Caracterización de los pacientes con tumores de células germinales testiculares llevados a metastasectomía pulmonar: experiencia de un centro oncológico
DOI:
https://doi.org/10.35509/01239015.1123Palabras clave:
neoplasias testiculares, neoplasias pulmonares, metastasectomía, medición de riesgo, pronóstico, tasa de supervivenciaResumen
Objetivo: los tumores de células germinales (TCG) testiculares son la principal causa de cáncer en hombres con edades de 15 a 45 años. El tratamiento comprende la orquiectomía radical y, en pacientes con tumores metastásicos, se da manejo adyuvante con quimioterapia basada en platino. Se ha reportado enfermedad residual pulmonar posterior a la primera línea de quimioterapia en el 25,0 % de los casos, en los que la metastasectomía pulmonar es esencial para excluir actividad residual tumoral. El objetivo de este estudio consistió en describir los desenlaces clínicos de los pacientes con TCG testiculares llevados a metastasectomía pulmonar entre 2010 y 2023, tras recibir quimioterapia adyuvante, en el Instituto Nacional de Cancerología (INC) de Colombia.
Métodos: se realizó un estudio descriptivo, longitudinal, retrospectivo. Se describieron las tendencias en la supervivencia global (SG) y en la supervivencia libre de progresión (SLP) según algunas características de relevancia clínica en estos pacientes.
Resultados: se incluyeron 19 pacientes. A los 24 meses, la SG fue del 89,2 %, y la SLP fue del 63,6 %. Las mayores estimaciones de SG y SLP se observaron en pacientes con enfermedad metastásica pulmonar al momento del diagnóstico; además, se obtuvieron estimaciones altas de SG en aquellos con clasificación pronóstica de bajo riesgo según el Grupo Colaborativo Internacional sobre Cáncer de Células Germinales (IGCCCG) y de SLP en pacientes con hallazgo histopatológico de ausencia de viabilidad tumoral en la resección pulmonar posterior a la quimioterapia.
Conclusiones: la metastasectomía pulmonar constituye una alternativa terapéutica relevante en pacientes con TCG testiculares y enfermedad pulmonar residual tras quimioterapia. En esta cohorte se observaron resultados favorables de supervivencia, especialmente en pacientes con características clínicas e histopatológicas que otros estudios han vinculado con un mejor pronóstico.
Biografía del autor/a
Catalina Castañeda-Motta, Especialista en entrenamiento de la Especialización en Cirugía de Tórax, convenio Universidad El Bosque - Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
1. Especialista en entrenamiento de la Especialización en Cirugía de Tórax, convenio Universidad El Bosque - Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
Rafael José Beltrán-Jiménez, Tórax, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
2. Tórax, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
Fernando Alvarado-Sarzosa, Tórax, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
2. Tórax, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
Miguel Ricardo Buitrago-Ramírez, Tórax, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
2. Tórax, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
Marino Cabrera-Fierro, Urología, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
3. Urología, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
4. Unidad Funcional Clínica de Urología Oncológica, Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo (CTIC), Bogotá, D. C., Colombia.
Ricardo Elías Bruges-Maya, Oncología, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
5. Oncología, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
Marcela Nuñez-Lemus, Apoyo Integral a la Gestión de la Información, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
6. Apoyo Integral a la Gestión de la Información, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
Carlos Andrés Carvajal-Fierro, Tórax, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
2. Tórax, Instituto Nacional de Cancerología, Bogotá, D. C., Colombia.
7. Unidad Funcional Clínica de Oncología Torácica, Centro de Tratamiento e Investigación sobre Cáncer Luis Carlos Sarmiento Angulo (CTIC), Bogotá, D. C., Colombia.
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