997 resultados para Espagne (1500-1600)


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OBJECTIVE: To compare outcomes of patients with lymph node (LN)-positive urothelial carcinoma of the bladder (UCB) treated with or without cisplatin-based combined adjuvant chemotherapy (AC) after radical cystectomy (RC). PATIENTS AND METHODS: We retrospectively analysed 1523 patients with LN-positive UCB, who underwent RC with bilateral pelvic LN dissection. All patients had no evidence of disease after RC. AC was administered within 3 months. Competing-risks models were applied to compare UCB-related mortality. RESULTS: Of the 1523 patients, 874 (57.4%) received AC. The cumulative 1-, 2- and 5-year UCB-related mortality rates for all patients were 16%, 36% and 56%, respectively. Administration of AC was associated with an 18% relative reduction in the risk of UCB-related death (subhazard ratio 0.82, P = 0.005). The absolute reduction in mortality was 3.5% at 5 years. The positive effect of AC was detectable in patients aged ≤70 years, in women, in pT3-4 disease, and in those with a higher LN density and lymphovascular invasion. This study is limited by its retrospective and non-randomised design, selection bias, the absence of central pathological review and lack in standardisation of LN dissection and cisplatin-based protocols. CONCLUSION: AC seems to reduce UCB-related mortality in patients with LN-positive UCB after RC. Younger patients, women and those with high-risk features such as pT3-4 disease, a higher LN density and lymphovascular invasion appear to benefit most. Appropriately powered prospective randomised trials are necessary to confirm these findings.

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Teokset Biblia sacra hebraice, graece & latine, Heidelberg 1587; teoksen omistanut Marcus Henrici Helsingius, joka on ostanut sen Wittenbergistä 1592; etukannen keskellä Lutherin kuva avattu kirja käsissään, sekä Georg Major, Enarrationes Epistolarum S. Pauli(I) Wittenberg 1569; teos kuulunut Christianus Bartholdii Ruuthille, jonka nimikirjaimet etukannan yläosassa; 1574 viittaa sidotusvuoteen.

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En este trabajo se explicitanlos resultados de los análisis esporopoiínicos realizados en múltiples niveles del Cretácico terminal-Terciario basa1 en el sector N:E. de la Península Ibérica. Los datos de los que actualmente se dispone permiten deducir variaciones climáticas significativas entre el Maastrichtiense y el Ilerdiense inferior-medio en el sector pirenaico catalano-aragonés. Es muy evidente que esos cambios climáticos no guardan una relación exacta con el límite actualmente aceptado entre el Cretácico y el Terciario. Finalmente hay que considerar que a faltade datos cronoe~tratigr~cos claramente fiables (vertebrados, micromamíferos, ... ), los datos suministrados por la paleoflora solo permiten aproximaciones, sobre todo si, como sucede en la zona estudiada, los datos corresponden a una sucesión vertical no completamente contínua.

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