Publication: Diseño de un esquema de seguimiento según el riesgo de recidiva en pacientes con cáncer de riñón tratados con cirugía
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2021-07-15
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Universidad Complutense de Madrid
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Abstract
El carcinoma de células renales (CCR) representa el 2-3% de todas las neoplasias, con un aumento progresivo de su incidencia en los últimos años a nivel mundial. Más de 300.000 pacientes son diagnosticados anualmente de cáncer renal, en parte por el desarrollo de técnicas de imagen como la ecografía o la tomografía, que han hecho que estos tumores sean diagnosticados cada vez en estadios más localizados. El tratamiento quirúrgico sigue siendo el estándar de tratamiento en tumores renales no metastásicos; la guía clínica de la European Association of Urology (EAU) recomienda en la actualidad la nefrectomía parcial laparoscópica o abierta en los estadios cT1 y la nefrectomía radical en los cT2 no tratables con nefrectomía parcial.
El seguimiento es crucial para detectar recurrencia; sin embargo, no existe un esquema de seguimiento establecido según el riesgo de recidiva de los pacientes. De tal modo que existe variabilidad a la hora del seguimiento presentando las recomendaciones de las guías clínicas un bajo nivel de evidencia científica. Nuestro objetivo es diseñar un esquema de seguimiento basado en variables patológicas según el riesgo de recidiva en los pacientes con CCR cT1-4 cN0-1 cM0 tratados con cirugía. Como objetivos secundarios establecemos evaluar el patrón de recidiva en estos pacientes e identificar las variables pronósticas patológicas relacionadas con la recidiva tumoral...
Renal cell carcinoma (RCC) represent 2-3% of all malignancies, with a progressive increase in its incidence worldwide. More than 300,000 patients are diagnosed annually, in part due to the development of imaging techniques such ultrasound or tomography, which have led to these tumors being increasingly diagnosed in more localized stages. Surgical treatment is the standard of treatment for non-metastatic kidney tumors; The European Association of Urology (EAU) recommend laparoscopic or open partial nephrectomy in stages cT1 and radical nephrectomy in cT2 not treatable with partial nephrectomy. Follow-up is crucial to detect recurrence; however, there is no consensus on the follow-up protocol after nephrectomy. Thus, there is variability at the time of follow-up, and the recommendations of the clinical guidelines presenting a low level of scientific evidence. Our aim is to design a follow-up protocol based on pathological variables according to the risk of recurrence. As secondary objectives, are to establish recurrence pattern and to identify pathological prognostic variables related to recurrence...
Renal cell carcinoma (RCC) represent 2-3% of all malignancies, with a progressive increase in its incidence worldwide. More than 300,000 patients are diagnosed annually, in part due to the development of imaging techniques such ultrasound or tomography, which have led to these tumors being increasingly diagnosed in more localized stages. Surgical treatment is the standard of treatment for non-metastatic kidney tumors; The European Association of Urology (EAU) recommend laparoscopic or open partial nephrectomy in stages cT1 and radical nephrectomy in cT2 not treatable with partial nephrectomy. Follow-up is crucial to detect recurrence; however, there is no consensus on the follow-up protocol after nephrectomy. Thus, there is variability at the time of follow-up, and the recommendations of the clinical guidelines presenting a low level of scientific evidence. Our aim is to design a follow-up protocol based on pathological variables according to the risk of recurrence. As secondary objectives, are to establish recurrence pattern and to identify pathological prognostic variables related to recurrence...
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Tesis inédita de la Universidad Complutense de Madrid, Facultad de Medicina, Departamento de Cirugía, leída el 05/03/2021