Valor pronóstico de la diseminación tumoral a través de espacios aéreos (STAS) en los pacientes llevados a metastasectomía pulmonar por adenocarcinoma colorrectal en el Instituto Nacional de Cancerologia

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dc.contributor.advisorToledo Arenas, José Daniel
dc.contributor.authorSalcedo Miranda, Diego Fernando
dc.contributor.authorParra-Medina, Rafael
dc.contributor.authorCarvajal Fierro, Carlos Andres
dc.contributor.orcidSalcedo Miranda, Diego Fernando [0000-0003-2663-3626]
dc.contributor.orcidParra-Medina, Rafael [0000-0002-8428-5837]
dc.contributor.orcidCarvajal Fierro, Carlos Andres [0000-0001-5915-0052]
dc.date.accessioned2024-07-30T16:21:52Z
dc.date.available2024-07-30T16:21:52Z
dc.date.issued2024-07
dc.description.abstractDescribir el valor pronostico del STAS en la supervivencia global (SG) y supervivencia libre de progresión (SLP) en pacientes sometidos a metastasectomía pulmonar con cáncer colorrectal (CCR) entre 2007 y 2023. Materiales y métodos: estudio analítico retrospectivo. Resultados: Se incluyeron setenta y dos pacientes, 50% eran mujeres y la mediana de edad fue 62.9 años. 42 pacientes (58.3%) fueron STAS positivo y 11,1% tenían ausencia de necrosis en la histología. La mediana del tiempo de seguimiento después de la primera metastasectomía fue de 31.9 meses (RIC=45.5–19.2). La SG y SLP a 5 años para toda la cohorte fue de 28.1% (IC95%:[17.8; 44.1]) y 21.1% (IC95%:[12.2; 36.6]), respectivamente. La SG a 5 años de los pacientes STAS+ fue de 20.4% (IC95%:[10.1; 41.0]) y 44.5% (IC95%:[27.6; 71.7]) para los STAS- (p=0,24). La SLP a 5 años fue del 10.4 % (IC95%:[3.69; 29.1]) STAS+ y del 40.7 % (IC95%:[24.8; 66.8]) para STAS- (p=0.053). En el análisis multivariado, mutación en el gen KRAS, bilateralidad, ACE elevado posterior a la metastasectomía y la ausencia de necrosis fueron variables independientes de peor SG. Por otro lado, las mujeres, STAS+, ACE elevado posterior a la metastasectomía y la ausencia de necrosis fueron variables independientes de peor SLP. Conclusiones: Los pacientes STAS+ no se asociaron con una peor SG, pero se encontró que los factores asociados con una peor SLP fueron ser mujer, STAS+, ACE elevado posterior a la metastasectomía y la ausencia de necrosis en la histología de la metástasis.
dc.description.abstractenglishTo describe the prognostic value of STAS in overall survival (OS) and progression-free survival (PFS) in patients undergoing lung metastasectomy with colorectal cancer (CRC) between 2007 and 2023. Materials and methods: retrospective analytical study.Results: Seventy-two patients were included, 50% were women and the median age was 62.9 years. 42 patients (58.3%) were STAS positive and 11.1% had absence of necrosis on histology. The median follow-up time after the first metastasectomy was 31.9 months (IQR=45.5–19.2). The 5-year OS and PFS for the entire cohort were 28.1% (95%CI:[17.8, 44.1]) and 21.1% (95%CI:[12.2, 36.6]), respectively. The 5-year OS for STAS+ patients was 20.4% (95%CI:[10.1, 41.0]) and 44.5% (95%CI:[27.6, 71.7]) for STAS- (p=0.24). The 5-year PFS was 10.4% (95%CI:[3.69, 29.1]) for STAS+ and 40.7% (95%CI:[24.8, 66.8]) for STAS- (p=0.053). In the multivariate analysis, mutation in the KRAS gene, bilaterality, elevated ACE after metastasectomy and the absence of necrosis were independent variables of worse OS. On the other hand, women, STAS+, elevated ACE after metastasectomy, and absence of necrosis were independent variables of worse PFS. Conclusions: STAS+ patients were not associated with worse OS, but the factors associated with worse PFS were female, STAS+, elevated ACE post-metastasectomy, and absence of necrosis on metastasis histology.
dc.description.degreelevelEspecializaciónspa
dc.description.degreenameEspecialista en Cirugía del Tóraxspa
dc.description.sponsorshipInstituto Nacional de Cancerologia
dc.format.mimetypeapplication/pdf
dc.identifier.instnameinstname:Universidad El Bosquespa
dc.identifier.reponamereponame:Repositorio Institucional Universidad El Bosquespa
dc.identifier.repourlrepourl:https://repositorio.unbosque.edu.co
dc.identifier.urihttps://hdl.handle.net/20.500.12495/12767
dc.language.isoes
dc.publisher.facultyFacultad de Medicinaspa
dc.publisher.grantorUniversidad El Bosquespa
dc.publisher.programEspecialización en Cirugía del Tóraxspa
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dc.rightsAtribución-NoComercial-CompartirIgual 4.0 Internacionalen
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.accessrightsinfo:eu-repo/semantics/openAccess
dc.rights.localAcceso abiertospa
dc.rights.urihttp://creativecommons.org/licenses/by-nc-sa/4.0/
dc.subjectNeoplasias pulmonares
dc.subjectDiseminación a través de espacios aéreos (STAS)
dc.subjectRecurrencia local de neoplasia
dc.subjectNeoplasias colorrectales
dc.subjectMetastasectomía pulmonar
dc.subject.keywordsPulmonary neoplasms
dc.subject.keywordsDissemination through airspace (STAS)
dc.subject.keywordsLocal Recurrence of neoplasia
dc.subject.keywordsColorectal neoplasms
dc.subject.keywordsPulmonary metastasectomy
dc.subject.nlmWF 980
dc.titleValor pronóstico de la diseminación tumoral a través de espacios aéreos (STAS) en los pacientes llevados a metastasectomía pulmonar por adenocarcinoma colorrectal en el Instituto Nacional de Cancerologia
dc.title.translatedPrognostic value of tumor spread through air spaces (STAS) in patients undergoing pulmonary metastasectomy for colorectal adenocarcinoma at National Cancer Institute
dc.type.coarhttps://purl.org/coar/resource_type/c_7a1f
dc.type.coarversionhttps://purl.org/coar/version/c_ab4af688f83e57aa
dc.type.driverinfo:eu-repo/semantics/bachelorThesis
dc.type.hasversioninfo:eu-repo/semantics/acceptedVersion
dc.type.localTesis/Trabajo de grado - Monografía - Especializaciónspa

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