{"id":117880,"date":"2018-03-11T10:47:33","date_gmt":"2018-03-11T10:47:33","guid":{"rendered":"https:\/\/www.deberes.net\/tesis\/sin-categoria\/factores-pronosticos-de-los-tumores-neuroendocrinos-de-pancreas-resecados-experiencia-con-95-pacientes\/"},"modified":"2018-03-11T10:47:33","modified_gmt":"2018-03-11T10:47:33","slug":"factores-pronosticos-de-los-tumores-neuroendocrinos-de-pancreas-resecados-experiencia-con-95-pacientes","status":"publish","type":"post","link":"https:\/\/www.deberes.net\/tesis\/cirugia\/factores-pronosticos-de-los-tumores-neuroendocrinos-de-pancreas-resecados-experiencia-con-95-pacientes\/","title":{"rendered":"Factores pron\u00f3sticos de los tumores neuroendocrinos de p\u00e1ncreas resecados. experiencia con 95 pacientes."},"content":{"rendered":"<h2>Tesis doctoral de <strong> Antonio Bernabe Pe\u00f1alver <\/strong><\/h2>\n<p>Res\u00famen objetivos: los tumores neuroendocrinos de p\u00e1ncreas (tnep) son neoplasias raras con una baja incidencia que se estima en torno a 1\/100.000, aunque su preValencia en estudios de necropsias ascienda hasta 0.5-1.5%. Representan menos del 5% de los tumores primarios malignos pancre\u00e1ticos. La incidencia est\u00e1 aumentando en la actualidad gracias a su mejor detecci\u00f3n cl\u00ednica, radiol\u00f3gica y bioqu\u00edmica. Causan con frecuencia diagn\u00f3sticos err\u00f3neos y su diagn\u00f3stico tard\u00edo se asocia a mayores complicaciones y mayor tasa de met\u00e1stasis a distancia. En ausencia de met\u00e1stais ganglionares o a distancia resulta dif\u00edcil predecir el comportamiento biol\u00f3gico de los tnep. Las caracter\u00edsticas histol\u00f3gicas y citol\u00f3gicas los hacen similares a los carcinoides, por lo que los criterios de malignidad se basan en los hallazgos quir\u00fargicos, la invasi\u00f3n local y\/o la presencia de met\u00e1stasis. Los objetivos de este estudio son: -evaluar los posibles factores pron\u00f3sticos que influyen en la supervivencia de estos tumores. -evaluar los posibles factores pron\u00f3sticos que influyen en la recidiva de estos tumores. material y m\u00e9todo: se ha llevado a cabo un estudio retrospectivo de 95 pacientes intervenidos y resecados de tumores neuroendocrinos de p\u00e1ncreas en el servicio de cirug\u00eda general del hospital cl\u00ednico universitario &quot;virgen de la arrixaca&quot; en el per\u00edodo comprendido entre los a\u00f1os 1990-2012. Se incluyen los pacientes diagnosticados de tnep intervenidos y resecados durante este per\u00edodo de tiempo. Dentro de esta serie hay un grupo de pacientes que est\u00e1n diagnosticados de s\u00edndrome men 1. Se excluyen los pacientes que han sido inoperables dada la extensi\u00f3n tumoral (24 pacientes), as\u00ed como, los irresecables por presentar invasi\u00f3n vascular o carcinomatosis (11 pacientes). Los pacientes que presentaban signos, s\u00edntomas y alteraciones anal\u00edticas hormonales, se establecieron como tumores funcionantes, siendo clasificados en funci\u00f3n de la alterci\u00f3n hormonal que predominaba. Aquellos en los que no se estableci\u00f3 bioqu\u00edmicamente una alteraci\u00f3n hormonal ni s\u00edndrome cl\u00ednico espec\u00edfico, se clasificaron como no funcionantes. Respecto a la forma de presentaci\u00f3n, los tumores neuroendocrinos de p\u00e1ncreas pueden aparecer de forma aislada o formando parte de un s\u00edndrome men 1. Las met\u00e1stasis hep\u00e1ticas se separaron en met\u00e1stasis sincr\u00f3nicas, estaban presentes en el momento del diagn\u00f3stico inicial, y met\u00e1stasis metacr\u00f3nicas, eran diagn\u00f3sticadas durante el seguimiento de los pacientes. Para la clasificaci\u00f3n tumoral se sigui\u00f3 la clasificaci\u00f3n de la oms de 2010. las variables estudiadas son: la edad, el sexo, forma de presentaci\u00f3n (espor\u00e1dica \/familiar), funcionalidad o no del tumor, pruebas diagnosticas (laboratorio e imagen), localizaci\u00f3n, tama\u00f1o del tumor, met\u00e1stasis, tipo cirug\u00eda realizada y clasificaci\u00f3n. conclusiones:  -la clasificaci\u00f3n oms es un factor pron\u00f3stico independiente en la supervivencia de los tnep. -las formas de presentaci\u00f3n del tnep y la funcionalidad son factores relacionados con la recidiva y supervivencia.  -las formas espor\u00e1dicas suelen ser tumores no funcionantes, con extensi\u00f3n extrapancre\u00e1tica y peor pron\u00f3stico. -el tratamiento de las met\u00e1stasis hep\u00e1ticas puede mejorar la supervivencia y calidad de vida de los pacientes.            abstrac objectives: pancreatic neuroendocrine tumors (pnet) are rare neoplasms with a low incidence estimated at about 1 \/ 100,000, although its prevalence in autopsy studies to rise to 0.5-1.5%. Represent less than 5% of pancreatic primary malignant tumors. The incidence is increasing at present thanks to its better clinical, radiological and biochemical detection. Often cause misdiagnosis and delayed diagnosis is associated with increased complications and higher rate of distant metastases. In the absence of nodal or distant met\u00e1stais difficult to predict the biological behavior of pnet. The histological and cytological characteristics make them similar to carcinoid, so that the criteria of malignancy are based on surgical findings, local invasion and \/ or metastasis. The objectives of this study are: -evaluate the possible prognostic factors influencing survival of these tumors. -evaluate the possible prognostic factors influencing the recurrence of these tumors. material and methods: we conducted a retrospective study of 95 patients operated and resected pancreatic neuroendocrine tumors in the department of surgery university hospital &quot;virgen de la arrixaca&quot; in the period between 1990-2012. Patients diagnosed with pnet operated and resected during this period are included. Within this series is a group of patients who are diagnosed with men 1 syndrome patients who have been given inoperable tumor extension (24 patients) were excluded, as well as to present unresectable vascular invasion or carcinomatosis (11 patients). Patients presenting signs, symptoms and laboratory abnormalities hormonal, functioning tumors were established as being classified according to the hormonal alteration predominated. Those which are not biochemically established a hormonal alteration or specific clinical syndrome, were classified as non-functioning. Regarding the presentation, pancreatic neuroendocrine tumors can occur in isolation or as part of a syndrome men 1. Liver metastases were separated into synchronous metastases were present at the time of initial diagnosis, and metachronous metastases were who have been diagnosed follow up of patients. For tumor classification who classification of 2010 was followed. the variables studied were: age, sex, presentation (sporadic \/ family), functionality or not the tumor, diagnostic tests (laboratory and image), location, tumor size, metastasis, type surgery performed and classification them. conclusions: -the who classification is an independent prognostic survival factor pnet. -the presentations of pnet and functionality are factors related to recurrence and survival. -the sporadic forms are usually nonfunctioning tumors with poor prognosis and extrapancreatic extension. -the treatment of liver metastases can improve survival and quality of life of patients.<\/p>\n<p>&nbsp;<\/p>\n<h3>Datos acad\u00e9micos de la tesis doctoral \u00ab<strong>Factores pron\u00f3sticos de los tumores neuroendocrinos de p\u00e1ncreas resecados. experiencia con 95 pacientes.<\/strong>\u00ab<\/h3>\n<ul>\n<li><strong>T\u00edtulo de la tesis:<\/strong>\u00a0 Factores pron\u00f3sticos de los tumores neuroendocrinos de p\u00e1ncreas resecados. experiencia con 95 pacientes. <\/li>\n<li><strong>Autor:<\/strong>\u00a0 Antonio Bernabe Pe\u00f1alver <\/li>\n<li><strong>Universidad:<\/strong>\u00a0 Murcia<\/li>\n<li><strong>Fecha de lectura de la tesis:<\/strong>\u00a0 14\/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>Pascual Parrilla Paricio<\/li>\n<\/ul>\n<\/li>\n<li><strong>Tribunal<\/strong>\n<ul>\n<li>Presidente del tribunal: pablo Ram\u00edrez romero <\/li>\n<li>pedro Gonzalez Martinez (vocal)<\/li>\n<li>Mar\u00eda -elena Mart\u00edn p\u00e9rez (vocal)<\/li>\n<li>Mar\u00eda dolores Balsalobre salmer\u00f3n (vocal)<\/li>\n<\/ul>\n<\/li>\n<\/ul>\n<p>&nbsp;<\/p>\n","protected":false},"excerpt":{"rendered":"<p>Tesis doctoral de Antonio Bernabe Pe\u00f1alver Res\u00famen objetivos: los tumores neuroendocrinos de p\u00e1ncreas (tnep) son neoplasias raras con una baja [&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 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