Efecto de la quimiorradiación preoperatoria en estadiaje ganglionar y sobrevida en cáncer de recto: revisión sistemática y metaanálisis
DOI:
https://doi.org/10.35434/rcmhnaaa.2022.15Supl.%201.1589Palabras clave:
cáncer de recto, terapia neoadyuvante, radioterapia preoperatoria, quimioterapia preoperatoria, ganglios linfáticosResumen
Objetivo: Evaluar el efecto de la resección quirúrgica de más de 12 nódulos linfáticos comparado con menos de 12 nódulos linfáticos en pacientes con cáncer de recto después la quimiorradiación neoadyuvante. Métodos: Se realizó la búsqueda en Pubmed, Scopus, Web of Science, EMBASE, seleccionando ensayos clínicos aleatorizados y cohorte prospectivo que comparen el número de LNs en cáncer de recto resecado después del tratamiento neoadyuvante. Los autores examinaron y seleccionaron los estudios a los que se les realizo el análisis de riesgo de sesgo mediante la herramienta NOS. La calidad y certeza de la evidencia para todos los resultados se evaluó mediante la metodología GRADE. Resultados: Fueron revisados 3964 artículos, de los cuales 10 artículos fueron incluidos en la revisión sistemática. El metaanálisis demostró que una cosecha ganglionar de menos de 12 ganglios (NL<12) no se relaciona con menor sobrevida general comparado a un hallazgo mayor a 12 nódulos (NL>12) (HR 0.75; IC95% 0.52-1.07; p=0.09; I2=63%) ni tampoco en la sobrevida libre de enfermedad (HR 0.69; IC95% 0.36-1.33; p=0.21; I2=92%;). En cuanto a la recurrencia (RR 1.46; IC95% 0.80-2.68; p=0.11; I2=1%;) tampoco se encontró relación al comparar ambos grupos. Conclusiones: La presente investigación mostró que no hay relación entre un hallazgo menor de 12 ganglios linfáticos en una menor sobrevida global ni tampoco una menor sobrevida libre de enfermedad al compararse con un hallazgo mayor a 12 nódulos.
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Derechos de autor 2022 Cristina Alejandra Armas-Maldonado, Edgar Fermín Yan-Quiroz
Esta obra está bajo una licencia internacional Creative Commons Atribución 4.0.
