Factores predictivos de neoplasia vesical metacrónica tras nefroureterectomía
Predictive factors of metachronous bladder neoplasm after nephroureterectomy
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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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| año/Mes | Html | Total | |
|---|---|---|---|
| 2024 Octubre | 0 | 8 | 8 |
| 2024 Septiembre | 0 | 6 | 6 |
| 2024 Agosto | 0 | 13 | 13 |
| 2024 Julio | 0 | 3 | 3 |
| 2024 Junio | 0 | 12 | 12 |
| 2024 Mayo | 0 | 8 | 8 |
| 2024 Abril | 0 | 7 | 7 |
| 2024 Marzo | 0 | 30 | 30 |
| 2024 Febrero | 0 | 10 | 10 |
| 2024 Enero | 0 | 6 | 6 |
| 2023 Diciembre | 0 | 22 | 22 |
| 2023 Noviembre | 0 | 25 | 25 |
| 2023 Octubre | 0 | 30 | 30 |
| 2023 Septiembre | 0 | 8 | 8 |
| 2023 Agosto | 0 | 18 | 18 |
| 2023 Julio | 0 | 41 | 41 |
| 2023 Junio | 0 | 8 | 8 |
| 2023 Abril | 0 | 6 | 6 |
| 2023 Marzo | 2 | 2 | 4 |
| 2023 Febrero | 0 | 3 | 3 |
| 2023 Enero | 0 | 2 | 2 |
| 2022 Diciembre | 0 | 10 | 10 |
| 2022 Noviembre | 0 | 2 | 2 |
| 2022 Octubre | 0 | 3 | 3 |
| 2022 Septiembre | 0 | 15 | 15 |
| 2022 Agosto | 0 | 21 | 21 |
| 2022 Julio | 0 | 2 | 2 |
| 2022 Junio | 0 | 6 | 6 |
| 2022 Mayo | 0 | 9 | 9 |
| 2022 Abril | 0 | 6 | 6 |
| 2022 Marzo | 0 | 7 | 7 |
| 2021 Diciembre | 0 | 7 | 7 |
| 2021 Noviembre | 0 | 5 | 5 |
| 2021 Octubre | 0 | 2 | 2 |
| 2021 Septiembre | 0 | 4 | 4 |
| 2021 Agosto | 0 | 1 | 1 |
| 2021 Julio | 0 | 4 | 4 |
| 2021 Junio | 0 | 1 | 1 |
| 2021 Mayo | 0 | 3 | 3 |
| 2021 Abril | 0 | 4 | 4 |
| 2021 Marzo | 0 | 1 | 1 |
| 2021 Febrero | 0 | 3 | 3 |
| 2021 Enero | 0 | 5 | 5 |
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| 2020 Noviembre | 0 | 3 | 3 |
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| 2020 Mayo | 0 | 5 | 5 |
| 2020 Abril | 0 | 2 | 2 |
| 2020 Marzo | 0 | 7 | 7 |
| 2020 Febrero | 0 | 3 | 3 |
| 2020 Enero | 0 | 16 | 16 |
| 2019 Diciembre | 1 | 20 | 21 |
| 2019 Noviembre | 0 | 3 | 3 |
| 2019 Octubre | 0 | 4 | 4 |
| 2019 Septiembre | 0 | 12 | 12 |
| 2019 Agosto | 0 | 3 | 3 |
| 2019 Julio | 0 | 10 | 10 |
| 2019 Junio | 0 | 14 | 14 |
| 2019 Mayo | 0 | 50 | 50 |
| 2019 Abril | 0 | 24 | 24 |
| 2019 Marzo | 0 | 4 | 4 |
| 2019 Febrero | 0 | 9 | 9 |
| 2019 Enero | 0 | 3 | 3 |
| 2018 Diciembre | 0 | 10 | 10 |
| 2018 Noviembre | 0 | 15 | 15 |
| 2018 Octubre | 0 | 13 | 13 |
| 2018 Septiembre | 0 | 2 | 2 |
| 2018 Agosto | 0 | 4 | 4 |
| 2018 Julio | 0 | 4 | 4 |
| 2018 Junio | 0 | 2 | 2 |
| 2018 Enero | 0 | 1 | 1 |
| 2017 Diciembre | 0 | 2 | 2 |
| 2017 Noviembre | 4 | 3 | 7 |
| 2017 Octubre | 4 | 14 | 18 |
| 2017 Septiembre | 5 | 12 | 17 |
| 2017 Agosto | 10 | 8 | 18 |
| 2017 Julio | 5 | 2 | 7 |
| 2017 Junio | 10 | 20 | 30 |
| 2017 Mayo | 7 | 5 | 12 |
| 2017 Abril | 15 | 11 | 26 |
| 2017 Marzo | 21 | 21 | 42 |
| 2017 Febrero | 3 | 3 | 6 |
| 2017 Enero | 2 | 3 | 5 |
| 2016 Diciembre | 13 | 3 | 16 |
| 2016 Noviembre | 21 | 4 | 25 |
| 2016 Octubre | 25 | 10 | 35 |
| 2016 Septiembre | 9 | 8 | 17 |
| 2016 Agosto | 10 | 7 | 17 |
| 2016 Julio | 12 | 2 | 14 |
| 2016 Junio | 15 | 12 | 27 |
| 2016 Mayo | 14 | 25 | 39 |
| 2016 Abril | 19 | 21 | 40 |
| 2016 Marzo | 15 | 27 | 42 |
| 2016 Febrero | 12 | 33 | 45 |
| 2016 Enero | 25 | 23 | 48 |
| 2015 Diciembre | 12 | 16 | 28 |
| 2015 Noviembre | 10 | 2 | 12 |
| 2015 Octubre | 16 | 11 | 27 |
| 2015 Septiembre | 7 | 9 | 16 |
| 2015 Agosto | 11 | 9 | 20 |
| 2015 Julio | 9 | 3 | 12 |
| 2015 Junio | 4 | 0 | 4 |
| 2015 Mayo | 11 | 8 | 19 |
| 2015 Abril | 11 | 7 | 18 |
| 2015 Marzo | 7 | 2 | 9 |
| 2015 Febrero | 5 | 2 | 7 |
| 2015 Enero | 12 | 7 | 19 |
| 2014 Diciembre | 6 | 8 | 14 |
| 2014 Noviembre | 9 | 1 | 10 |
| 2014 Octubre | 20 | 6 | 26 |
| 2014 Septiembre | 14 | 1 | 15 |
| 2014 Agosto | 13 | 3 | 16 |
| 2014 Julio | 15 | 2 | 17 |
| 2014 Junio | 7 | 6 | 13 |
| 2014 Mayo | 2 | 2 | 4 |
| 2014 Abril | 5 | 4 | 9 |
| 2014 Marzo | 8 | 2 | 10 |
| 2014 Febrero | 8 | 5 | 13 |
| 2014 Enero | 3 | 1 | 4 |
| 2013 Diciembre | 6 | 2 | 8 |
| 2013 Noviembre | 9 | 3 | 12 |
| 2013 Octubre | 6 | 3 | 9 |
| 2013 Septiembre | 9 | 7 | 16 |
| 2013 Agosto | 8 | 3 | 11 |
| 2013 Julio | 2 | 2 | 4 |
| 2009 Marzo | 347 | 0 | 347 |
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