Estudio correlacional de derrame pleural maligno y la supervivencia en cancer de mama
Fecha
2022
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Universidad de Guayaquil. Facultad de Ciencias Médicas. Escuela de Graduados
Resumen
El cáncer de mama es una neoplasia heterogénea que en estadios avanzados presenta
múltiples complicaciones, entre ellas el derrame pleural maligno, manifestándose con
disnea, lo cual afecta el pronóstico y la supervivencia del paciente, se desconoce en
nuestro país la supervivencia de estos pacientes. Objetivo: Determinar el pronóstico del
derrame pleural maligno en pacientes con Cáncer de mama atendidos en el Hospital
Juan Tanca Marengo SOLCA. Diseño: descriptivo- correlacional de cohorte transversal.
Se incluyeron a las pacientes con cáncer de mama que desarrollaron derrame pleural
maligno durante el periodo 2015-2021. Resultados: Se incluyeron a 104 pacientes para
el estudio, en el cual el 16.3 % de pacientes desarrollaron derrame pleural maligno en el
rango de edad de 50-55 años, 51 pacientes tuvieron una supervivencia menor a un mes,
LDH (lactato deshidrogenasa) de líquido pleural 42 pacientes tuvieron un valor mayor a
1500U/L considerándose de mal pronóstico. En la escala LENT 24 pacientes se
clasificaron de alto riesgo y 27 pacientes con riesgo moderado. De acuerdo al subtipo
molecular 18 pacientes con cáncer de mama triple negativo tuvieron una supervivencia
menor a un mes. En relación a la puntación ECOG, 36 pacientes tenían grado 2 y
solamente 31 pacientes tuvieron un valor de la relación sérica neutrófilos-linfocitos menor
a 9, considerada de mejor pronóstico. Conclusión: Según la puntuación LENT con un
riesgo moderado solamente un cuarto de pacientes vivió menos de un mes. Estos
hallazgos destacan la necesidad de emplear escalas pronósticas de supervivencia para
enfocar una terapéutica paliativa óptima.
Breast cancer is a heterogeneous neoplasm that in advanced stages presents multiple complications, among them malignant pleural effusion, manifesting itself with dyspnea, which affects the patient's prognosis and survival, the survival of these patients is unknown in our country. Objective: To determine the prognosis of malignant pleural effusion in patients with breast cancer treated at the Juan Tanca Marengo SOLCA Hospital. Design: descriptive-correlational cross-sectional cohort. Patients with breast cancer who developed malignant pleural effusion during the period 2015-2021 were included. Results: 104 patients were included for the study, in which 16.3 % of patients developed malignant pleural effusion in the age range of 50-55 years, 51 patients had a survival of less than one month, LDH (lactate dehydrogenase) of pleural fluid 42 patients had a value greater than 1500U/L being considered of poor prognosis. In the LENT scale 24 patients were classified as high risk and 27 patients as moderate risk. According to the molecular subtype 18 patients with triple negative breast cancer had a survival of less than one month. In relation to the ECOG score, 36 patients had grade 2 and only 31 patients had a serum neutrophil-lymphocyte ratio value of less than 9, considered to have a better prognosis. Conclusion: According to the LENT score with a moderate risk on ly a quarter of patients lived less than one month. These findings highlight the need to use prognostic survival scales for optimal palliative therapy.
Breast cancer is a heterogeneous neoplasm that in advanced stages presents multiple complications, among them malignant pleural effusion, manifesting itself with dyspnea, which affects the patient's prognosis and survival, the survival of these patients is unknown in our country. Objective: To determine the prognosis of malignant pleural effusion in patients with breast cancer treated at the Juan Tanca Marengo SOLCA Hospital. Design: descriptive-correlational cross-sectional cohort. Patients with breast cancer who developed malignant pleural effusion during the period 2015-2021 were included. Results: 104 patients were included for the study, in which 16.3 % of patients developed malignant pleural effusion in the age range of 50-55 years, 51 patients had a survival of less than one month, LDH (lactate dehydrogenase) of pleural fluid 42 patients had a value greater than 1500U/L being considered of poor prognosis. In the LENT scale 24 patients were classified as high risk and 27 patients as moderate risk. According to the molecular subtype 18 patients with triple negative breast cancer had a survival of less than one month. In relation to the ECOG score, 36 patients had grade 2 and only 31 patients had a serum neutrophil-lymphocyte ratio value of less than 9, considered to have a better prognosis. Conclusion: According to the LENT score with a moderate risk on ly a quarter of patients lived less than one month. These findings highlight the need to use prognostic survival scales for optimal palliative therapy.
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Neoplasias de la mama, Derrame pleural, Supervivencia, Hospital Solca de Guayaquil, Cantón Guayaquil, Ecuador