Jacinto Lopez Garcia - Academia.edu (original) (raw)
Papers by Jacinto Lopez Garcia
PloS one, 2018
Given the different nature and better outcomes of oropharyngeal carcinoma (OPC) associated with h... more Given the different nature and better outcomes of oropharyngeal carcinoma (OPC) associated with human papillomavirus (HPV) infection, a novel clinical stage classification for HPV-related OPC has been accepted for the 8th edition AJCC TNM (ICON-S model). However, it is still unclear the HPV-relatedness definition with best diagnostic accuracy and prognostic value. The aim of this study was to compare different staging system models proposed for HPV-related OPC patients: 7th edition AJCC TNM, RPA stage with non-anatomic factors (Princess Margaret), RPA with N categories for nasopharyngeal cancer (MD-Anderson) and AHR-new (ICON-S), according to different HPV-relatedness definitions: HPV-DNA detection plus an additional positive marker (p16INK4a or HPV-mRNA), p16INK4a positivity alone or the combination of HPV-DNA/p16INK4a positivity as diagnostic tests. A total of 788 consecutive OPC cases diagnosed from 1991 to 2013 were considered eligible for the analysis. Of these samples, 66 (8.4...
Acta Otorrinolaringológica Española, 2018
Introduction and objectives: The treatment of locally advanced carcinomas of the hypopharynx may ... more Introduction and objectives: The treatment of locally advanced carcinomas of the hypopharynx may include surgery or several combinations of radiotherapy and chemotherapy as organ preservation strategies. The objective of the present study is to analyze the results of locally advanced hypopharyngeal carcinoma patients treated in a single centre over a 30-year period. Methods: Retrospective chart review of 278 patients with T3-T4 hypopharyngeal carcinomas treated between 1985 and 2015 at a tertiary institution. Results: As much as 15.5% of the patients received only palliative treatment. Surgery, usually followed by radiotherapy or chemoradiotherapy was offered to 38.1% of the patients, and radiotherapy or chemoradiotherapy alone was offered to the remaining 46.6% of the patients. Cause-specific survival at 5 years was 39.7% (95% CI 33.7-45.7) for the whole sample. Surgery achieved better local control of the disease, but these figures did not translate into an increase of cause-specific survival for T3 tumours. Five-year survival free of laryngeal dysfunction for patients who received conservative treatment was 36.4%. In a multivariate analysis, only T4 local extension, N2-3 category, and posterior hypopharyngeal wall location related significantly with cause-specific survival. Conclusions: There were no significant differences in cause-specific survival related to treatment modality for T3 carcinomas. On the other hand, surgery achieved a significant increase in cause-specific survival for T4 hypopharyngeal carcinomas.
Acta otorrinolaringologica espanola, Jan 4, 2018
The epidemiological characteristics of patients with head and neck cancer squamous cell carcinoma... more The epidemiological characteristics of patients with head and neck cancer squamous cell carcinoma (HNSCC) have changed over recent years. The increase in life expectancy of the population, changed patterns of tobacco and alcohol use, and human papillomavirus infection (HPV) have brought about significant changes. The objective of the present study is to analyze the changes in the epidemiological and clinical characteristics of these patients over a 30-year period. Retrospective study of 5,123 patients with HNSCC treated over the period 1985-2017. We evaluated the existence of changes in the patterns of age, sex, tobacco and alcohol use, and location and extension of the tumours throughout the study period. HPV status was evaluated for patients with oropharyngeal carcinomas. Throughout the study period there was a significant increase in the mean age at presentation and in the percentage of women, and a decrease in the percentage of patients with history of high consumption of toxic ...
Brazilian journal of otorhinolaryngology, Jan 5, 2018
The pectoralis major flap is a reconstructive option to consider in the treatment of pharyngocuta... more The pectoralis major flap is a reconstructive option to consider in the treatment of pharyngocutaneous fistula after a total laryngectomy. There are not large studies assessing variables related to pharyngocutaneous fistula recurrence after removal of the larynx. Our objectives were to review the results obtained with this type of treatment when pharyngocutaneous fistula appears in laryngectomized patients, and to evaluate variables related to the results. We retrospectively reviewed our results using either a myocutaneous or fasciomuscular pectoralis major flap to repair pharyngocutaneous fistula in 50 patients. There were no cases of flap necrosis. Oral intake after fistula repair with a pectoralis major flap was restored in 94% of cases. Fistula recurrence occurred in 22 cases (44%), and it was associated with a lengthening of the hospital stay. Performing the flap as an emergency procedure was associated with a significantly higher risk of fistula recurrence. Hospital stay was s...
Oral oncology, 2018
The presence of nodes with extracapsular spread (ECS) and the lymph node ratio (LNR) have prognos... more The presence of nodes with extracapsular spread (ECS) and the lymph node ratio (LNR) have prognostic competence in the pathologic evaluation of patients with a head and neck squamous cell carcinoma (HNSCC) treated with a neck dissection. The purpose of this study is to assess the effect of ECS & LNR on prognosis of HPV negative HNSCC patients treated with neck dissection and to compare to 8th edition TNM/AJCC classification. We carried out a retrospective study of 1383 patients with HNSCC treated with a neck dissection between 1985 and 2013. We developed a classification of the patients according to the presence of nodes with ECS and the LNR value with a recursive partitioning analysis (RPA) model. We obtained a classification tree with four terminal nodes: for patients without ECS (including patients pN0) the cut-off point for LNR was 1.6%, while for patients with lymph nodes with ECS it was 11.4%. The 5-year disease-specific survival for patients without ECS/LNR < 1.6% was 83.3...
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, Jan 25, 2017
Tumor-infiltrating lymphocytes (TILs) have a recognized antitumor activity in head and neck squam... more Tumor-infiltrating lymphocytes (TILs) have a recognized antitumor activity in head and neck squamous cell carcinoma (HNSCC). CD45 is one of the most highly expressed proteins in lymphocytes. We carry out a study to assess the prognostic value of transcriptional expression of CD45 in HNSCC. We determined the transcriptional expression of CD45 in 160 consecutive HNSCC patients and compared the TIL values according to the CD45 expression. Five-year disease-free survival for patients with a high transcriptional expression of CD45 (n = 107) was 62.4% and for patients with a low expression (n = 53) it was 36.2% (P = 0.003). Patients with a high expression of CD45 had a better local recurrence-free survival and disease-specific survival. The results of a multivariate analysis showed that patients with a low expression of CD45 had 2.0-fold high risk of recurrence (95% CI 1.2-3.2, P = 0.003). In oropharyngeal carcinomas, HPV-positive tumors showed a higher transcriptional CD45 expression tha...
Acta otorrinolaringologica espanola, Jan 17, 2017
Total laryngectomy is one of the most mutilating oncological operations. There are no specific st... more Total laryngectomy is one of the most mutilating oncological operations. There are no specific studies evaluating return to work after this surgery. A cross-sectional study was performed on a sample of 116 laryngectomized patients who were disease- free and had a minimum follow-up of 2 years from total laryngectomy. A survey was conducted to find out their employment situation before and after surgery. At the time of surgery, 62 (53%) were working, 40 (35%) were retired and 14 (12%) were in a disability situation. 60% had professions with low qualification requirements, the largest group being construction workers. Of the 62 patients active at the time of total laryngectomy, 29 became inactive and 33 (53%) maintained their work activity. The most important factors in maintaining work activity were the level of professional qualification and the method of vocal rehabilitation. Eighty percent of the patients with high-intermediate qualification maintained their jobs, compared to 35% o...
Oral oncology, Jul 1, 2017
One of the main changes in the 8th edition of the TNM Classification for head and neck tumors is ... more One of the main changes in the 8th edition of the TNM Classification for head and neck tumors is the inclusion of extracapsular spread (ECS) as a criterion for evaluating the regional extension, both clinical (cN) and pathological (pN). The objective of our study is to evaluate the prognostic capacity derived from the inclusion of the ECS in the pathological classification of head and neck squamous cell carcinoma (HNSCC) patients treated with a neck dissection, as established by the 8th edition TNM Classification. Retrospective study of 1188 patients with HNSCC treated with a neck dissection between1990 and 2013. There were lymph node metastasis in 50.1% of the neck dissections. The pathological record revealed ECS in 50.5% of the positive neck dissections. The implementation of the changes of the 8th edition TNM classification produced the upstaging of 20.9% of the patients classified as pN1 with the 7th edition TNM classification to pN2a¸ and the upstaging of 58.4% of the patients...
European Archives of Oto-Rhino-Laryngology, 2016
Expression of the CXCL12/CXCR4 chemokine axis has been related with the appearance of metastatic ... more Expression of the CXCL12/CXCR4 chemokine axis has been related with the appearance of metastatic recurrence survival, including regional and distant recurrence, in patients with head and neck squamous cell carcinoma (HNSCC). RT-PCR was used to determine mRNA expression levels of CXCL12 and CXCR4 in biopsy tumor samples in 111 patients with HNSCC. Five-year regional recurrence-free survival for patients with low CXCR4 expression (n = 39, 31.5 %) was 97.4 %, for patients with high CXCR4/high CXCL12 expression (n = 22, 19.8 %) it was 94.7 %, and for patients with high CXCR4/low CXCL12 expression (n = 50, 45.0 %) it was 63.3 %. We found significant differences in the regional recurrence-free survival according to CXCR4/CXCL12 expression values (P = 0.001). HNSCC patients with high CXCR4 and low CXCL12 expression values had a significantly higher risk of regional recurrence and could benefit from a more intense treatment of lymph node areas in the neck. Keywords CXCL12 Á CXCR4 Á Regional recurrence Á Biomarker Á Head and neck squamous cell carcinoma Electronic supplementary material The online version of this article (
European Archives of Oto-Rhino-Laryngology, 2016
The presence of extracapsular spread (ECS) in patients with oral squamous cell carcinoma (OSCC) i... more The presence of extracapsular spread (ECS) in patients with oral squamous cell carcinoma (OSCC) indicates a poor prognosis and is associated with a higher risk of regional recurrence and distant metastasis. The aim of this study was to analyse this important feature of cervical lymph nodes in the clinically nodenegative setting. The study included 61 patients with clinically T1-T3N0 OSCC who underwent primary surgical treatment; 52 were male and nine were female, and their median age was 57 years. The 5-year disease-free survival, disease-specific survival, and overall survival rates were 30.6%, 28.3%, and 14.3%, respectively, in the ECS group compared to 61.9%, 61.9%, and 48.2%, respectively, in the pN +/ECS-negative group and 76.7%, 81.9%, and 47.0%, respectively, in the pN0 group. The differences between the survival curves were highly significant (P = 0.023, P = 0.003, and P = 0.029, respectively). The incidence of local (50% vs. 14.9%, P = 0.011) and regional (28.6% vs. 2.1%, P = 0.008) recurrence was significantly greater in the ECS group compared to the other subgroups of patients. Furthermore, the time to recurrence was significantly shorter in the ECS subjects. The presence of ECS in patients with oral cancer indicates a poor prognosis. ECS is a frequent feature in clinically node-negative settings and may be more common in smaller lymph nodes than is generally appreciated.
Auris Nasus Larynx, 2017
Background: The prognostic value of elevated pretreatment platelet counts remains controversial i... more Background: The prognostic value of elevated pretreatment platelet counts remains controversial in lung cancer patients. We performed the present meta-analysis to determine its precise role in these patients. Methods: We employed a multiple search strategy in the PubMed, EMBASE and Cochrane Library databases to identify eligible studies. Disease-free survival (DFS)/progression-free survival (PFS)/time to progression (TTP) and overall survival (OS) were used as outcomes with hazard ratios (HRs) and 95% confidence intervals (CIs). Heterogeneity among the studies and publication bias were also evaluated. Results: A total of 40 studies including 16,696 lung cancer patients were eligible for the analysis. Overall, the pooled analysis showed that compared with normal platelet counts, elevated pretreatment platelet counts were associated with poorer OS (HR = 1.54, 95% CI: 1.37-1.72, P < 0.001) and poorer DFS/PFS/TTP (HR = 1.62, 95% CI: 1.33-1.98, P < 0.001) in patients with lung cancer. In subgroup analyses, elevated pretreatment platelet counts were also associated with poorer OS and DFS/PFS/TTP in most subgroups. There was no evidence of publication bias. Conclusions: This meta-analysis revealed that elevated pretreatment platelet counts were an independent predictor of OS and DFS/PFS/TTP in lung cancer patients. Large-scale prospective studies and a validation study are warranted.
Pragmalinguistica, 1997
En un momento de la historia de la lingüística en que tan escasa atención se concede al estudio d... more En un momento de la historia de la lingüística en que tan escasa atención se concede al estudio de la sintaxis 1 se habrá de reconocer el inestimable valor que, sin lugar a dudas, adquiere la recopilación de artículos que sobre la unidad sintáctica oracional y las funciones que en este nivel desempeñan sus elementos constituyentes nos ofrece S. Gutiérrez Ordóñez. No se trata, al contrario de Jo que cabría esperar, de una revisión de las ideas, conceptos y conclusiones que en cada trabajo se presentaban. Tampoco es una actualización de las diversas teorías sintácticas que en el momento de la publicación de los referidos artículos se proponían, sino un compendio de ellos, agrupados por temas y no por orden cronológico. En cualquier caso, como el mismo autor refleja en el prólogo (pág. 12), por encima de las tesis que se defienden, se concede especial trascendencia al razonamiento, a la discusión, al análisis crítico y no al dogmatismo que con tanta frecuencia aparece en los estudios de sintaxis: «El lector no hallará en estas páginas un catecismo ni un breviario de dogmas ni un protocolo del 1 En este mismo sentido se expresa S. GutiérrezOrdMez(págs. ll-12) al prologar su libro: «Por ello me causan asombro y dolor el abandono y desdén que recibe esta disciplina en los •'dtsei\os curriculares" de la nueva ensei'lanza secundana. Los argumentos que se ofrecen para arrinconarla no dejan de ser peregrinos. La Sintaxis, claro está, no ensei\a a redactar ni a expresamos con fluidez. No nos engai'lemos: ni con el estudio de las figuras retóricas aprendíamos a componer poesías ni con la Pragmática y la Linglllstica del Texto nos convertiremos en buenos escritores, Ayudan pero no enseftan. Eso es cosa de práctica.»
PloS one, 2018
Given the different nature and better outcomes of oropharyngeal carcinoma (OPC) associated with h... more Given the different nature and better outcomes of oropharyngeal carcinoma (OPC) associated with human papillomavirus (HPV) infection, a novel clinical stage classification for HPV-related OPC has been accepted for the 8th edition AJCC TNM (ICON-S model). However, it is still unclear the HPV-relatedness definition with best diagnostic accuracy and prognostic value. The aim of this study was to compare different staging system models proposed for HPV-related OPC patients: 7th edition AJCC TNM, RPA stage with non-anatomic factors (Princess Margaret), RPA with N categories for nasopharyngeal cancer (MD-Anderson) and AHR-new (ICON-S), according to different HPV-relatedness definitions: HPV-DNA detection plus an additional positive marker (p16INK4a or HPV-mRNA), p16INK4a positivity alone or the combination of HPV-DNA/p16INK4a positivity as diagnostic tests. A total of 788 consecutive OPC cases diagnosed from 1991 to 2013 were considered eligible for the analysis. Of these samples, 66 (8.4...
Acta Otorrinolaringológica Española, 2018
Introduction and objectives: The treatment of locally advanced carcinomas of the hypopharynx may ... more Introduction and objectives: The treatment of locally advanced carcinomas of the hypopharynx may include surgery or several combinations of radiotherapy and chemotherapy as organ preservation strategies. The objective of the present study is to analyze the results of locally advanced hypopharyngeal carcinoma patients treated in a single centre over a 30-year period. Methods: Retrospective chart review of 278 patients with T3-T4 hypopharyngeal carcinomas treated between 1985 and 2015 at a tertiary institution. Results: As much as 15.5% of the patients received only palliative treatment. Surgery, usually followed by radiotherapy or chemoradiotherapy was offered to 38.1% of the patients, and radiotherapy or chemoradiotherapy alone was offered to the remaining 46.6% of the patients. Cause-specific survival at 5 years was 39.7% (95% CI 33.7-45.7) for the whole sample. Surgery achieved better local control of the disease, but these figures did not translate into an increase of cause-specific survival for T3 tumours. Five-year survival free of laryngeal dysfunction for patients who received conservative treatment was 36.4%. In a multivariate analysis, only T4 local extension, N2-3 category, and posterior hypopharyngeal wall location related significantly with cause-specific survival. Conclusions: There were no significant differences in cause-specific survival related to treatment modality for T3 carcinomas. On the other hand, surgery achieved a significant increase in cause-specific survival for T4 hypopharyngeal carcinomas.
Acta otorrinolaringologica espanola, Jan 4, 2018
The epidemiological characteristics of patients with head and neck cancer squamous cell carcinoma... more The epidemiological characteristics of patients with head and neck cancer squamous cell carcinoma (HNSCC) have changed over recent years. The increase in life expectancy of the population, changed patterns of tobacco and alcohol use, and human papillomavirus infection (HPV) have brought about significant changes. The objective of the present study is to analyze the changes in the epidemiological and clinical characteristics of these patients over a 30-year period. Retrospective study of 5,123 patients with HNSCC treated over the period 1985-2017. We evaluated the existence of changes in the patterns of age, sex, tobacco and alcohol use, and location and extension of the tumours throughout the study period. HPV status was evaluated for patients with oropharyngeal carcinomas. Throughout the study period there was a significant increase in the mean age at presentation and in the percentage of women, and a decrease in the percentage of patients with history of high consumption of toxic ...
Brazilian journal of otorhinolaryngology, Jan 5, 2018
The pectoralis major flap is a reconstructive option to consider in the treatment of pharyngocuta... more The pectoralis major flap is a reconstructive option to consider in the treatment of pharyngocutaneous fistula after a total laryngectomy. There are not large studies assessing variables related to pharyngocutaneous fistula recurrence after removal of the larynx. Our objectives were to review the results obtained with this type of treatment when pharyngocutaneous fistula appears in laryngectomized patients, and to evaluate variables related to the results. We retrospectively reviewed our results using either a myocutaneous or fasciomuscular pectoralis major flap to repair pharyngocutaneous fistula in 50 patients. There were no cases of flap necrosis. Oral intake after fistula repair with a pectoralis major flap was restored in 94% of cases. Fistula recurrence occurred in 22 cases (44%), and it was associated with a lengthening of the hospital stay. Performing the flap as an emergency procedure was associated with a significantly higher risk of fistula recurrence. Hospital stay was s...
Oral oncology, 2018
The presence of nodes with extracapsular spread (ECS) and the lymph node ratio (LNR) have prognos... more The presence of nodes with extracapsular spread (ECS) and the lymph node ratio (LNR) have prognostic competence in the pathologic evaluation of patients with a head and neck squamous cell carcinoma (HNSCC) treated with a neck dissection. The purpose of this study is to assess the effect of ECS & LNR on prognosis of HPV negative HNSCC patients treated with neck dissection and to compare to 8th edition TNM/AJCC classification. We carried out a retrospective study of 1383 patients with HNSCC treated with a neck dissection between 1985 and 2013. We developed a classification of the patients according to the presence of nodes with ECS and the LNR value with a recursive partitioning analysis (RPA) model. We obtained a classification tree with four terminal nodes: for patients without ECS (including patients pN0) the cut-off point for LNR was 1.6%, while for patients with lymph nodes with ECS it was 11.4%. The 5-year disease-specific survival for patients without ECS/LNR < 1.6% was 83.3...
European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery, Jan 25, 2017
Tumor-infiltrating lymphocytes (TILs) have a recognized antitumor activity in head and neck squam... more Tumor-infiltrating lymphocytes (TILs) have a recognized antitumor activity in head and neck squamous cell carcinoma (HNSCC). CD45 is one of the most highly expressed proteins in lymphocytes. We carry out a study to assess the prognostic value of transcriptional expression of CD45 in HNSCC. We determined the transcriptional expression of CD45 in 160 consecutive HNSCC patients and compared the TIL values according to the CD45 expression. Five-year disease-free survival for patients with a high transcriptional expression of CD45 (n = 107) was 62.4% and for patients with a low expression (n = 53) it was 36.2% (P = 0.003). Patients with a high expression of CD45 had a better local recurrence-free survival and disease-specific survival. The results of a multivariate analysis showed that patients with a low expression of CD45 had 2.0-fold high risk of recurrence (95% CI 1.2-3.2, P = 0.003). In oropharyngeal carcinomas, HPV-positive tumors showed a higher transcriptional CD45 expression tha...
Acta otorrinolaringologica espanola, Jan 17, 2017
Total laryngectomy is one of the most mutilating oncological operations. There are no specific st... more Total laryngectomy is one of the most mutilating oncological operations. There are no specific studies evaluating return to work after this surgery. A cross-sectional study was performed on a sample of 116 laryngectomized patients who were disease- free and had a minimum follow-up of 2 years from total laryngectomy. A survey was conducted to find out their employment situation before and after surgery. At the time of surgery, 62 (53%) were working, 40 (35%) were retired and 14 (12%) were in a disability situation. 60% had professions with low qualification requirements, the largest group being construction workers. Of the 62 patients active at the time of total laryngectomy, 29 became inactive and 33 (53%) maintained their work activity. The most important factors in maintaining work activity were the level of professional qualification and the method of vocal rehabilitation. Eighty percent of the patients with high-intermediate qualification maintained their jobs, compared to 35% o...
Oral oncology, Jul 1, 2017
One of the main changes in the 8th edition of the TNM Classification for head and neck tumors is ... more One of the main changes in the 8th edition of the TNM Classification for head and neck tumors is the inclusion of extracapsular spread (ECS) as a criterion for evaluating the regional extension, both clinical (cN) and pathological (pN). The objective of our study is to evaluate the prognostic capacity derived from the inclusion of the ECS in the pathological classification of head and neck squamous cell carcinoma (HNSCC) patients treated with a neck dissection, as established by the 8th edition TNM Classification. Retrospective study of 1188 patients with HNSCC treated with a neck dissection between1990 and 2013. There were lymph node metastasis in 50.1% of the neck dissections. The pathological record revealed ECS in 50.5% of the positive neck dissections. The implementation of the changes of the 8th edition TNM classification produced the upstaging of 20.9% of the patients classified as pN1 with the 7th edition TNM classification to pN2a¸ and the upstaging of 58.4% of the patients...
European Archives of Oto-Rhino-Laryngology, 2016
Expression of the CXCL12/CXCR4 chemokine axis has been related with the appearance of metastatic ... more Expression of the CXCL12/CXCR4 chemokine axis has been related with the appearance of metastatic recurrence survival, including regional and distant recurrence, in patients with head and neck squamous cell carcinoma (HNSCC). RT-PCR was used to determine mRNA expression levels of CXCL12 and CXCR4 in biopsy tumor samples in 111 patients with HNSCC. Five-year regional recurrence-free survival for patients with low CXCR4 expression (n = 39, 31.5 %) was 97.4 %, for patients with high CXCR4/high CXCL12 expression (n = 22, 19.8 %) it was 94.7 %, and for patients with high CXCR4/low CXCL12 expression (n = 50, 45.0 %) it was 63.3 %. We found significant differences in the regional recurrence-free survival according to CXCR4/CXCL12 expression values (P = 0.001). HNSCC patients with high CXCR4 and low CXCL12 expression values had a significantly higher risk of regional recurrence and could benefit from a more intense treatment of lymph node areas in the neck. Keywords CXCL12 Á CXCR4 Á Regional recurrence Á Biomarker Á Head and neck squamous cell carcinoma Electronic supplementary material The online version of this article (
European Archives of Oto-Rhino-Laryngology, 2016
The presence of extracapsular spread (ECS) in patients with oral squamous cell carcinoma (OSCC) i... more The presence of extracapsular spread (ECS) in patients with oral squamous cell carcinoma (OSCC) indicates a poor prognosis and is associated with a higher risk of regional recurrence and distant metastasis. The aim of this study was to analyse this important feature of cervical lymph nodes in the clinically nodenegative setting. The study included 61 patients with clinically T1-T3N0 OSCC who underwent primary surgical treatment; 52 were male and nine were female, and their median age was 57 years. The 5-year disease-free survival, disease-specific survival, and overall survival rates were 30.6%, 28.3%, and 14.3%, respectively, in the ECS group compared to 61.9%, 61.9%, and 48.2%, respectively, in the pN +/ECS-negative group and 76.7%, 81.9%, and 47.0%, respectively, in the pN0 group. The differences between the survival curves were highly significant (P = 0.023, P = 0.003, and P = 0.029, respectively). The incidence of local (50% vs. 14.9%, P = 0.011) and regional (28.6% vs. 2.1%, P = 0.008) recurrence was significantly greater in the ECS group compared to the other subgroups of patients. Furthermore, the time to recurrence was significantly shorter in the ECS subjects. The presence of ECS in patients with oral cancer indicates a poor prognosis. ECS is a frequent feature in clinically node-negative settings and may be more common in smaller lymph nodes than is generally appreciated.
Auris Nasus Larynx, 2017
Background: The prognostic value of elevated pretreatment platelet counts remains controversial i... more Background: The prognostic value of elevated pretreatment platelet counts remains controversial in lung cancer patients. We performed the present meta-analysis to determine its precise role in these patients. Methods: We employed a multiple search strategy in the PubMed, EMBASE and Cochrane Library databases to identify eligible studies. Disease-free survival (DFS)/progression-free survival (PFS)/time to progression (TTP) and overall survival (OS) were used as outcomes with hazard ratios (HRs) and 95% confidence intervals (CIs). Heterogeneity among the studies and publication bias were also evaluated. Results: A total of 40 studies including 16,696 lung cancer patients were eligible for the analysis. Overall, the pooled analysis showed that compared with normal platelet counts, elevated pretreatment platelet counts were associated with poorer OS (HR = 1.54, 95% CI: 1.37-1.72, P < 0.001) and poorer DFS/PFS/TTP (HR = 1.62, 95% CI: 1.33-1.98, P < 0.001) in patients with lung cancer. In subgroup analyses, elevated pretreatment platelet counts were also associated with poorer OS and DFS/PFS/TTP in most subgroups. There was no evidence of publication bias. Conclusions: This meta-analysis revealed that elevated pretreatment platelet counts were an independent predictor of OS and DFS/PFS/TTP in lung cancer patients. Large-scale prospective studies and a validation study are warranted.
Pragmalinguistica, 1997
En un momento de la historia de la lingüística en que tan escasa atención se concede al estudio d... more En un momento de la historia de la lingüística en que tan escasa atención se concede al estudio de la sintaxis 1 se habrá de reconocer el inestimable valor que, sin lugar a dudas, adquiere la recopilación de artículos que sobre la unidad sintáctica oracional y las funciones que en este nivel desempeñan sus elementos constituyentes nos ofrece S. Gutiérrez Ordóñez. No se trata, al contrario de Jo que cabría esperar, de una revisión de las ideas, conceptos y conclusiones que en cada trabajo se presentaban. Tampoco es una actualización de las diversas teorías sintácticas que en el momento de la publicación de los referidos artículos se proponían, sino un compendio de ellos, agrupados por temas y no por orden cronológico. En cualquier caso, como el mismo autor refleja en el prólogo (pág. 12), por encima de las tesis que se defienden, se concede especial trascendencia al razonamiento, a la discusión, al análisis crítico y no al dogmatismo que con tanta frecuencia aparece en los estudios de sintaxis: «El lector no hallará en estas páginas un catecismo ni un breviario de dogmas ni un protocolo del 1 En este mismo sentido se expresa S. GutiérrezOrdMez(págs. ll-12) al prologar su libro: «Por ello me causan asombro y dolor el abandono y desdén que recibe esta disciplina en los •'dtsei\os curriculares" de la nueva ensei'lanza secundana. Los argumentos que se ofrecen para arrinconarla no dejan de ser peregrinos. La Sintaxis, claro está, no ensei\a a redactar ni a expresamos con fluidez. No nos engai'lemos: ni con el estudio de las figuras retóricas aprendíamos a componer poesías ni con la Pragmática y la Linglllstica del Texto nos convertiremos en buenos escritores, Ayudan pero no enseftan. Eso es cosa de práctica.»