Factores clínicopatológicos y supervivencia de pacientes con adenocarcinoma gástrico sometidos a tratamiento oncoespecífico
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2018
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
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Problema: El cáncer gástrico es una de las neoplasias malignas comunes a nivel mundial, corresponde a la tercera causa de mortalidad más alta por cáncer a nivel mundial y es una patología diagnosticada en etapas avanzadas. La supervivencia en esta neoplasia es poco satisfactoria, y no se ha investigado en la población ecuatoriana que factores pudiesen influir en la misma, sobre todo los factores clínico-patológicos que se recaban en las piezas resultantes de las intervenciones quirúrgicas realizadas con o sin quimioterapia previa. Objetivos: Determinar la influencia existente entre los factores clínicopatológicos en la supervivencia de los pacientes con adenocarcinoma gástrico gástrico sometidos a tratamiento oncoespecífico. Metodología: Estudio cuantitativo, retrospectivo, transversal, en los pacientes que han presentado diagnóstico de adenocarcinoma gástrico desde enero 2011 a diciembre 2017 en el Hospital Teodoro Maldonado Carbo. Resultados: De un universo de 1760 pacientes se estimó una muestra de 129 pacientes. La sobrevida global de la población fue del 53.9%, con una mediana de supervivencia de 24.3 meses. Al contrastar cada una de las características demográficas, clínicas, histopatológicas y de estadio clínico versus desenlace, el análisis univariado reveló una relación estadísticamente significativa tanto en edad [HR 0.528 (0.345 - 0.809; 0.003)] y sitio de tumor [HR 0.682 (0.446 - 1.041; 0.076)]. Esta tendencia se mantuvo en el análisis multivariado: HR 0.477 (0.308 - 0.740; <0.001) y 0.596 (0.390 - 0.911; 0.017), respectivamente. Conclusión: La edad avanzada y la localización distal del tumor son los factores clínico-patológicos asociados a mejor supervivencia, estos podrían ser considerados en el momento de seleccionar la agresividad del régimen terapéutico en quienes no presenten estas características.
Problem: Gastric cancer is one of the malignant neoplasms common worldwide, it corresponds to the third highest cause of cancer mortality worldwide and is a pathology diagnosed in advanced stages. Survival in this pathology is unsatisfactory, and it has not been investigated in our population which factors could influence on it, especially the clinicopathological factors that are collected in the pieces resulting from surgical interventions performed with or without prior chemotherapy. Objectives: To determine the existing influence between the clinicopathological factors in the survival of patients with gastric cancer undergoing onco-specific treatment. Methodology: Transversal, retrospective quantitative study in patients who have presented a diagnosis of gastric adenocarcinoma since January 2011 to December 2017 at Teodoro Maldonado Carbo Hospital. Results: A sample of 129 patients was estimated from a universe of 1760 patients. The overall survival of the population was 53.9%, with a median survival of 24.3 months. By contrasting each of the demographic, clinical, histopathological, and clinical stage versus outcome, the univariate analysis revealed a statistically significant relationship in both age [HR 0.528 (0.345 - 0.809; 0.003)] and tumor site [HR 0.682 (0.446 - 1.041; 0.076)]. This trend was maintained in the multivariate analysis: HR 0.477 (0.308 - 0.740; <0.001) and 0.596 (0.390 - 0.911; 0.017), respectively. Conclusion: The advanced age and distal location of the tumor are the clinicopathological factors associated with better survival, these could be considered at the time of selecting the aggressiveness of the therapeutic regimen in those who don´t have these features
Problem: Gastric cancer is one of the malignant neoplasms common worldwide, it corresponds to the third highest cause of cancer mortality worldwide and is a pathology diagnosed in advanced stages. Survival in this pathology is unsatisfactory, and it has not been investigated in our population which factors could influence on it, especially the clinicopathological factors that are collected in the pieces resulting from surgical interventions performed with or without prior chemotherapy. Objectives: To determine the existing influence between the clinicopathological factors in the survival of patients with gastric cancer undergoing onco-specific treatment. Methodology: Transversal, retrospective quantitative study in patients who have presented a diagnosis of gastric adenocarcinoma since January 2011 to December 2017 at Teodoro Maldonado Carbo Hospital. Results: A sample of 129 patients was estimated from a universe of 1760 patients. The overall survival of the population was 53.9%, with a median survival of 24.3 months. By contrasting each of the demographic, clinical, histopathological, and clinical stage versus outcome, the univariate analysis revealed a statistically significant relationship in both age [HR 0.528 (0.345 - 0.809; 0.003)] and tumor site [HR 0.682 (0.446 - 1.041; 0.076)]. This trend was maintained in the multivariate analysis: HR 0.477 (0.308 - 0.740; <0.001) and 0.596 (0.390 - 0.911; 0.017), respectively. Conclusion: The advanced age and distal location of the tumor are the clinicopathological factors associated with better survival, these could be considered at the time of selecting the aggressiveness of the therapeutic regimen in those who don´t have these features
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Neoplasias gástricas, Factores clínicos-patológicos, Supervivencia, Oncología médica, Estudios retrsopectivos, Hospital de Especialidades Dr. Teodoro Maldonado Carbo, Cantón Guayaquil, Ecuador