Cosecha ganglionar en cáncer de colon

Mitos y magia

  • Ricardo Misa Hospital de Clínicas, Clínica Quirúrgica “B”. Prof. Agdo
  • Mario Almada Hospital de Clínicas, Clínica Quirúrgica “B”. Asistente
  • Noelia Brito Hospital de Clínicas, Clínica Quirúrgica “B”. Asistente
  • José Martínez Hospital de Clínicas, Clínica Quirúrgica “B”. Ex residente
  • Andrés Pouy Hospital de Clínicas, Clínica Quirúrgica “B”. Residente
  • Camila Haro Hospital de Clínicas, Clínica Quirúrgica “B”. Residente
Palabras clave: NEOPLASIAS DEL COLON, ESTADIFICACIÓN DE NEOPLASIAS, COSECHA GANGLIONAR

Resumen

El compromiso ganglionar es crítico en la estadificación del cáncer de colon como factor pronóstico y como determinante de tratamiento adyuvante. Se sigue discutiendo el número de ganglios adecuados a resecar, cuáles son los factores que inciden en la cosecha ganglionar y el significado biológico de ésta. Se revisan las variables clínicas y de la propia biología tumoral que hacen que la definición de un número determinado de ganglios, como gold standard de cosecha ganglionar adecuada, sea controversial. El número 12 no necesariamente es un número “mágico” marcador de calidad. Extender la resección para aumentar la cosecha ganglionar no mejora la estadificación, expone al paciente a riesgos innecesarios, sin efecto terapéutico comprobado. La “magia” sigue siendo realizar resecciones regladas, que incluyan el pedículo vascular y el meso satélite al tumor, ajustando la resección a las características del paciente. Menos no es más, pero más no es necesariamente mejor.

Citas

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Publicado
2020-04-23
Cómo citar
1.
Misa R, Almada M, Brito N, Martínez J, Pouy A, Haro C. Cosecha ganglionar en cáncer de colon. Rev. Méd. Urug. [Internet]. 23 de abril de 2020 [citado 26 de septiembre de 2020];36(2):177-85. Disponible en: http://www2.rmu.org.uy/ojsrmu311/index.php/rmu/article/view/533
Sección
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