{"id":117863,"date":"2018-03-11T10:47:33","date_gmt":"2018-03-11T10:47:33","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/experiencia-del-hospital-cla%c2%adnico-universitario-virgen-de-la-arrixaca-en-el-tratamiento-del-liposarcoma-de-extremidades\/"},"modified":"2018-03-11T10:47:33","modified_gmt":"2018-03-11T10:47:33","slug":"experiencia-del-hospital-cla%c2%adnico-universitario-virgen-de-la-arrixaca-en-el-tratamiento-del-liposarcoma-de-extremidades","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/traumatologia\/experiencia-del-hospital-cla%c2%adnico-universitario-virgen-de-la-arrixaca-en-el-tratamiento-del-liposarcoma-de-extremidades\/","title":{"rendered":"Experiencia del hospital cl\u00ednico universitario virgen de la arrixaca en el tratamiento del liposarcoma de extremidades"},"content":{"rendered":"<h2>Tesis doctoral de <strong> Francisco Javier Carrillo Pi\u00f1ero <\/strong><\/h2>\n<p>Resumen tesis doctoral. Experiencia del hospital clinico universitario virgen de la arrixaca en el tratamiento del liposarcoma de extremidades.  francisco javier carrillo pi\u00f1ero  objetivos analizar las caracter\u00edsticas del liposarcoma musculoesquel\u00e9tico seg\u00fan nuestra experiencia. Valorar si las diferentes aplicaciones de las t\u00e9cnicas diagn\u00f3sticas influyen en el pron\u00f3stico del liposarcomas musculoesquel\u00e9tico. Estudiar la influencia del tratamiento quir\u00fargico y m\u00e9dico en el pron\u00f3stico del liposarcoma musculoesquel\u00e9tico. Valorar los cambios en las t\u00e9cnicas diagn\u00f3sticas y en los tratamientos del liposarcoma musculoesquel\u00e9tico, as\u00ed como las posibles ventajas o desventajas de los mismos. Establecer un protocolo en el manejo del liposarcoma de extremidades para disminuir el retardo en el diagn\u00f3stico y tratamiento. metodolog\u00eda el estudio presentado es un an\u00e1lisis retrospectivo que incluye 76 pacientes que con el diagn\u00f3stico de liposarcoma de miembros fueron tratados por el servicio de cirug\u00eda ortop\u00e9dica y traumatolog\u00eda de nuestro hospital, durante el periodo comprendido entre enero de 1985 y octubre de 2013. En primer lugar se han caracterizado de forma descriptiva los pacientes de la serie. Adem\u00e1s todos los pacientes fueron sometidos a una exhaustiva exploraci\u00f3n f\u00edsica, con el fin de localizar la masa tumoral haciendo referencia al miembro afecto y la lateralidad del mismo, su segmento y dentro de este a la localizaci\u00f3n en tres dimensiones. Se han estudiando la relaci\u00f3n de los diferentes grados de la rm seg\u00fan su contenido en tejido adiposo con las variables  y clasificaciones histol\u00f3gicas, as\u00ed como su relaci\u00f3n con los resultados pron\u00f3sticos. Se ha estudiado la supervivencia global y libre de enfermedad, las recidivas locales y met\u00e1stasis para todos los enfermos de la serie. Se realiz\u00f3 un estudio de la eficacia del tratamiento, agrupando a la poblaci\u00f3n seg\u00fan los tratamientos aplicados y comparando estos con los resultados pron\u00f3sticos como la recidiva local primaria, secundaria y met\u00e1stasis as\u00ed como los resultados de las escalas funcionales. Se trataron de identificar los diferentes factores de riesgo para la supervivencia, las recidivas locales, la met\u00e1stasis y la funcionalidad antes y despu\u00e9s del tratamiento. Adem\u00e1s hemos analizado el efecto de los factores de riesgo en el pron\u00f3stico mediante an\u00e1lisis de regresi\u00f3n proporcional, y solo las variables que muestran en el an\u00e1lisis univariante p&lt;0,15 son analizadas en el an\u00e1lisis multivariante. Hemos diferenciado dos etapas en el manejo del liposarcoma agrupando los pacientes en dos grupos seg\u00fan el a\u00f1o de tratamiento para comparar c\u00f3mo ha evolucionado con el tiempo el diagn\u00f3stico y el tratamiento del liposarcoma.  resultados- conclusiones:  el liposarcoma de extremidades es un tumor de partes blandas definido por su variable histol\u00f3gica, que afecta con mayor preValencia a varones en la quinta d\u00e9cada de edad y que se presenta como tumoraci\u00f3n de crecimiento progresivo no dolorosa principalmente en tercio medio de miembro inferior. La clasificaci\u00f3n en cuatro grados seg\u00fan su porcentaje de tejido adiposo en la rm para los liposarcomas de extremidades permite cuantificar mediante la imagen el grado histol\u00f3gico y estadiaje adem\u00e1s de prever el riesgo de met\u00e1stasis y la supervivencia. La prueba diagn\u00f3stica del liposarcoma por excelencia es la biopsia tru-cut la cual se debe realizar guiada con la ecograf\u00eda pues as\u00ed se aumenta la potencia de la prueba. El tama\u00f1o del liposarcoma en extremidades no tiene influencia sobre el pron\u00f3stico, siendo m\u00e1s importante que el tama\u00f1o su extensi\u00f3n extracompartimental. El tratamiento por excelencia del liposarcoma es la resecci\u00f3n quir\u00fargica, la cual se debe realizar en el hospital de referencia, por una unidad de expertos en patolog\u00eda tumoral musculoesquel\u00e9tica por la importancia de los m\u00e1rgenes libres en el control de la recidiva local. La radioterapia y la quimioterapia en el tratamiento del liposarcoma, se debe aplicar de forma adyuvante, seg\u00fan la variable histol\u00f3gica y de manera combinada. El manejo de los sarcomas de partes blandas requiere para un \u00e9xito diagn\u00f3stico y de tratamiento de un equipo multidisciplinar, lo cual va ligado a un aumento de la supervivencia y mejores resultados funcionales.   summary of doctoral thesis.  \u00c2\u00bf the experience in the treatment of limb liposarcoma at hospital cl\u00ednico universitario virgen de la arrixaca\u00c2\u00bf .  francisco javier carrillo pi\u00f1ero objectives the objectives of this study were to investigate the characteristics of musculoskeletal liposarcoma. We study if different applications of diagnostic techniques will influence the prognosis of musculoskeletal liposarcoma. In addition, the influence of surgical and medical treatment of the musculoskeletal prognosis of liposarcoma was also studied. Moreover, we analyzed possible changes in diagnostic techniques and treatment of the musculoskeletal liposarcoma, and the advantages or disadvantages of them. To sum up, we wanted to establish a protocol for the management of limb liposarcoma to decrease the delay in the diagnosis and treatment.  methods:  this study is a retrospective analysis including 76 patients with the diagnosis of limb liposarcoma treated in our hospital between january 1985 and october 2013. First of all, we characterized the patients in our population. We performed a complete physical examination to locate the tumor mass according to the affected limb, the segment and the 3d location. We studied the relationship between different levels of the rm by content in adipose tissue with histological variables and their classifications, and their relationship with prognostic factors. we have studied the global and disease-free survival, local recurrence and metastasis for all patients. We also analyzed the effectiveness of the performed  treatment, grouping the population by the applied treatments and comparing these results with prognostics: global survival, primary local recurrence, metastases and the results of functional scales. We tried to identify different risk factors for survival, local recurrence, metastasis and function before and after treatment. We also studied the effect of risk factors in the prognostic through proportional regression analysis, including in the multivariate analysis the variables showing a p&lt;0,15 in the univariate analysis. We defined two stages in the management of liposarcoma grouping the patients into two groups according to the year of treatment, comparing their evolution over time, the diagnosis and treatment of liposarcoma.  conclusions:  limb liposarcoma is a soft tissue sarcoma defined by their histologic variable, more prevalent in males in the fifth decade of age and its main clinical manifestation is a painless slow-growing tumor mainly in the middle third of the lower limb. The classification into four grades according to the percentage of fat tissue in the rm for limb liposarcoma allows to quantify by histologic grade and also to predict the risk of metastasis and global survival. The gold standard diagnostic test in the liposarcoma is the true-cut biopsy which should be performed guided by ultrasound to improve the results of the test. The prognosis is not associated with the size of the musculoskeletal liposarcoma but with the size of the extracompartimental extension. The gold standard treatment of liposarcoma in the limb is surgical resection, which should be done in the referral hospital, by a unit of experts in musculoskeletal tumor pathology for the importance of the free margins after surgery to control local recurrence. Radiotherapy and chemotherapy in the treatment of liposarcoma should be applied as adjuvant therapy according to histological type and must be given together. The success in the management of soft tissue sarcomas required a multidisciplinary team, linked to increased survival and better functional outcomes.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Experiencia del hospital cl\u00ednico universitario virgen de la arrixaca en el tratamiento del liposarcoma de extremidades<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Experiencia del hospital cl\u00ednico universitario virgen de la arrixaca en el tratamiento del liposarcoma de extremidades <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Francisco Javier Carrillo Pi\u00f1ero <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 13\/07\/2015<\/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>Antonio Valcarcel Diaz<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: pascual Parrilla paricio <\/li>\n<li>Jos\u00e9 rogelio Fern\u00e1ndez s\u00e1nchez (vocal)<\/li>\n<li>Fernando L\u00f3pez prats (vocal)<\/li>\n<li>Luis Rafael Ramos  pascua (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Francisco Javier Carrillo Pi\u00f1ero Resumen tesis doctoral. Experiencia del hospital clinico universitario virgen de la arrixaca en [&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":[8235,254],"tags":[218513,40642,232020,232021,123906,34764],"class_list":["post-117863","post","type-post","status-publish","format-standard","hentry","category-murcia","category-traumatologia","tag-antonio-valcarcel-diaz","tag-fernando-lopez-prats","tag-francisco-javier-carrillo-pinero","tag-jose-rogelio-fernandez-sanchez","tag-luis-rafael-ramos-pascua","tag-pascual-parrilla-paricio"],"_links":{"self":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/117863","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=117863"}],"version-history":[{"count":0,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/posts\/117863\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/media?parent=117863"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/categories?post=117863"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.deberes.net\/tesis\/wp-json\/wp\/v2\/tags?post=117863"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}