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INTRODUCTION: Many risk scores for malignancy in gastrointestinal stromal tumors (GISTs) are based on the combination of size, mitotic index, and location in order to predict recurrence, appearance of metastases, or survival. DESIGN: This is a prospective analysis of prognosis factors (size, mitotic index, Ki-67, and others) and malignancy risk scores (Fletcher's, modified NIH, Miettinen, NCCN, and A or B Goh's scores). This is a study of the sensitivity and specificity of the different malignancy risk scores in the prognosis of recurrence and survival. MATERIALS AND METHODS: We operated on 52 patients from 1 January 2002 to 10 January 2008. Mean follow-up was 35 months. We used SPSS 13.0 for Windows for the statistical analysis. The differences between frequencies and means were calculated using the chi-square test, Student's t test, and analysis of variance. Kaplan-Meier and the Cox multiple regression methods were used to calculate overall and disease-free survival. Sensitivity and specificity were depicted graphically as receiver operating characteristic (ROC) curves. RESULTS: Thirteen patients suffered recurrences (27.7%). Eleven died from disease-related causes. Two-year and 5-year actuarial survival was 80% and 76%, respectively, and the mean survival was 60 months (CI 95% 51.9-69.5). Two-year and 5-year actuarial disease-free survival was 76% and 72% respectively, and the mean disease-free survival was 52 months (CI 95% 43.5-61.1). The score proposed by Fletcher has the greatest sensitivity and specificity in our series to predict overall survival (AUROC = 0.761; SE 0.084, p = 0.009; CI 95% 0.597-0.926) and recurrence (AUROC RECURRENCE = 0.693; SE 0.087, p = 0.042; CI 95% 0.523-0.864) compared with other scores.
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Tumores del Estroma Gastrointestinal/metabolismo , Tumores del Estroma Gastrointestinal/mortalidad , Tumores del Estroma Gastrointestinal/patología , Adulto , Anciano , Anciano de 80 o más Años , Área Bajo la Curva , Supervivencia sin Enfermedad , Femenino , Humanos , Inmunohistoquímica , Estimación de Kaplan-Meier , Masculino , Persona de Mediana Edad , Pronóstico , Modelos de Riesgos Proporcionales , Curva ROC , Medición de Riesgo/métodos , Factores de Riesgo , Sensibilidad y EspecificidadRESUMEN
INTRODUCTION: Bronchogenic cyst is pathology of the respiratory track. It consists of a defect during the embryological development of the tracheobronchial tree. Most common presentation is as a solid or cystic mass located in mediastinum, and it is usually diagnosed in relation to respiratory problems or recurrent infections in children. In adulthood, it is a rare pathology, and its diagnosis is usually incidental. CASE REPORT: We present a case of a patient with a paraesophageal cystic mass suggestive of intraabdominal esophageal duplication cyst but, after the histopathological examination, was discovered to be a bronchogenic cyst, something extremely rare as in most cases of subdiaphragmatic location; bronchogenic cysts appear as retroperitoneal lesions. DISCUSSION: After we review the current literature, surgical extirpation appears to be the treatment of choice due to potential complications, and laparoscopic approach is a feasibily and safe procedure for this pathology up to date.
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Abdomen/cirugía , Quiste Broncogénico/cirugía , Laparoscopía/métodos , Anciano , Quiste Broncogénico/diagnóstico , Diagnóstico Diferencial , Quiste Esofágico/diagnóstico , Humanos , MasculinoRESUMEN
No disponible
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Humanos , Femenino , Persona de Mediana Edad , Factores de Riesgo , Vagina/patología , Vagina/cirugía , Exenteración Pélvica/instrumentación , Exenteración Pélvica , Fibrilación Atrial/complicaciones , Fibrilación Atrial/diagnóstico , Histerectomía , Histerectomía Vaginal/métodos , Intestinos/patología , Intestinos/cirugíaAsunto(s)
Actinomicosis/cirugía , Hepatectomía/métodos , Hepatopatías/microbiología , Hepatopatías/cirugía , Adulto , Humanos , MasculinoRESUMEN
No disponible