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Factores pronósticos de supervivencia en pacientes mexicanos con glioblastoma multiforme
Resumen
Objetivo: se revisaron los factores pre y transoperatorios que influyen en la supervivencia de los pacientes con glioblastoma multiforme.
Métodos: se estudiaron todos los pacientes con este tumor entre 2000 y 2006. Se evaluaron las manifestaciones clínicas y el material histológico. La supervivencia posoperatoria se clasificó en menor y mayor de ocho meses, y se asoció con tipo de resección, grado de vascularización, grado de edema cerebral durante el transoperatorio y al Karnofsky preoperatorio.
Resultados: se estudiaron 120 (75 hombres). La edad osciló entre siete y 85 años; cuatro pacientes menores de 16 años (3.3 %) y 15 (12.5 %) de 70 años o más. La cefalea fue la manifestación más frecuente. Del total, 40 pacientes presentaron hemiparesia y seis, parestesias. De 120 tumores, 65 (54 %) se localizaron en el hemisferio derecho y 30 (25 %) en el izquierdo. La bilateralidad hemisférica (7 %) involucró lóbulos frontales. Histológicamente, 1.6 % de los tumores tuvieron componente sarcomatoso; 35 % de los pacientes vivió menos de ocho meses después del diagnóstico.
Conclusiones: la evaluación preoperatoria de Karnofsky y el edema transoperatorio son factores pronósticos de supervivencia.
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