{"id":115198,"date":"2018-03-11T10:43:36","date_gmt":"2018-03-11T10:43:36","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/analisis-epidemiologico-del-carcinoma-del-suelo-de-boca-en-la-region-de-murcia\/"},"modified":"2018-03-11T10:43:36","modified_gmt":"2018-03-11T10:43:36","slug":"analisis-epidemiologico-del-carcinoma-del-suelo-de-boca-en-la-region-de-murcia","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/estomatologia-y-ortodoncia\/analisis-epidemiologico-del-carcinoma-del-suelo-de-boca-en-la-region-de-murcia\/","title":{"rendered":"An\u00e1lisis epidemiol\u00f3gico del carcinoma del suelo de boca en la regi\u00f3n de murcia"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Mar\u00eda  Gabriela Cortez Lede <\/strong><\/h2>\n<p>An\u00e1lisis epidemiol\u00f3gico del carcinoma de suelo de boca en la regi\u00f3n de murcia.  m\u00aa gabriela cortez lede  objetivos  los objetivos de esta tesis son realizar un an\u00e1lisis estad\u00edstico descriptivo y anal\u00edtico de la muestra. Analizar la morbimortalidad postoperatoria, la supervivencia global, la supervivencia espec\u00edfica por enfermedad y la supervivencia libre de enfermedad de los pacientes con carcinoma epidermoide de suelo de boca. As\u00ed mismo, analizar la supervivencia espec\u00edfica seg\u00fan distintas variables como el sexo, la edad, el consumo de tabaco y alcohol, las complicaciones postquir\u00fargicas, el grado histol\u00f3gico, la afectaci\u00f3n de m\u00e1rgenes quir\u00fargicos, la infiltraci\u00f3n perivascular o perilinf\u00e1tica, la invasi\u00f3n perineural, la afectaci\u00f3n \u00f3sea, las met\u00e1stasis ganglionares, la rotura extracapsular, el estadio tnm (seg\u00fan la t postquir\u00fargica), el estadio tnm (seg\u00fan la n postquir\u00fargica), el estadio tumoral postquir\u00fargico, la existencia de recidivas locorregionales y de met\u00e1stasis a distancia. Por \u00faltimo, determinar qu\u00e9 variables influyen de forma independiente en la supervivencia y comparar los resultados con la bibliograf\u00eda.  metodolog\u00eda  se realiz\u00f3 un estudio retrospectivo, basado en los pacientes que fueron diagnosticados y tratados quir\u00fargicamente de forma primaria por el servicio de cirug\u00eda oral y maxilofacial del hospital universitario virgen de la arrixaca desde 1996 hasta 2011 por carcinoma de suelo de boca, incluyendo a 90 pacientes. Mediante el programa estad\u00edstico spss se realiz\u00f3 un an\u00e1lisis descriptivo para cada variable cualitativa y cuantitativa, un an\u00e1lisis estad\u00edstico anal\u00edtico utilizando el test de la x2 de pearson (o test exacto de fisher), comparaci\u00f3n de medias mediante la t de student y el riesgo relativo. En el an\u00e1lisis de supervivencia se utiliz\u00f3 la prueba de kaplan-meier y el test de log-rank. Las variables significativas en el an\u00e1lisis de supervivencia se sometieron a un estudio multivariante mediante un an\u00e1lisis de regresi\u00f3n de cox. Se consider\u00f3 que la diferencia era significativa cuando p&lt; 0,05.   conclusiones  el consumo de tabaco y de alcohol influyen disminuyendo la edad de presentaci\u00f3n del carcinoma epidermoide de suelo de boca. el carcinoma epidermoide de suelo de boca en la regi\u00f3n de murcia es llamativamente m\u00e1s frecuente en hombres que en mujeres al compararlo con la mayor\u00eda de series revisadas, no existiendo un aumento de la incidencia de este c\u00e1ncer en el sexo femenino en los \u00faltimos 20 a\u00f1os. el riesgo relativo de presentar complicaciones postquir\u00fargicas aumenta considerablemente en primer lugar en los pacientes tratados con mandibulectom\u00edas (rr: 13), en segundo lugar con las traqueostom\u00edas (rr: 4,2) y en tercer lugar con el uso de las reconstrucciones microquir\u00fargicas (rr: 3,6). Cualquier complicaci\u00f3n postquir\u00fargica empeora el pron\u00f3stico vital del paciente, aumentando el riesgo de fallecer 8,37 veces sobre los que no la han presentado.  la presencia de m\u00e1rgenes quir\u00fargicos afectos aumenta el riesgo de presentar recidivas locales, mientras que la infiltraci\u00f3n perivascular o perilinf\u00e1tica y la infiltraci\u00f3n perineural aumentan el riesgo de presentar una met\u00e1stasis a distancia.   la supervivencia espec\u00edfica por enfermedad est\u00e1 afectada negativamente por los siguientes factores: las complicaciones postquir\u00fargicas, los m\u00e1rgenes afectos y pr\u00f3ximos, el infiltrado inflamatorio peritumoral, la infiltraci\u00f3n perivascular o perilinf\u00e1tica, la infiltraci\u00f3n perineural, la infiltraci\u00f3n de la musculatura estriada, la infiltraci\u00f3n de las gl\u00e1ndulas salivales menores y mayores, la presencia de adenopat\u00edas cervicales positivas, la clasificaci\u00f3n ganglionar (pn), el tama\u00f1o tumoral (pt), el estadio tumoral,  el tiempo transcurrido entre la cirug\u00eda y la recidiva, las recidiva locales y las met\u00e1stasis a distancia. la infiltraci\u00f3n \u00f3sea no influye en la supervivencia, ni est\u00e1 relacionada con las recidivas locales o regionales, ni con las met\u00e1stasis a distancia. el tama\u00f1o tumoral (t4), la afectaci\u00f3n ganglionar (pn2), los m\u00e1rgenes afectos, los m\u00e1rgenes pr\u00f3ximos, la infiltraci\u00f3n perineural, la infiltraci\u00f3n de la musculatura estriada, las complicaciones postquir\u00fargicas y las recidivas locales afectan de forma independiente a la supervivencia espec\u00edfica por enfermedad.  epidemiologic analysis of the carcinoma of the floor of mouth in the region of murcia.  m\u00aa gabriela cortez lede  objetives  the objetive of this thesis is a descriptive and analytical analysis of the sample. To analyze the postoperarative morbidity and mortality, overral survival, disease-especific survival and disease-free survival of patients with squamous cell carcinoma of the floor of mouth. Also, analyze the specific survival according to different variables such as sex ,age ,consumption of tabacco and alcohol, postsurgical complications, histologic grade, involvement of surgical margins, perilymphatic or perivascular infiltration, perineural invasion, involvement of bone, lymph node metastasis, extracapsular spread, tnm stage (according to the postoperative t), tnm stage (as postoperative n), postoperative tumor stage , the presence of locoregional recurrence and distant metastases. Finally, determine which variables independently influence survival and compare the results with the literature.  methodology  a retrospective study based on patients who were diagnosed and surgically treated, primarily by the department of oral and maxillofacial surgery of the university hospital virgen de la arrixaca from 1996 to 2011 with carcinoma of the floor of mouth, which included 90 patients. Descriptive analysis for each qualitative and quantitative variable, an analytical statistical analysis using the x2 test of pearson (or fisher exact test), comparison of means the t test (student) and the relative risk was performed using spss. In survival analysis the kaplan-meier and log-rank test was used. Significant variables in survival analysis were subjected to multivariate analysis using a cox regression analysis. It was considered that the difference was significant when p &lt; 0.05.  conclusions  tabacco smoking and consumption of alcohol had an influence by decreasing the age of presentation the squamous cell carcinoma of floor of the mouth. squamous cell carcinoma of floor of the mouth in the region of murcia is significantly more common in men than in women when compared with most revised series, not existing an increase in the incidence of cancer in women in the last 20 years. the relative risk for postoperative complications increases significantly, firstly in mandibulectomies treated patients (rr: 13), secondly with tracheostomy (rr: 4.2) and thirdly with the use of microsurgical reconstructions (rr: 3.6). Any postoperative complication worsens the prognosis of the patient, increasing the risk of death it approximately 8.37 times on those patients who have not encounted complications. the presence of affected surgical margins increases the risk of local recurrence, whereas perilymph, perivascular and perineural infiltration increase the risk for developing distant metastases. specific survival by disease is adversely affected by the following factors: the postoperative complications, involved and close surgical margins, peritumoral inflammatory infiltrate, perivascular and perilymphatic infiltration, perineural infiltration, infiltration of striated muscle, infiltration of the minor and major salivary glands, the presence of positive cervical nodes, nodal classification (pn), tumor size (pt), tumor stage, the time between surgery and recurrence, local recurrence and distant metastases. bone infiltration did not influence survival, or is related to local or regional recurrence, or with distant metastases. the tumor size (t4), nodal involvement (pn2), affected margins, close margins, perineural infiltration, infiltration of striated muscle, the postoperative complications and local recurrences independently affect the disease-specific survival.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>An\u00e1lisis epidemiol\u00f3gico del carcinoma del suelo de boca en la regi\u00f3n de murcia<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 An\u00e1lisis epidemiol\u00f3gico del carcinoma del suelo de boca en la regi\u00f3n de murcia <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Mar\u00eda  Gabriela Cortez Lede <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 31\/01\/2014<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n<h3>Direcci\u00f3n y tribunal<\/h3>\n<ul>\n<li><strong>Director de la tesis<\/strong>\n<ul>\n<li>Jos\u00e9 Luis Calvo Guirado<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: Mar\u00eda  pia Lopez jornet <\/li>\n<li>Antonio Aguilar-salvatierra raya (vocal)<\/li>\n<li>Javier Guardia mu\u00f1oz (vocal)<\/li>\n<li>gerardo G\u00f3mez moreno (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Mar\u00eda Gabriela Cortez Lede An\u00e1lisis epidemiol\u00f3gico del carcinoma de suelo de boca en la regi\u00f3n de murcia. [&hellip;]<\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"site-sidebar-layout":"default","site-content-layout":"","ast-site-content-layout":"","site-content-style":"default","site-sidebar-style":"default","ast-global-header-display":"","ast-banner-title-visibility":"","ast-main-header-display":"","ast-hfb-above-header-display":"","ast-hfb-below-header-display":"","ast-hfb-mobile-header-display":"","site-post-title":"","ast-breadcrumbs-content":"","ast-featured-img":"","footer-sml-layout":"","theme-transparent-header-meta":"","adv-header-id-meta":"","stick-header-meta":"","header-above-stick-meta":"","header-main-stick-meta":"","header-below-stick-meta":"","astra-migrate-meta-layouts":"default","ast-page-background-enabled":"default","ast-page-background-meta":{"desktop":{"background-color":"var(--ast-global-color-4)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"ast-content-background-meta":{"desktop":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"tablet":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""},"mobile":{"background-color":"var(--ast-global-color-5)","background-image":"","background-repeat":"repeat","background-position":"center center","background-size":"auto","background-attachment":"scroll","background-type":"","background-media":"","overlay-type":"","overlay-color":"","overlay-gradient":""}},"footnotes":""},"categories":[7472,140,8235],"tags":[224628,58829,187873,77686,228015,65960],"class_list":["post-115198","post","type-post","status-publish","format-standard","hentry","category-cirugia-maxilofacial","category-estomatologia-y-ortodoncia","category-murcia","tag-antonio-aguilar-salvatierra-raya","tag-gerardo-gomez-moreno","tag-javier-guardia-munoz","tag-jose-luis-calvo-guirado","tag-maria-gabriela-cortez-lede","tag-maria-pia-lopez-jornet"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/115198","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/users\/1"}],"replies":[{"embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/comments?post=115198"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/115198\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=115198"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=115198"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=115198"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}