. Gaspar Aguilar, 90 - 46017 Valencia
Servicio de Urología
D. Bautista Rentero*
* Sección de Medicina Preventiva. Hospital Universitario Dr. Peset, Valencia,
Leído
1872
Vecesse ha leído el artículo
1157
Total PDF
715
Total HTML
Compartir estadísticas
array:23 [ "pii" => "S0210480606735148" "issn" => "02104806" "doi" => "10.1016/S0210-4806(06)73514-8" "estado" => "S300" "fechaPublicacion" => "2006-01-01" "aid" => "73514" "copyright" => "Asociación Española de Urología (AEU)" "copyrightAnyo" => "2006" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2006;30:655-60" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1393 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 714 "PDF" => 674 ] ] "itemSiguiente" => array:18 [ "pii" => "S021048060673515X" "issn" => "02104806" "doi" => "10.1016/S0210-4806(06)73515-X" "estado" => "S300" "fechaPublicacion" => "2006-01-01" "aid" => "73515" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2006;30:661-6" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1537 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 958 "PDF" => 574 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Resección transuretral de próstata bipolar vs monopolar: análisis peroperatorio de los resultados" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "661" "paginaFinal" => "666" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Bipolar Versus Monopolar Transurethral Resection Of The Prostate: Peroperative Analysis Of The Results" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "J.Mª. Abascal Junquera, L. Cecchini Rosell, C. Salvador Lacambra, R. Martos Calvo, A. Celma Domenech, J. Morote Robles" "autores" => array:6 [ 0 => array:2 [ "nombre" => "J.Mª." "apellidos" => "Abascal Junquera" ] 1 => array:2 [ "nombre" => "L." "apellidos" => "Cecchini Rosell" ] 2 => array:2 [ "nombre" => "C." "apellidos" => "Salvador Lacambra" ] 3 => array:2 [ "nombre" => "R." "apellidos" => "Martos Calvo" ] 4 => array:2 [ "nombre" => "A." "apellidos" => "Celma Domenech" ] 5 => array:2 [ "nombre" => "J." "apellidos" => "Morote Robles" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S021048060673515X?idApp=UINPBA00004N" "url" => "/02104806/0000003000000007/v1_201304251821/S021048060673515X/v1_201304251821/es/main.assets" ] "itemAnterior" => array:18 [ "pii" => "S0210480606735136" "issn" => "02104806" "doi" => "10.1016/S0210-4806(06)73513-6" "estado" => "S300" "fechaPublicacion" => "2006-01-01" "aid" => "73513" "copyright" => "Asociación Española de Urología (AEU)" "documento" => "article" "crossmark" => 0 "subdocumento" => "fla" "cita" => "Actas Urol Esp. 2006;30:649-54" "abierto" => array:3 [ "ES" => false "ES2" => false "LATM" => false ] "gratuito" => false "lecturas" => array:2 [ "total" => 1295 "formatos" => array:3 [ "EPUB" => 5 "HTML" => 816 "PDF" => 474 ] ] "es" => array:10 [ "idiomaDefecto" => true "titulo" => "Características inmunofenotípicas y clínicas del carcinoma renal mucinoso tubular y de células fusiformes" "tienePdf" => "es" "tieneTextoCompleto" => 0 "tieneResumen" => array:2 [ 0 => "es" 1 => "en" ] "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "649" "paginaFinal" => "654" ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Immunohistochemical profile and clinical features of mucinous tubular and spindle renal cell carcinoma" ] ] "contieneResumen" => array:2 [ "es" => true "en" => true ] "contienePdf" => array:1 [ "es" => true ] "autores" => array:1 [ 0 => array:2 [ "autoresLista" => "L.F. Arias, j. Blanco, S. Hernández, G. Bocardo, L. González" "autores" => array:5 [ 0 => array:2 [ "nombre" => "L.F." "apellidos" => "Arias" ] 1 => array:2 [ "nombre" => "j." "apellidos" => "Blanco" ] 2 => array:2 [ "nombre" => "S." "apellidos" => "Hernández" ] 3 => array:2 [ "nombre" => "G." "apellidos" => "Bocardo" ] 4 => array:2 [ "nombre" => "L." "apellidos" => "González" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480606735136?idApp=UINPBA00004N" "url" => "/02104806/0000003000000007/v1_201304251821/S0210480606735136/v1_201304251821/es/main.assets" ] "es" => array:13 [ "idiomaDefecto" => true "titulo" => "Análisis de supervivencia de los carcinomas de células renales órgano-confinados. Valor pronóstico de la clasificación TNM 1997" "tieneTextoCompleto" => 0 "paginas" => array:1 [ 0 => array:2 [ "paginaInicial" => "655" "paginaFinal" => "660" ] ] "autores" => array:2 [ 0 => array:4 [ "autoresLista" => "M. García Torrelles, M. Sánchez Sanchís, J.R. Beltrán Armada, J. Vidal Moreno, C. Sanjuán de Laorden" "autores" => array:5 [ 0 => array:4 [ "nombre" => "M." "apellidos" => "García Torrelles" "email" => array:1 [ 0 => "garcia_martor@gva.es" ] "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">1</span>" "identificador" => "cor0005" ] ] ] 1 => array:2 [ "nombre" => "M." "apellidos" => "Sánchez Sanchís" ] 2 => array:2 [ "nombre" => "J.R." "apellidos" => "Beltrán Armada" ] 3 => array:2 [ "nombre" => "J." "apellidos" => "Vidal Moreno" ] 4 => array:2 [ "nombre" => "C." "apellidos" => "Sanjuán de Laorden" ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Urología" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "1" "correspondencia" => "Dra. M. García Torrelles Servicio de Urología. Hospital Dr. Peset Av. Gaspar Aguilar, 90 - 46017 Valencia" ] ] ] 1 => array:3 [ "autoresLista" => "D. Bautista Rentero" "autores" => array:1 [ 0 => array:3 [ "nombre" => "D." "apellidos" => "Bautista Rentero" "referencia" => array:1 [ 0 => array:2 [ "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] ] "afiliaciones" => array:1 [ 0 => array:3 [ "entidad" => "Sección de Medicina Preventiva. Hospital Universitario Dr. Peset, Valencia," "etiqueta" => "<span class="elsevierStyleSup">*</span>" "identificador" => "aff0005" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Survival analysis for localized renal cell carcinoma.prognostic value of 1997 tnm classification." ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2006-03-29" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec87966" "palabras" => array:3 [ 0 => "Carcinoma de células renales" 1 => "Tamaño tumoral" 2 => "Clasificación TNM" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec87965" "palabras" => array:3 [ 0 => "Renal cell carcinoma" 1 => "Tumor size" 2 => "TNM classification" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:2 [ "titulo" => "Resumen" "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En la 5ª edición de la clasificación TNM de 1997 para tumores renales se modificó el punto de corte del tamaño del tumor primario para los estadios I y II, permitiendo una mejor agrupación de pacientes con distinta supervivencia. Sin embargo, dada la variable evolución del carcinoma de células renales determinada por su agresividad biológica, se cuestiona la utilidad del tamaño tumoral como elemento pronóstico y de estadiaje. Se realiza un estudio de supervivencia del carcinoma de células renales para valorar si la nueva clasificación TNM para el estadio I y II es la que mejor predice la supervivencia basándose en el tamaño del tumor.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se ha realizado un estudio retrospectivo de 158 carcinomas de células renales intervenidos en nuestro hospital en un periodo de 12 años. Se ha creado una base de datos con variables clínicas debidas al paciente y al tumor, y se ha valorado estadio patológico, grado nuclear y supervivencia causa específica, centrándonos en los estadios I y II.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Según la categoría pT obtuvimos 27 pT1 (17,08%), 52 pT2 (32,91%), 45 pT3A (28,45%), 10 pT3B (6,32%), y 24 pT4 (15,18%). La supervivencia tumor-específica a los 5 años para pT1-pT2, estadio I-II, es de 100% y 94% respectivamente, sin encontrar diferencias estadísticamente significativas entre los estadios I y II (log-rank test 0,53, p no significativa). La supervivencia tumor-específica a los 5 años para la categoría pT3A, pT3B, y pT4 es de 76,5%, 66,6% y 38,4%. Encontrando una diferencia en la supervivencia estadísticamente significativa según la localización del tumor primario intrarrenal (T1 y T2) y la extrarrenal (T3A, T3B, T4) (log-rank test 9,06, p < 0.05). Para pT1 y pT2 no se encuentran diferencias estadísticamente significativas según el grado nuclear (test exacto de Fisher, p=1). Comparando la relación entre estadio pT y grado nuclear del tumor primario obtenemos un valor para ?2 de tendencia lineal de 38,19, p < 0.001.</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">Las diferencias en la evolución del carcinoma de células renales órgano-confinado según el tamaño tumoral pueden ser debidas a la existencia de otras variables biológicas y moleculares, posiblemente asociadas al estadio, que no se controlan en los estudios. La clasificación TNM en los carcinomas de células renales órgano-confinados basándose en el tamaño del tumor nos parece artificiosa. Son necesarias nuevas revisiones del sistema de clasificación para identificar qué grupo de pacientes con carcinoma de células renales órgano-confinado va a presentar evolución desfavorable e incluirlos en una categoría distinta.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<span class="elsevierStyleSectionTitle">Background</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">the 5th edition of TNM classification for renal cell carcinoma changed the cut-off point of the tumor size for localized tumors, achieving a better distribution of patients with similar survival. Nevertheless, because of the variable evolution of renal cell carcinoma, the prognostic significance of tumor size is questioned as a staging criterion in organ-confined renal cell carinoma. We analyse renal cell carcinoma specific survival and the prognostic significance of tumor size in I and II stage.</p> <span class="elsevierStyleSectionTitle">Methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">We made a retrospective study with 158 renal cell carcinoma surgically treated in our hospital along 12 years. It was created a data base with clinical variables from patient and tumor and analyzed pathological staging, nuclear grade and specific survival, overall stage I and II.</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">27 renal cell carcinoma were pT1 (17.08%), 52 pT2 (32.91%), 45 pT3A (28.45%), 10 pT3B (6.32%), y 24 pT4 (15.18%). The specific survival at 5 years for pT1-pT2, I-II stage, was 100% and 94% respectively, and no statistic significant differences were found between stage I and II (log-rank test 0.53, p>0.05). The specific survival at 5 years for pT3A, pT3B, y pT4 was 76.5%, 66.6% y 38.4%. There was a significant difference in survival in accordance with the tumor location, intrarenal (T1 y T2) versus extrarenal (T3A, T3B, T4) (log-rank test 9.06, p < 0.05). According to nuclear grade we don’t find significant differences for pT1 y pT2 (Fisher test, p=1). Regarding the relation between pT stage and nuclear grade of the tumor we obtained a ?2 inear tendency of 38.19, p < 0.001.</p> <span class="elsevierStyleSectionTitle">Conclusion</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">The differences in the evolution of the organ-confined renal cell carcinoma with respect to the tumor size may be due to other molecular and biological variables, probably associated with stage. not controlled in essays. The TNM classification for organ-confined renal cell carcinoma based in tumor size seems artificial. New revisions of the classification system are necessary to identify which organ-confined carcinoma will have unfavourable evolution and to include them in a different category.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Referencias" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:21 [ 0 => array:3 [ "identificador" => "bib0005" "etiqueta" => "1." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal tumors" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:2 [ 0 => "A.C. Novick" 1 => "S.C. Campbell" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Campbell’s Urology" "paginaInicial" => "2672" "paginaFinal" => "2719" "serieFecha" => "2002" ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib0010" "etiqueta" => "2." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Estadiaje tumoral y factores pronósticos del carcinoma de células renales" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "L.E. Resel Folkersma" 1 => "F. Ramirez Rodríguez" 2 => "R. Marrero Domínguez" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "LibroEditado" => array:4 [ "titulo" => "Moreno Sierra JTratado de oncología urológica" "paginaInicial" => "337" "paginaFinal" => "356" "serieFecha" => "2003" ] ] ] ] ] ] 2 => array:3 [ "identificador" => "bib0015" "etiqueta" => "3." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Histopathologic prognostic indicators for renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "B. Delahunt" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Semin Diagn Pathol" "fecha" => "1998" "volumen" => "15" "numero" => "1" "paginaInicial" => "68" "paginaFinal" => "76" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9503507" "web" => "Medline" ] ] ] ] ] ] ] ] 3 => array:3 [ "identificador" => "bib0020" "etiqueta" => "4." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic importance of tumor size for localized conventional clear cell renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "B. Delahunt" 1 => "J.M. Kittelson" 2 => "M. McCredie" 3 => "A.E. Reeve" 4 => "J.H. Stewart" 5 => "A.M. Bilous" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Cancer" "fecha" => "2002" "volumen" => "94" "numero" => "3" "paginaInicial" => "658" "paginaFinal" => "664" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11857297" "web" => "Medline" ] ] ] ] ] ] ] ] 4 => array:3 [ "identificador" => "bib0025" "etiqueta" => "5." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Pathologic Staging of renal cell carcinoma. Significance of tumor classification with the 1997 TNM staging system" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:5 [ 0 => "M.T. Gettman" 1 => "M.L. Blute" 2 => "B. Spotts" 3 => "S.C. Bryant" 4 => "H. Zincke" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Cancer" "fecha" => "2001" "volumen" => "91" "numero" => "2" "paginaInicial" => "354" "paginaFinal" => "361" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11180082" "web" => "Medline" ] ] ] ] ] ] ] ] 5 => array:3 [ "identificador" => "bib0030" "etiqueta" => "6." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic significance of the 1997 TNM classification of renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:7 [ 0 => "J. Javidan" 1 => "H.J Stricker" 2 => "P. Tamboli" 3 => "M.B Amin" 4 => "J.A. Peabody" 5 => "A. Deshpande" 6 => "M. Menon" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Urol" "fecha" => "1999" "volumen" => "162" "numero" => "4" "paginaInicial" => "1277" "paginaFinal" => "1281" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10492179" "web" => "Medline" ] ] ] ] ] ] ] ] 6 => array:3 [ "identificador" => "bib0035" "etiqueta" => "7." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic factors of renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "A. Mejean" 1 => "S. Oudard" 2 => "N. Thiounn" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1097/01.ju.0000051378.14270.2a" "Revista" => array:7 [ "tituloSerie" => "J Urol" "fecha" => "2003" "volumen" => "169" "numero" => "3" "paginaInicial" => "821" "paginaFinal" => "827" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12576793" "web" => "Medline" ] ] ] ] ] ] ] ] 7 => array:3 [ "identificador" => "bib0040" "etiqueta" => "8." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic indicators for renal cell carcinoma: a multivariate analysis of 643 patients using the revised 1997 TNM staging criteria" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:3 [ 0 => "K. Tsui" 1 => "O. Shvarts" 2 => "R. Smith" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "J Urol" "fecha" => "2000" "volumen" => "163" "paginaInicial" => "1090" "paginaFinal" => "1095" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10737472" "web" => "Medline" ] ] ] ] ] ] ] ] 8 => array:3 [ "identificador" => "bib0045" "etiqueta" => "9." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Renal cell carcinoma: presentation, staging, and surgical treatment" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:1 [ 0 => "P. Russo" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Semin Oncol" "fecha" => "2000" "volumen" => "27" "numero" => "2" "paginaInicial" => "160" "paginaFinal" => "176" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10768595" "web" => "Medline" ] ] ] ] ] ] ] ] 9 => array:3 [ "identificador" => "bib0050" "etiqueta" => "10." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic fators in patients with renal cell carcinoma: retrospective analysis of 675 cases" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "V. Ficarra" 1 => "R. Righetti" 2 => "S. Pilloni" 3 => "A. D’amico" 4 => "N. Maffei" 5 => "G. Novella" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "European Urology" "fecha" => "2002" "volumen" => "41" "numero" => "2" "paginaInicial" => "190" "paginaFinal" => "198" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/12074408" "web" => "Medline" ] ] ] ] ] ] ] ] 10 => array:3 [ "identificador" => "bib0055" "etiqueta" => "11." "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Medeiros LJ, Gelb AB, Weiss LM. Renal cell carcinoma.Prognostic significance of morphologic parameters in 121cases. Cancer.;61(8):1639-1651." ] ] ] 11 => array:3 [ "identificador" => "bib0060" "etiqueta" => "12." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The impact of a 4 cm cutoff point for stratification of T1N0M0 renal cell carcinoma after radical nephrectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Igarashi" 1 => "T. Tobe" 2 => "H. Nakatsu" 3 => "N. Suzuki" 4 => "S. Murakami" 5 => "M. Hamano" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Urol" "fecha" => "2001" "volumen" => "165" "numero" => "4" "paginaInicial" => "1103" "paginaFinal" => "1106" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11257647" "web" => "Medline" ] ] ] ] ] ] ] ] 12 => array:3 [ "identificador" => "bib0065" "etiqueta" => "13." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Nephron sparing surgery for localized renal cell carcinoma: impact of tumor size on patient survival, tumor recurrence and TNM staging" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:3 [ 0 => "K.S. Hafez" 1 => "A. Fergany" 2 => "A.C. Novick" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Urol" "fecha" => "1999" "volumen" => "162" "numero" => "6" "paginaInicial" => "1930" "paginaFinal" => "1933" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10569540" "web" => "Medline" ] ] ] ] ] ] ] ] 13 => array:3 [ "identificador" => "bib0070" "etiqueta" => "14." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Impact of tumor size on the clinical outcomes of patients with Robson Stage I renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "T. Kinouchi" 1 => "MD" 2 => "Shigeru Saiki" 3 => "MD" 4 => "N. Meguro" 5 => "MD" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:6 [ "tituloSerie" => "Cancer" "fecha" => "1999" "volumen" => "85" "numero" => "3" "paginaInicial" => "6895" "paginaFinal" => "6896" ] ] ] ] ] ] 14 => array:3 [ "identificador" => "bib0075" "etiqueta" => "15." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Reevaluation of the 1997 TNM classification for renal cell carcinoma: T1 and T2 cutoff point at 4.5 rather than 7cm better correlates with clinical outcome" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:6 [ 0 => "A. Zisman" 1 => "A.J. Pantuck" 2 => "D. Chao" 3 => "F. Dorey" 4 => "J.W. Said" 5 => "B.J. Gitlitz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Urol" "fecha" => "2001" "volumen" => "166" "numero" => "1" "paginaInicial" => "54" "paginaFinal" => "58" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11435822" "web" => "Medline" ] ] ] ] ] ] ] ] 15 => array:3 [ "identificador" => "bib0080" "etiqueta" => "16." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic features of pathologic stage T1 renal cell carcinoma after radical nephrectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "W.K. Lau" 1 => "J.C. Cheville" 2 => "M.L. Blute" 3 => "A. Weaver" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Urology" "fecha" => "2002" "volumen" => "59" "numero" => "4" "paginaInicial" => "532" "paginaFinal" => "537" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11927308" "web" => "Medline" ] ] ] ] ] ] ] ] 16 => array:3 [ "identificador" => "bib0085" "etiqueta" => "17." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "The impact of tumor size on clinical outcome in patients with localizad renal cell carcinoma treated by radical nephrectomy" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "O. Nativ" 1 => "E. Sabo" 2 => "G. Raviv" 3 => "S. Macjar" 4 => "S. Halachmi" 5 => "B. Moskovitz" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "J Urol" "fecha" => "1997" "volumen" => "158" "numero" => "3 Pt 1" "paginaInicial" => "729" "paginaFinal" => "732" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/9258069" "web" => "Medline" ] ] ] ] ] ] ] ] 17 => array:3 [ "identificador" => "bib0090" "etiqueta" => "18." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic utility of the recently recommended histologic classification and revised TNM staging system of renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "H. Moch" 1 => "T. Gasser" 2 => "M. Amin" 3 => "J. Torhorst" 4 => "G. Sauter" 5 => "M. Mihatsch" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:8 [ "tituloSerie" => "Cancer" "fecha" => "2000" "volumen" => "89" "numero" => "3" "paginaInicial" => "604" "paginaFinal" => "614" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10931460" "web" => "Medline" ] ] "itemHostRev" => array:3 [ "pii" => "S0140673610608355" "estado" => "S300" "issn" => "01406736" ] ] ] ] ] ] ] 18 => array:3 [ "identificador" => "bib0095" "etiqueta" => "19." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Prognostic significance of the Heidelberg classification of renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "B. Ljungberg" 1 => "F.I. Alamdari" 2 => "R. Stenling" 3 => "G. Roos" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "20049" "Revista" => array:7 [ "tituloSerie" => "Eur Urol" "fecha" => "1999" "volumen" => "36" "numero" => "6" "paginaInicial" => "565" "paginaFinal" => "699" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/10559609" "web" => "Medline" ] ] ] ] ] ] ] ] 19 => array:3 [ "identificador" => "bib0100" "etiqueta" => "20." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Clinical significance of cell proliferation, microvessel density, and CD44 adhesion molecule expression in renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => true "autores" => array:5 [ 0 => "N. Rioux-Leclercq" 1 => "J.I. Epstein" 2 => "J.Y. Bansard" 3 => "B. Turlin" 4 => "J.J. Patard" ] ] ] ] ] "host" => array:1 [ 0 => array:1 [ "Revista" => array:7 [ "tituloSerie" => "Hum Pathol" "fecha" => "2001" "volumen" => "32" "numero" => "11" "paginaInicial" => "1209" "paginaFinal" => "1215" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11727260" "web" => "Medline" ] ] ] ] ] ] ] ] 20 => array:3 [ "identificador" => "bib0105" "etiqueta" => "21." "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Expression levels of genes that regulate metastasis and angiogenesis correlate with advanced pathological stage of renal cell carcinoma" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:7 [ 0 => "J.W. Slaton" 1 => "K. Inoue" 2 => "P. Perrote" 3 => "A.K. El-Naggar" 4 => "D.A. Swanson" 5 => "J. Filder" 6 => "C.P.N. Dinney" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/S0002-9440(10)64016-3" "Revista" => array:7 [ "tituloSerie" => "Am J Pathol" "fecha" => "2001" "volumen" => "158" "numero" => "2" "paginaInicial" => "735" "paginaFinal" => "743" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/11159211" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/02104806/0000003000000007/v1_201304251821/S0210480606735148/v1_201304251821/es/main.assets" "Apartado" => array:4 [ "identificador" => "6429" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Original" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/02104806/0000003000000007/v1_201304251821/S0210480606735148/v1_201304251821/es/main.pdf?idApp=UINPBA00004N&text.app=https://www.elsevier.es/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0210480606735148?idApp=UINPBA00004N" ]
| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 0 | 2 | 2 |
| 2024 Septiembre | 0 | 6 | 6 |
| 2024 Agosto | 0 | 6 | 6 |
| 2024 Julio | 0 | 2 | 2 |
| 2024 Junio | 0 | 15 | 15 |
| 2024 Mayo | 0 | 5 | 5 |
| 2024 Abril | 0 | 20 | 20 |
| 2024 Marzo | 0 | 22 | 22 |
| 2024 Febrero | 0 | 5 | 5 |
| 2024 Enero | 0 | 11 | 11 |
| 2023 Diciembre | 0 | 28 | 28 |
| 2023 Noviembre | 0 | 20 | 20 |
| 2023 Octubre | 0 | 29 | 29 |
| 2023 Septiembre | 0 | 13 | 13 |
| 2023 Agosto | 0 | 4 | 4 |
| 2023 Julio | 0 | 26 | 26 |
| 2023 Junio | 0 | 3 | 3 |
| 2023 Mayo | 0 | 4 | 4 |
| 2023 Abril | 0 | 5 | 5 |
| 2023 Marzo | 1 | 1 | 2 |
| 2023 Febrero | 0 | 5 | 5 |
| 2023 Enero | 0 | 6 | 6 |
| 2022 Diciembre | 0 | 3 | 3 |
| 2022 Noviembre | 0 | 6 | 6 |
| 2022 Octubre | 0 | 7 | 7 |
| 2022 Septiembre | 0 | 17 | 17 |
| 2022 Agosto | 0 | 19 | 19 |
| 2022 Julio | 0 | 5 | 5 |
| 2022 Mayo | 0 | 1 | 1 |
| 2022 Abril | 0 | 8 | 8 |
| 2022 Marzo | 0 | 1 | 1 |
| 2022 Enero | 0 | 3 | 3 |
| 2021 Diciembre | 0 | 5 | 5 |
| 2021 Noviembre | 0 | 3 | 3 |
| 2021 Septiembre | 0 | 2 | 2 |
| 2021 Julio | 0 | 3 | 3 |
| 2021 Junio | 0 | 3 | 3 |
| 2021 Abril | 0 | 1 | 1 |
| 2021 Marzo | 0 | 5 | 5 |
| 2021 Febrero | 0 | 4 | 4 |
| 2021 Enero | 0 | 2 | 2 |
| 2020 Diciembre | 0 | 1 | 1 |
| 2020 Octubre | 0 | 7 | 7 |
| 2020 Septiembre | 0 | 11 | 11 |
| 2020 Agosto | 0 | 15 | 15 |
| 2020 Julio | 0 | 12 | 12 |
| 2020 Junio | 0 | 90 | 90 |
| 2020 Mayo | 0 | 7 | 7 |
| 2020 Marzo | 0 | 2 | 2 |
| 2020 Febrero | 0 | 6 | 6 |
| 2020 Enero | 0 | 10 | 10 |
| 2019 Diciembre | 0 | 22 | 22 |
| 2019 Noviembre | 0 | 1 | 1 |
| 2019 Octubre | 0 | 2 | 2 |
| 2019 Septiembre | 0 | 1 | 1 |
| 2019 Agosto | 0 | 1 | 1 |
| 2019 Julio | 0 | 6 | 6 |
| 2019 Junio | 0 | 10 | 10 |
| 2019 Mayo | 0 | 40 | 40 |
| 2019 Abril | 0 | 14 | 14 |
| 2019 Marzo | 0 | 1 | 1 |
| 2019 Febrero | 0 | 4 | 4 |
| 2018 Diciembre | 0 | 4 | 4 |
| 2018 Noviembre | 0 | 2 | 2 |
| 2018 Octubre | 0 | 9 | 9 |
| 2018 Febrero | 0 | 9 | 9 |
| 2018 Enero | 0 | 5 | 5 |
| 2017 Diciembre | 2 | 5 | 7 |
| 2017 Noviembre | 2 | 9 | 11 |
| 2017 Octubre | 1 | 12 | 13 |
| 2017 Septiembre | 1 | 12 | 13 |
| 2017 Agosto | 1 | 9 | 10 |
| 2017 Julio | 3 | 11 | 14 |
| 2017 Junio | 7 | 18 | 25 |
| 2017 Mayo | 7 | 13 | 20 |
| 2017 Abril | 3 | 7 | 10 |
| 2017 Marzo | 13 | 26 | 39 |
| 2017 Febrero | 13 | 7 | 20 |
| 2017 Enero | 3 | 3 | 6 |
| 2016 Diciembre | 13 | 11 | 24 |
| 2016 Noviembre | 20 | 15 | 35 |
| 2016 Octubre | 31 | 11 | 42 |
| 2016 Septiembre | 14 | 10 | 24 |
| 2016 Agosto | 13 | 9 | 22 |
| 2016 Julio | 9 | 1 | 10 |
| 2016 Junio | 7 | 11 | 18 |
| 2016 Mayo | 11 | 17 | 28 |
| 2016 Abril | 6 | 19 | 25 |
| 2016 Marzo | 8 | 16 | 24 |
| 2016 Febrero | 6 | 21 | 27 |
| 2016 Enero | 9 | 19 | 28 |
| 2015 Diciembre | 4 | 24 | 28 |
| 2015 Noviembre | 10 | 18 | 28 |
| 2015 Octubre | 6 | 22 | 28 |
| 2015 Septiembre | 5 | 11 | 16 |
| 2015 Agosto | 8 | 14 | 22 |
| 2015 Julio | 6 | 16 | 22 |
| 2015 Junio | 1 | 6 | 7 |
| 2015 Mayo | 7 | 13 | 20 |
| 2015 Abril | 11 | 27 | 38 |
| 2015 Marzo | 8 | 15 | 23 |
| 2015 Febrero | 3 | 9 | 12 |
| 2015 Enero | 5 | 3 | 8 |
| 2014 Diciembre | 8 | 6 | 14 |
| 2014 Noviembre | 11 | 1 | 12 |
| 2014 Octubre | 15 | 4 | 19 |
| 2014 Septiembre | 13 | 2 | 15 |
| 2014 Agosto | 14 | 1 | 15 |
| 2014 Julio | 9 | 0 | 9 |
| 2014 Junio | 13 | 1 | 14 |
| 2014 Mayo | 11 | 0 | 11 |
| 2014 Abril | 10 | 1 | 11 |
| 2014 Marzo | 9 | 1 | 10 |
| 2014 Febrero | 5 | 1 | 6 |
| 2014 Enero | 7 | 2 | 9 |
| 2013 Diciembre | 6 | 4 | 10 |
| 2013 Noviembre | 12 | 8 | 20 |
| 2013 Octubre | 3 | 2 | 5 |
| 2013 Septiembre | 7 | 15 | 22 |
| 2013 Agosto | 8 | 10 | 18 |
| 2013 Julio | 3 | 0 | 3 |
| 2006 Junio | 273 | 0 | 273 |
Mostrar todo
