El problema de las metástasis para-aórticas en cáncer de cuello uterino

Hernán Castro Vita

doi:10.56969/oc.v20i1.106

Autores/as

Hernán Castro Vita Centro Médico Deán Funes, Córdoba

DOI:

https://doi.org/10.56969/oc.v20i1.106

Palabras clave:

cáncer de cuello uterino, metástasis ganglionares para-aórticas, evaluación y tratamiento de metástasis para-aórticas, uterine cervix cancer, para-aortic ganglionar metastasis, evaluation and treatment of para-aortic me- tastasis

Resumen

El cáncer de cuello uterino (CCU) puede metastatizar a los ganglios para-aórticos (PA) con frecuencia creciente, acorde al estadio inicial. El Grupo Ginecológico de EE. UU. (GOG) evaluó quirúrgicamente 621 pacientes con CCU y comunicó una incidencia de 6% para aquellos con estadio I vs. 25% con estadio III. Mientras más avanzado sea el estadio p TN, mayor es la posibilidad de diagnosticar ganglios positivos y de mayor tamaño. También, a mayor volumen de las adenopatías más difícil el control local con cualquier terapéutica y mayor posibilidad de metástasis a distancia. Este análisis bibliográfico analiza el estado actual del papel de la cirugía, radioterapia y quimioterapia en el logro de controlar este desfavorable evento para curar la enfermedad.

Se enfatizan los logros recientes tanto en el diagnóstico como en la terapéutica de las metástasis de esta enfermedad en los ganglios PA. Se remarcan algunos hechos importantes tales como el uso del PET para diagnóstico y seguimiento, la utilización de la laparotomía por vía retroperitoneal para determinar el estado de los ganglios PA, y el tratamiento de radioterapia y quimioterapia. Se le da relieve a la utilización de la intensidad modulada (IMRT) como técnica radiante capaz de entregar mayor dosis con menos complicaciones. Probablemente conllevará al mejor manejo de las metástasis PA, y por ende un resultado terapéutico en CCU.

Citas

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