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Factores pronósticos en seminoma / Prognostic factors in seminoma
Neciosup Delgado, Silvia Patricia.
  • Neciosup Delgado, Silvia Patricia; Instituto Nacional de Enfermedades Neoplásicas. Lima. PE
Acta cancerol ; 36(1): 25-28, dic. 2008. tab, graf
Artigo em Espanhol | LILACS, LIPECS | ID: lil-673594
RESUMEN
Pacientes y

métodos:

Se revisaron 714 pacientes con Seminoma diagnosticados en el INEN (1990-2005). Se describe, las características clínicas, respuesta al tratamiento, seguimiento y sobrevida.

Resultados:

La mediana de edad fue 33 años (rango 15-80). El sitio primario de presentación fue testicular (97.2%), mediastinal (2.2%), RTP (0,6%). El (54%) fue ECI, (26.6%) EC II, (15.8%) ECIII. Los sitios de compromiso de enfermedad fueron RTP (12%), Supraclavicular (6%). Mediastinal (4.6%). Pulmonar (4.2%), hepática (2.4%). La calificación de riesgo fue 83% BR, 17% RI. La mediana de seguimiento fue 65 meses. Los pacientes con EC I que recibieron RT la Sobrevida Global (SG) a los 5 y 10 años fue de 99% y 98% frente a 85% en pacientes que sólo fueron observados. En pacientes EC II-III que recibieron quimioterapia, la SGa los 5 y 10 años fue en BR 98% y 86%, en RI 73% y 72%. Los factores pronóstico para la SG fueron Edad > 50 años (p=0.023, RR=2.8), EC II (p <0.001 RR=19.3). EC III (p<0.001, RR=54.0), metástasis hepática (p=0.025, RR=3).

Conclusión:

La sobrevida de nuestro grupo de pacientes estuvo en relación a los factores pronósticos edad, EC y metástasis hepática. La calificación del riesgo no fue factor pronóstico. Es necesario estudios que incluyan la biología molecular del tumor y análisis genéticos para identificar factores pronósticos y crear dianas terapéuticas según clasificación molecular.
ABSTRACT

Purpose:

To determine the prognostic factors and to assess the relationship between selected pretreatment characteristics and survival in patients with seminoma. Patients and

methods:

714 patients with seminoma diagnosed at INEN, Lima-Peru from 1990 to 2005 and were the subjects of the study. We describe the clinic behavior, response to treatment, follow up and survival. The overall patterns were compared in relation to clinical characteristics with Logrank/Breslow test. We identified the prognostic factor through the Cox model. The statistical evaluation was performed with 5% significance level. The results were processed with SPSS v. 12.0 program.

Results:

The median age was 33 years (15-80y). The presentation the primary site was testicular (97,2%), mediastinum (2,2%) and retroperitoneum (0,6%). 54.6% of them were CS I, 29,6% CS II, 15,8% CS III. The involved sites were lungs (4,2%), liver (2,4%) and Central Nervous System (0,6%). According to the IGCCCG risk classification, 83% were low risk (LR) and 17% intermediate risk (IR). The median follow up was 65 months. The patients with CS I, who received para-aortic radiotherapy (RT), had overall survival (OS) at 10 years of 98% in relation to 85% in patients with observation (p=<0.001). In CS II-III patients who received chemotherapy (CT), the OS at 5 and 10 years were 98% and 86% in LR, 73% and 72% in IR respectively. The prognostic factors for the OS were age > 50 years (p=0.023, RR=2,8), CS II (p<0.001, RR=54.0) and liver metastasis (p=0.025, RR=3).

Conclusions:

In our study the survival was related with prognostic factor such as age, clinical stage and liver metastasis. The risk qualification was not prognostic factor in our population. We observe that in CS I, radiotherapy was significant in relation to observation in survival. Further studies of tumor biology, including genetic analysis are required to identify other parameters that may correlate with survival.
Assuntos
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Índice: LILACS (Américas) Assunto principal: Prognóstico / Seminoma Tipo de estudo: Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Adolescente / Adulto / Idoso / Aged80 / Feminino / Humanos / Masculino Idioma: Espanhol Revista: Acta cancerol Ano de publicação: 2008 Tipo de documento: Artigo Instituição/País de afiliação: Instituto Nacional de Enfermedades Neoplásicas/PE

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Índice: LILACS (Américas) Assunto principal: Prognóstico / Seminoma Tipo de estudo: Estudo observacional / Estudo prognóstico / Fatores de risco Limite: Adolescente / Adulto / Idoso / Aged80 / Feminino / Humanos / Masculino Idioma: Espanhol Revista: Acta cancerol Ano de publicação: 2008 Tipo de documento: Artigo Instituição/País de afiliação: Instituto Nacional de Enfermedades Neoplásicas/PE