Asunto(s)
Neoplasias de Cabeza y Cuello/mortalidad , Neoplasias de Cabeza y Cuello/patología , Melanoma/mortalidad , Melanoma/patología , Neoplasias Cutáneas/mortalidad , Neoplasias Cutáneas/patología , Adulto , Anciano , Estudios Transversales , Supervivencia sin Enfermedad , Femenino , Neoplasias de Cabeza y Cuello/terapia , Humanos , Masculino , Melanoma/terapia , Persona de Mediana Edad , Membrana Mucosa , Estadificación de Neoplasias , Estudios Retrospectivos , Neoplasias Cutáneas/terapia , Tasa de Supervivencia , Melanoma Cutáneo MalignoAsunto(s)
Neoplasias Laríngeas/cirugía , Sarcoma/cirugía , Adulto , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Supervivencia sin Enfermedad , Femenino , Humanos , Neoplasias Laríngeas/mortalidad , Neoplasias Laríngeas/patología , Masculino , México , Persona de Mediana Edad , Sarcoma/mortalidad , Sarcoma/patología , Tasa de Supervivencia , Resultado del Tratamiento , Adulto JovenRESUMEN
BACKGROUND: This study was performed to define prognostic factors and management of minor salivary gland carcinoma of the oral cavity and oropharynx . METHODS: Retrospective analyses of patients with salivary gland carcinoma of the oral cavity or oropharynx, treated in 1989 to 2006. Statistics included univariate analyses to identify prognostic factors associated with disease-free survival (DFS) and disease-specific survival. A multivariate analysis model was constructed by the Cox method. RESULTS: Seventy-seven patients constituted our cohort. Significant prognostic factors regarding DFS and disease-specific survival in univariate analyses comprised tumor size, surgical margins, grade, lymph node status, and Karnofsky status and T classification. A multivariate model identified tumor size, grade, surgical margins, and lymph node status significant regarding DFS. CONCLUSIONS: Tumor size, grade, surgical margins, and lymph node status could be used for a rational design of treatment strategies in these rare tumors.
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Carcinoma/mortalidad , Neoplasias de la Boca/mortalidad , Neoplasias Orofaríngeas/mortalidad , Neoplasias de las Glándulas Salivales/mortalidad , Glándulas Salivales Menores/patología , Adolescente , Adulto , Anciano , Anciano de 80 o más Años , Carcinoma/patología , Carcinoma/terapia , Supervivencia sin Enfermedad , Femenino , Humanos , Ganglios Linfáticos/patología , Metástasis Linfática , Masculino , Persona de Mediana Edad , Neoplasias de la Boca/patología , Neoplasias de la Boca/terapia , Análisis Multivariante , Clasificación del Tumor , Neoplasias Orofaríngeas/patología , Neoplasias Orofaríngeas/terapia , Pronóstico , Radioterapia Adyuvante , Estudios Retrospectivos , Neoplasias de las Glándulas Salivales/patología , Neoplasias de las Glándulas Salivales/terapia , Glándulas Salivales Menores/cirugía , Adulto JovenRESUMEN
INTRODUCTION: Malignant sinonasal tumors are very rare in Mexico. They ussually present as advanced disease because it is extremely difficult to make an early diagnosis; in addition, its treatment is complicated by a variety of lesions. Surgical resection remains the mainstay of treatment, but its relative therapeutic value compared with alternative treatments is controversial. OBJECTIVE: We undertook a retrospective analysis in order to evaluate results of craniofacial resections for sinonasal tumors. MATERIALS AND METHODS: A total of 20 patients, 11 men and 9 women were considered, median age was 49 years (18-74). Eleven had received previous treatment elsewhere. In 13 patients tumor was limited to maxillo-ethmoid complex, but in 6 cases tumor involved anteroinferior aspect of sphenoid sinus, in 7 extended to the orbit, in 3 to dura and two to the brain. One had cervical metastases. Median tumoral size was 5.8 cm (1-10). RESULTS: Overall complication rate was 50%. Major surgical complications occurred in 4 patients (20%): one patient developed isolated cerebrospinal fluid leakage (CEFL), 1 developed deterioration of mental status, and two developed meningitis associated with CEFL. Late complications occurred in 30% of the patients. There was not any operative death. Eleven patients received postoperative radiotherapy. Fifteen patients recurred. There were 11 local relapses, although one associated with a regional relapse, and another with regional and distant relapse. There were four isolated regional fails and six isolated distant failures. Three year overall survival was 65%, and 3-year disease free survival was 50%. Patients without previous treatment median survival was 28.3 months, meanwhile with previous treatment was 18.2 months. CONCLUSIONS: Craniofacial resection is a safe and valuable tool in the treatment of advanced sinonasal tumors involving cranial base.
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Neoplasias Nasales/cirugía , Neoplasias de los Senos Paranasales/cirugía , Adolescente , Adulto , Anciano , Neoplasias Encefálicas/secundario , Neoplasias Encefálicas/cirugía , Terapia Combinada , Duramadre/cirugía , Senos Etmoidales/cirugía , Femenino , Humanos , Masculino , Neoplasias del Seno Maxilar/cirugía , Neoplasias Meníngeas/secundario , Neoplasias Meníngeas/cirugía , Persona de Mediana Edad , Metástasis de la Neoplasia , Recurrencia Local de Neoplasia , Neoplasias Nasales/radioterapia , Neoplasias Orbitales/secundario , Neoplasias Orbitales/cirugía , Neoplasias de los Senos Paranasales/radioterapia , Radioterapia Adyuvante , Estudios Retrospectivos , Terapia Recuperativa , Seno Esfenoidal/cirugía , Análisis de Supervivencia , Tasa de Supervivencia , Resultado del TratamientoRESUMEN
Previous reports suggest that morbidity and mortality post acute myocardial infarction (AMI) are increased in patients with non-insulin-dependent diabetes (NIDDM). To obtain information in our population related to the prognosis after an AMI in diabetic patients and its major determinants, we studied 96 NIDDM patients admitted consecutively with a diagnosis of AMI. We used a control group (CG) of age and sex matched non-diabetic individuals. Patients with NIDDM had more frequently a history of angina (40 vs 23%, p < 0.001) and previous MI (30 vs 15%, p < 0.05). The AMI localization and extension, and the presence of arrhythmias were similar for both groups. Early mortality after the AMI was 22% in the NIDDM group and 12% in the CG with Odds ratio of 1.9 (CI 95% 0.91-5.15), being higher in diabetic females [2.3 (CI 95% 0.77-14.6) vs female CG and 1.5 (CI 95% 0.8-7.6) vs male NIDDM]. Extended MIs predicted higher mortality rate, especially among NIDDM patients (p < 0.05). Stepwise logistic regression test supported diabetes mellitus, per se, as a major contributor for mortality (p < 0.02), followed by MI localization and extension. The worst outcome was in NIDDM female patients of advanced age and hypertensive (p < 0.00001).