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FACTORES PRONOSTICOS EN EL CARCINOMA DE CELULAS RENALES

(especial para SIIC © Derechos reservados)
Los factores pronósticos más contundentes en el carcinoma de células renales son los patológicos. Para mejorar la precisión en la predicción de la evolución de esta entidad se crean nuevos sistemas integradores de todos los factores pronósticos conocidos.
ficarra9.jpg Autor:
Ficarra, vicenzo
Columnista Experto de SIIC

Institución:
Dipartamento de Urología Azienda Ospedaliera Di Verona Universitá degli Studi di Verona Verona, Italia

Artículos publicados por Ficarra, vicenzo
Coautores
Antonio Galfano*  Walter Artibani** 
Academic degrees Resident in Urology. University of Verona*
Professor. Chief of Department. Department of Urology, University of Verona**
Recepción del artículo
12 de Mayo, 2004 		Aprobación
27 de Mayo, 2004
Primera edición
7 de Marzo, 2005 		Segunda edición, ampliada y corregida
7 de Junio, 2021

FACTORES PRONOSTICOS EN EL CARCINOMA DE CELULAS RENALES

Resumen
Los factores pronósticos en el carcinoma de células (CCR) renales se usan para predecir la supervivencia de los pacientes, planear el esquema terapéutico adecuado, para seleccionar los subgrupos de pacientes que se podrían beneficiar con nuevas terapias en ensayos clínicos y para evitar tratamientos no efectivos. Una distinción clásica separa los factores pronósticos en dos grupos. Uno incluye aquellos relacionados con el paciente (modalidad de detección, pérdida de peso, estado general, anemia, hipercalcemia, fosfatasa alcalina, ferritina sérica elevada). El otro comprende los relacionados con el tumor (estadio TNM, grado y tipo histológico, biomarcadores, morfometría nuclear y ploidía del ADN). Un panel internacional de expertos los subdividió en tres categorías, sobre la base de la literatura existente. Nos hemos propuesto realizar una revisión completa de la literatura existente en este tema. Los factores pronósticos más relevantes son los patológicos; algunas manifestaciones clínicas como la modalidad de presentación o el estado general según ECOG pueden ayudar al médico a distinguir aquellos pacientes que merecen una particular atención en el tratamiento o seguimiento. La investigación en el campo de los marcadores moleculares está en desarrollo y se conocen resultados alentadores. El más reciente avance en el campo de los factores pronósticos es la creación de sistemas integrados que podrían mejorar la precisión en la predicción del pronóstico.

Palabras clave
Carcinoma de células renales, factores pronósticos, TNM, grado


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PROGNOSTIC FACTORS IN RENAL CELL CARCINOMA

Abstract
Prognostic factors in renal cell carcinoma (RCC) are used to predict patients survival, to plan the right therapeutic scheme, to select the subgroups of patients who would take benefit from new therapies in clinical trials or avoid ineffective treatments. A classical distinction divides patient-related (modality of detection, weight loss, performance status, anemia, hypercalcemia, alkaline phosphatase, elevated serum ferritin) from tumour-related prognostic factors (TNM stage, grade and histological type, biomarkers, nuclear morphometry and DNA ploidy), and an international panel of experts subdivided them in three categories on the basis of the existing Literature. A complete revision of the existing Literature on this topic is proposed. The strongest prognostic factors are the pathological ones, even if some clinical features such as modality of presentation or ECOG performance status can help the clinician to distinguish patients deserving particular attention in the treatment schedule or follow-up. Research in the field of molecular markers is developing, but today only encouraging results are present. The most recent advance in the field of prognostic factors is the development of integrated systems which can improve the accuracy of prognosis prediction.

Key words
 Renal cell carcinoma, prognosis factors, TNM, grading


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Especialidades
Principal: Medicina Interna
Relacionadas: Diagnóstico por Laboratorio, Nefrología y Medio Interno, Oncología



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