CNCER GASTRICO

DR. EDWIN GUALLASAMIN CIRUJANO ONCOLOGOHOSPITAL SOLON ESPINOSA AYALASOLCA NUCLEO DE QUITO

EPIDEMIOLOGA1930-1980 CADA DRAMTICA EN USA

1980-1994 CASI IGUAL

EN USA SE HALLA DENTRO DE LAS 10 CAUSAS DE MUERTES.

JAPN MORTALIDAD HOMBRES 50% MUJERES 40%.Silverberg E, Boring CC, Squires TS. Cancer Statistics, CA 2000;40:9.

CNCER GSTRICOSilverberg E, Boring CC, Squires TS. Cancer Statistics, CA 2000;40:9.

TASAS ESTANDARIZADAS / A.S.R.W.

FUENTE:/ SOURCE: IARC - IACR CI5C. Vol. VII (1997)NOTA: Si un pas tiene varios registros, slo se toma en cuenta la incidencia ms alta. (53 pases)NOTE: If a country has many cancer registries we select only highest incidence

GRAFICO / FIGURE 17ESTOMAGO. INCIDENCIAS MAS ALTAS EN ELMUNDO Y LATINOAMERICA. HOMBRESSTOMACH. HIGHEST INCIDENCE RATES IN THE WORLD AND LATINAMERICA. MALES

1234567101112

CNCER GASTRICOSilverberg E, Boring CC, Squires TS. Cancer Statistics, CA 2000;40:9.

TASAS ESTANDARIZADAS / A.S.R.W.

FUENTE:/ SOURCE: IARC - IACR CI5C. Vol. VII (1997)NOTA: Si un pas tiene varios registros, slo se toma en cuenta la incidencia ms alta. (53 pases)NOTE: If a country has many cancer registries we select only highest incidence

GRAFICO / FIGURE 18ESTOMAGO. INCIDENCIAS MAS ALTAS EN ELMUNDO Y LATINOAMERICA. MUJERESESTOMAGO. HIGHEST INCIDENCE RATES IN THE WORLD AND LATINAMERICA. FEMALES

12345678913

EPIDEMIOLOGASilverberg E, Boring CC, Squires TS. Cancer Statistics, CA 2000;40:9.

CNCER GSTRICO

CNCER DE ESTOMAGO. TASAS DE INCIDENCIA ESTANDARIZADAS EN REGIONES DEL ECUADOR

Cuenca H 30.9 M 21.3

Loja H 56.4 M 40.3

Manab H 30.0 M 16.9

Quito H 25.6 M 18.2

Tungurahua H 38.0 M 29.3

CNCER GSTRICO

Prstata 35.5

Estmago 25.6

Piel 29.9

Sist. Hematop. 10.0

Linfticos 8.9

Pulmn 8.6

Cuello terino (inv) 23.3

Cuello uterino (In situ) 9.8

Mama 29.9

Piel 27.3

Estmago 18.2

Tiroides 8.4

Ovario 8.3

PRIMERAS LOCALIZACIONES EN CANCER Residentes en Quito 1995-1999

Tasas de incidencia est. x 100.000

FACTORES DE RIESGO

FACTORES DE RIESGOFACTORES EXOGENOSDIETA:ALTA INGESTA DE HC DE ALTO CONTENIDO EN ALMIDN.

BAJA INGESTA DE PROTENAS DE ORIGEN ANIMAL.

ALTA PROPORCIN DE PROTENAS DE ORIGEN VEGETAL.

CONSUMO DE FRUTAS Y VEGETALES.

ALTO CONSUMO DE ALIMENTOS MAL CONSERVADOS Y SAL (NITRATOS, NITRITOS, NITROSAMINAS, CARCINOGENOS )

BAJO CONSUMO DE VITAMINA A Y C

ALCOHOL, TABACO, ACTIVIDAD LABORAL (CAUCHO, CARBN ).ROBERT B. CAMERON., PROCESOS MALIGNOS DEL ESTOMAGO, EN: ONCOLOGIA PRACTICA, 2000, Pp:254-264

FACTORES DE RIESGOFACTORES ENDOGENOSEDAD: 50 70 AOS.SEXO: H / M ( 2: 1 )RAZA: N / B ( 3 : 1 )APF: ( 3 : 1 )GRUPO SANGUNEO: A ( 15 20 % )SIND. FAMILIAR: SIND. PEUTZ JEGHERS HAMARTOMAS ENF. MENETRIER CIRUGA GSTRICA PREVIA INFECCIN H. PYLORIROBERT B. CAMERON., PROCESOS MALIGNOS DEL ESTOMAGO, EN: ONCOLOGIA PRACTICA, 2000, Pp:254-264

FACTORES DE RIESGOGENTICOS:

- METILACIN DEL GEN E-CADERINA/CDH1 EL CUAL EST LOCALIZADO EN EL CROMOSOMA 16Q Y 22

- LOS SD. FAMILIARES PRESENTAN TUMORES MUY AGRESIVOS, POCO DIFERENCIADOS, Y TUMORES CON CELULAS EN ANILLO DE SELLOROBERT B. CAMERON., PROCESOS MALIGNOS DEL ESTOMAGO, EN: ONCOLOGIA PRACTICA, 2000, Pp:254-264

H. PYLORIZinsser, MICROBIOLOGA, 20 a. edicin; Duke University Medical Center 1997.

H. PYLORIZinsser, MICROBIOLOGA, 20 a. edicin; Duke University Medical Center 1997.

FISIOPATOLOGIA

Infeccion por H.Pylori

Gastritis cronica

Atrofia gastrica Metaplasia intestinal

Displasia

AdenocarcinomaSleisenger & Fordtran; Enfermedades Gastrointestinales, Medical Center S. Fco: 2000

EVOLUCIN NATURAL

EN LA MAYORA DE LOS INDIVIDUOS LA DISPLASIA LEVE Y MODERADA TIENDE A REMITIR, O A PERMANECER ESTABLE, SIN EMBARGO, CUANDO HAY DISPLASIA DE ALTO GRADO, SE HALLA CNCER GSTRICO CONCURRENTE O QUE APARECE EN CUESTIN DE MESES.Sleisenger & Fordtran; Enfermedades Gastrointestinales, Medical Center S. Fco: 2000

ANATOMIA PATOLOGICA

ANATOMIA PATOLOGICALA NEOPLASIA EPITELIAL MALIGNA DE LA MUCOSA GASTRICA SEGN EL GRADO DE INFILTRACION DE LA PARED SE DIVIDE EN:

- CARCINOMA PRECOZ. - CARCINOMA AVANZADO.VINCENT T. DE VITA, JR., CANCER DE ESTOMAGO, EN: CANCER PRINCIPIOS Y PRACTICA ONCOLOGICA, V EDICION, TOMO I, 2000, Pp: 1021-1053

ANATOMIA PATOLOGICACARCINOMA PRECOZ: INFILTRA MUCOSA O MUCOSA Y SUBMUCOSA INDEPENDIENTE DE QUE HAYA O NO METZ GANGLIONARES

CARCINOMA AVANZADO: INFILTRA MAS HALLA DE SUBMUCOSA AFECTANDO LA MUSCULAR PROPIA, SEROSA Y GRASA PERIVISCERAL.VINCENT T. DE VITA, JR., CANCER DE ESTOMAGO, EN: CANCER PRINCIPIOS Y PRACTICA ONCOLOGICA, V EDICION, TOMO I, 2000, Pp: 1021-1053

CLASIFICACIN DEL CNCER GSTRICO DE ACUERDO A LA PROFUNDIDAD DEL TUMOR (T), RELACIN CON EE.Sleisenger & Fordtran; Enfermedades Gastrointestinales, Medical Center S. Fco: 2000

CLASIFICACION PATOLOGICA CA GASTRICO PRECOZ

TIPO I: ELEVADOTIPO II: PLANO. SUBTIPOS: IIA: SUPERFICIAL ELEVADO IIB: SUPERFICIAL PLANO IIC: SUPERFICIAL DEPRIMIDOTIPO III: EXCAVADO O ULCERADOVINCENT T. DE VITA, JR., CANCER DE ESTOMAGO, EN: CANCER PRINCIPIOS Y PRACTICA ONCOLOGICA, V EDICION, TOMO I, 2000, Pp: 1021-1053

CLASIFICACION BORRMANN CA GASTRICO AVANZADOTIPO 1: MASA POLIPODEA.TIPO 2: MASA POLIPOIDEA CON ULCERACION CENTRAL (FUNGOSO).TIPO 3: LESION INFILTRANTE CON ULCERACION CENTRAL (ULCERADO).TIPO 4: LESION INFILTRANTE DIFUSA (LINITIS PLASTICA).TIPO 5: LESIONES NO CLASIFICABLES.VINCENT T. DE VITA, JR., CANCER DE ESTOMAGO, EN: CANCER PRINCIPIOS Y PRACTICA ONCOLOGICA, V EDICION, TOMO I, 2000, Pp: 1021-1053

CLASIFICACION BORRMANN CA GASTRICO AVANZADOFRECUENCIA:

- LESION TIPO SUPERFICIAL 6% - LESION TIPO POLIPOIDE 7% - LESION TIPO FUNGOSO 36% - LESION TIPO ULCERADO 25% - LESION TIPO DIFUSO 26%BARRY W. FEIG., CARCINOMA GASTRICO, EN: ONCOLOGIA QUIRUGICA MD ANDERSON, 2005, Pp: 139-177.

CLASIFICACION DE LAURENTIPO INTESTINAL:

HISTOLOGIA SIMILAR AL CA COLON.

SE ASOCIA CON ATROFIA DE LA MUCOSA GSTRICA, GASTRITIS CRNICA, METAPLASIA INTESTINAL Y DISPLASIA, TIENDEN A FORMAR GLNDULAS. Y SE ASOCIA CON INFECCION POR H. PYLORI

MAYOR EN VARONES Y VIEJOS.

MAYOR EN AREAS ENDEMICAS COMO JAPN Y CHINA .

DISEMINACION POR VA HEMATGENA

FRECUENCIA DEL 53%HALLAND FREI., CANCER DE ESTOMAGO, EN: CANCER MEDICINE, 2003, Pp: 1325-1372.

CLASIFICACION DE LAURENTIPO DIFUSO:

SON TUMORES POCO DIFERENCIADOS, POR TENER CLULAS EN ANILLO DE SELLO.

MAYOR EN MUJERES Y JVENES SIN ANTECEDENTES DE PATOLOGIA GASTRICA PREVIA.

MAYOR EN AREAS CON PREVALENCIA BAJA.

MAYOR EN GRUPO SANGUINEO A.

DISEMINACION VA LINFTICA.

FRECUENCIA 33%.HALLAND FREI., CANCER DE ESTOMAGO, EN: CANCER MEDICINE, 2003, Pp: 1325-1372.

CLASIFICACION DE LAURENTIPO INDETERMINADO

SON LOS QUE NO SE PUEDE CLASIFICAR EN LOS GRUPOS ANTERIORES YA QUE POSEEN CARACTERISTICAS INTERMEDIAS.

FRECUENCIA DEL 14%.HALLAND FREI., CANCER DE ESTOMAGO, EN: CANCER MEDICINE, 2003, Pp: 1325-1372.

LOCALIZACION FRECUENTE

CNCER GSTRICOBARRY W. FEIG., CARCINOMA GASTRICO, EN: ONCOLOGIA QUIRUGICA MD ANDERSON, 2005, Pp: 139-177.

LOCALIZACION DE ADENOCARCINOMAS GASTRICOSEEUU(1996-2001)

Grfico2

19

38

35

59

MAESTRA

PLANILLA MAESTRA PIEZAS DIGESTIVAS

CASO NBIOPSIANOMBREEDADSEXO M/FRUTFICHATIPO CIRUGIAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLEESOFAGOTERCIO MEDIOTERCIO INFERESTOMAGOU. GA-ESOFCARDIALFONDOANTROC. MENORC. MAYORDUODENOCOLONCIEGOASCENDENTETRANSVERSODESCENDENTESIGMOIDESRECTOANODG MACROINCIPIENTEINTERMEDIOAVANZADOTIPO MACROINCIPENTEAVANZADO (B)TIPO HISTOGICOT. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAINV. PAREDMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIACOMPROMISOLINFATICOSANGUINEOPERINEURALMARGENES QUIRPROXIMALDISTALRADIALGANGLIOSNUMERO TOTALPOSITIVOSCOMPR EPIPLONMAYORMENORORG VECINOSVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALTTO ADICIONALQUIMIORADIO

7133.92LSM62M4366211111II c L11000000113000

8133.932LFP67M4295191111II a+ II c11000000130000

9139.786RAA57M4397861111B II111000000330000

10133945DPR75M440506111B III1100000072000

12133944ACS76F62683111B III11000000255000

2014059864M439987111B IV1100000051000001

2114059743M442361111B II1110000005000

2214096364M600215111B II110000007200

2414091876M443276111I1100000016000

25141605PPR60M443285111B III11110000225110

43143064CNC60M44610411#"1"1"1#3"""1#II c+III"""B III#41"2""1#1#1#1#0002817010

46143092JMG67M409736111II c+ III L110000002100000

47143117MIH37F6042201111B II11000000251010

48143135MCF62F4273771111B III110000005320000

49143.13LRM67F42695811110000004000

50143.131IAH50F4467281111B III11100001201210

52143295CSM20M6062741111B II1111000023120000

54143.202LAM61M6048771111II a+ II c1100000032000

56143.217JHH70M446375111II c110000001200

57143.227AMD67M604816111B III11111000198000

58143.234NBG45F446946111I110000002000

59143251FARNCM11357311B IV11000000200000

62145011FMS55M6048761111B II1110000028140011

63145.09HFP65M336869111B III110000001700011

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67145.075RER53M605693111B II11000000312001

68145.076CRH74M608929111B II111100000201200

7014509965M3368691111B III110000001700000

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7714519155M447252111B III111111100022150

78145.20279F447.294111B III1111100013400

81145.24869M447.32811NC1B III11010000112000

82145.25573F192.977111BIII1110000002470011

87145.31537M203.1151111BII11100000499001

90145.34556M616071111B II1111000022120

91145.35726F615006111B III1101000010800

92145.35842M447392111B V11110010000000

9414538127M1352101111B V110000005470000

9614540168M4474451 (ID)1B V11000000

98145.411159M613333111IIC1100000000

10114544958M355791111B III111100000000

10214545074M6047301111BIII11000000112000

108149.04646F61815111111100000032000

109149.07672M622343111B IV111110002010

113149.14343M623974111B III11000000246000

114149.14984M621900111B II110000005000

118149.20775F3212341111B III1110100038100

119149.18157M6254351111111110003018000

120149.18774M613387111B III11010000200000

12314919868M227300111B I1111000002700000

128149.23684F616357111B III1100001011000

131149.26767F140587111B III1100000060000

132149.28948F626787111IIC+III like1111101000321000

133149.29763F631803111B III1100000029140000

147149.419FHP77M635195111B III11100001112

149149.435HRA63M635573111I1100000010000

150149.45PMM69M633207111B III11000000200001

151149.458MSS66F635945111B II11111100016000

153149.462RRY50M6333351111B III1111100129260000

157149490HCN48M634727111BII111100003811100

211149942JRA72M15191111B III11100000152000

215149951AZ68F64964211111B II1111110002651010

217149983NRR52FNC111II c110000004000

219149996EJ51F6537761111II c110000014000

254155256JAJ59M66444511#1111B II110000002820000

276155475JOC60M6634571111BII11000000180000

282160799RBB70M436440111#1B III11#1110000290010

283160800MSA74F68049811#1"1#1"2#"BII#;B I"1#"1#"1#1"1000004316000

286161140FGF57F8609011111BII1111100012001

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291161488LUG83MNC111II b1100000080000

292161683JUP42M686477111B III1110000001360

7735825-02LMG48F7654801I DELG1000000NCNC

7786341-02ARA64F8372611111B V11000001563100

7796342-02AFS40F853290111B III111000005013000

7836997-02IMR51M629514111B III111000005611000

7846899-02ELE58F409281111B I111110008401

7857342-02LLI76M604811111B III1100000118001

7937661-02ESG59F389784111IIc+III1110000016100

8028778-02YAP69F862076111B III1111100063100

8038788-02JIA61M860808111B III111000003610000

8069014-02HJV51F8609811111B II11000000390000

8109282-02AJM47F8631041I DELG100000

8119345-02ACR81F844094111100000

8149399-02JFZ50M8612241111B II11000000263000

8220098-03CLA62M8643741111B V111001001359000

A2133.756AGS79F423664111II c like1100000027000

A3133.755JTM51M2427301111I V1111000000121100

A4133.744CVL73M14396111#11#1#1II a #I+ II a L1#11#1000000192000

A5133.732SVL51M427023111BI110000002770000

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A13133.592FSS66MNC111B III111000001010000

A18133.541HMC69M4230451111B III1111100001461011

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A 25133835PCC75M131459111B III110000001910000

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A41133817LCE29M4332171111100000090

ESTOMAGO

PLANILLA PATOLOGIA GASTRICATIPO MACROSCOPICO

INCIPIENTEAVANZADO

DATOS GENERALES PACIENTETIPO DE CIRUGIAUBICACIN DEL TUMORDUODENODIAGNOSTICO MACROSCOPICOTIPO ITIPO IITIPO IIICOMBINACIONESINCIPENTEBORRMANNTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARG QUIRURGICOSGANGLIOSCOMPROMISO EPIPLONCOMPROMISO ORGANOS VECINOSTRATAMIENTO ADICIONAL

numerarCASO NBIOPSIANOMBREEDADSEXOFICHAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLEU. GA-ESOFCARDIALFONDOANTROC. MENORC. MAYORDUODENOINCIPIENTEINTERMEDIOAVANZADOIIIaIIbIIcIIIIIa + IIcIIa + IIbIIc + IIIIIc + IIbtotalIIIIIIIVVLtotalTUB BDTUB MDTUB PDTUBULO PAPILPAPILARANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAM PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALN TOTALPOSITIVOSMAYORMENORVESICULAPANCRBAZOHIGRIUTEOVVAGP ABDAP CECQUIMIORADIO

17133920LSM62M4366211111IIcII c L11000000113000

28133932LFP67M42951911111II a+ II c11000000130000

39139786RAA57M43978611111B II111000000330000

410133945DPR75M4405061111B III1100000072000

512133944ACS76F626831111B III11000000255000

62014059864M4399871111B IV1100000051000001

72114059743M4423611111B II1110000005000

82214096364M6002151111B II110000007200

92414091876M4432761111I1100000016000

1025141605PPR60M4432851111B III11110000225110

1127141271JGP77MNC1111B III110001500

1229141317NRS53M44427011111B II111000007000

1330141322NLG32F4450101111II c1110100013300

1431141323CAV49M4450131111II c1110000010200

1533141335FRQ78M1413971111B III11000000201000

1634141427DSMO67M44503311111B IV1100016000

1735141406JGG59F4332361111B II1110100026600

1843143064CNC60M44610411#"1"1"1#3"""1#II c+III"""B III#41"2""1#1#1#1#0002817010

1946143092JMG67M409736111Iic + IIIII c+ III L110000002100000

2047143117MIH37F60422011111B II11000000251010

2148143135MCF62F42737711111B III110000005320000

2249143130LRM67F42695811110000004000

2350143131IAH50F44672811111B III11100001201210

2452143295CSM20M60627411111B II1111000023120000

2554143202LAM61M60487711111II a+ II c1100000032000

2656143217JHH70M4463751111II c110000001200

2757143227AMD67M6048161111B III11111000198000

2858143234NBG45F4469461111I110000002000

2959143251FARNCM113573111B IV11000000200000

3062145011FMS55M60487611111B II1110000028140011

3163145090HFP65M3368691111B III110000001700011

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4082145255ESF73F192.9771111B III1110000002470011

4187145315LCF37M203.11511111B II11100000499001

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4391145357ESR26F6150061111B III1101000010800

4492145358FC42M4473921111B V11110010000000

4594145381RPF27M13521011111B V110000005470000

4696145401LJ68M4474451 (ID)11B V11000000

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53114149149MHA84M6219001111B II110000005000

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55119149181ORG57M6254351111111110003018000

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60132149289EDRDR48F626787111Iic + iiiIIC+III like1111101000321000

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62147149419FHP77M6351951111B III11100001112

63149149435HRA63M6355731111I1100000010000

64150149450PMM69M6332071111B III11000000200001

65151149458MSS66F6359451111B II11111100016000

66153149462RRY50M63333511111B III1111100129260000

67157149490HCN48M6347271111B II111100003811100

68211149942JRA72M151911111B III11100000152000

69215149951AZ68F649642111111B II1111110002651010

70217149983NRR52FNC1111II c110000004000

71219149996EJ51F65377611111II c110000014000

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73276155475JOC60M66345711111B II11000000180000

74282160799RBB70M436440111#11B III11#1110000290010

75283160800MSA74F68049811#1"1#1"2#"BII#;B I"1#"1#"1#1"1000004316000

76286161140FGF57F86090111111B II1111100012001

77287161258FCC63F69009811111B III11000000471000

78291161488LUG83MNC1111II b1100000080000

79292161683JUP42M6864771111B III1110000001360

80296162148JMV50M6856461111B V11000190

81304162754EPV75F6885921111B III110001740

82305162775MOC67M68639711111B III1100023130100

83307162909LSR34F6895161111II c100043000

84308163054JCM68F6878731111111B IV111100036171000

85311163191IGM26F666547111111II c + III1100022000

86312163332RMM56M6893371111B V1111000442100

87321164026SFC61M6974541111B II1100090000

88331164889CCG41F69299311111II c11000272000

89332164893RNQ75F6760321111B III11000300000

90335165143GI60M6595611111B III111000302401

91336165144CGR68M4168431111B III111110001750

92346166018MTV65F3048941111B III11004510000

93349166022MVR44M701288111111B V11003820000

94353166197BAB60M7085211111B III11101002828010

95356166267JOE62M7004031111B II110000020000

96358166579CLI52M69672611111B IV110056810

97359166843MBL36F71123611111B II1110019100

98362167051RdFC26F697921111PLIEGUES GRUESOS1100000145000

99363167108MDT75F62015811111B III110050000

100368167510ASA66M71032311111B III1111100015301

101369167511KCE62F71559611111B II1100000040000

102371167608JAV71M6926721111B II1100100059001000

103372167596JPP66M2900621111B III110001510010

104373167644MCG35F7091671111B II110002930

105378168024MVC70M3268651111B IV110003924000

106379168112PSCM38M7150121111B III111110002790100

107384168236EVD63F65527311111B III111110001910

108386168765HSM56M3654181111B III110002131

109388168768MLY49F28934111111B II11111000231510

110392169428MVG62F712520111#11B I1#111900

111393169435VSA68M6197211tercio medio del estmago11B I110003500100

112395169434JBG55M681313111111B IV111111??29261

113398169553GCP70M712241111B III110004310100

114399169729AAV61M7274481111II c11100080000

115404169876RLV67M60326011111B III11000313000

116406170172MHC69M72893511111B IV110002015010

117408170181RGV50M7217321111III11100000220

118410170663MBI63M7255031CUERPO11B III1110001040000

119421163564SBM70M355616111#1 - 1#1-1#B II1100035140100

1207393168-02JMC77M8320901111B III111010002311010

1217413349-02CDD76M6771341111B I11000000317100

1227614887-02HMB62M8409711111B III11001000373010

1237666312-02GZG71F8489531111II c11000000260000

1247675278-02RCC62M8451571111B III11001000511110

1257705331-02MMH50F84472511111II b + II c1100000021000

1267735825-02LMG48F7654801I DELG1000000NCNC

1277786341-02ARA64F83726111111B V11000001563100

1287796342-02AFS40F8532901111B III111000005013000

1297836997-02IMR51M6295141111B III111000005611000

1307846899-02ELE58F4092811111B I111110008401

1317857342-02LLI76M6048111111B III1100000118001

1327937661-02ESG59F3897841111IIc+III1110000016100

1338028778-02YAP69F8620761111B III1111100063100

1348038788-02JIA61M8608081111B III111000003610000

1358069014-02HJV51F86098111111B II11000000390000

1368109282-02AJM47F8631041I DELG100000

1378119345-02ACR81F84409411100000

1388149399-02JFZ50M86122411111B II11000000263000

1398220098-03CLA62M86437411111B V111001001359000

140A2133756AGS79F423664111IicII c like1100000027000

141A3133755JTM51M24273011111I V1111000000121100

142A4133744CVL73M14396111#11#1#1II a #I + IiaI+ II a L1#11#1000000192000

143A5133732SVL51M4270231111B II110000002770000

144A6133668DANCFNC1111II c11000000900

145A7133668SGG78M15652911111II c1100000011000

146A8133655SHR64F4248291111II a11000000210000

147A10133625MFC76F40942111111B III1100000032000

148A12133607FS40F4243661111II c+ II b110000001200

149A13133592FSS66MNC1111B III111000001010000

150A18133541HMC69M42304511111B III1111100001461011

151A20133714EGP74F1031211111B II11000000341001

152A21133768JUR65M40899811111B III1100000017000

153A22133769LSV71M35612611111B I1100000080001

154A23133772MVS57F2440211111B II111101000001

155A24133776FJE67FJE42997811111B III11000000315001

156A 25133835PCC75M1314591111B III110000001910000

157A 26133836MA66F4347921111B II111010003331100

158A 28133841VMB63M4361781111B III111111110004828000

159A30133854HRS48F4365311111B II110000002550000

160A33133871JOM70M11111II a+ II b11000000401000

161A34133911BHH66F4391971111B III111000000311000

162A35133767TVR60F7178611#1"100%2"%1#I"/ II a%B I#1%1#1"10000002310000

163A37133194ASS46M4320971111B I110000002540000

164A39133809RRR38M8481611111III110000005700000

165A40133815NCC62F4219491111B III1101100000

166A41133817LCE29M4332171111100000090

167A42162639JDSch72M60396911111B V111110001571

total60.3090909091113922100002101938355962922781243121432121290834631090124037.012929230227100273050713313945551691563233116367476813243311200000000

ESTOMAGO

0

0

0

0

LOCALIZACION DE CARCINOMAS GASTRICOS

ESOFAGO

0

0

0

0

0

0

0

0

0

Tipo macroscpico

Nmero

Distribucin Cncer Gstrico Incipiente

COLON

0

0

0

0

0

Tipo Macroscpico

Nmero

Distribucin Cncer Gstrico Avanzado

WHIPPLE

37.01

29

29

23

0

22

7

1

0

0

27

3

0

5

0

7

Tipo Histolgico

Nmero

Tipo Histolgico en Cnceres Gstricos

OTROS

PLANILLA PIEZAS DE ESOFAGO

TIPO DE CIRUGIAESOFAGODIAGNOSTICO MACROSCOPICOTIPO MACROSCOPICOTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARGENESGANGLIOSCOMPROMISO EPIPLONORGANOS VECINOSTRATAMIENTO ADICIONAL

CASO NBIOPSIANOMBREEDADSEXO M/FFICHATIPO CIRUGIAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLETERCIO MEDIOTERCIO INFERINCIPIENTEINTERMEDIOAVANZADOINCIPENTEAVANZADO (B)T. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALNUMERO TOTALPOSITIVOSMAYORMENORVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALQUIMIORADIO

11614916046M62346811B I11000000180

148149434ECF68M628282111B II11111000125C Claras

A9133626MPR45M424172111B III1100000000

A31133855ISR66F133855111B II110000001400

A38133806HYV65M430818111B II110000005000

A44133822SCS63M434248111B II1100000015000

A45133824EC54MNC111II c+ III11100000390000

A49149947EM67F64868811B II1100000151

PIEZAS DIGESTIVAS DE COLON

TIPO DE CIRUGIASEGMENTO RESECADODIAGNOSTICO MACROSCOPICOTIPO MACROSCOPICOTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARGENESGANGLIOSCOMPROMISO EPIPLONORGANOS VECINOSTRATAMIENTO ADICIONAL

CASO NBIOPSIANOMBREEDADSEXO M/FFICHAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLECIEGOASCENDENTETRANSVERSODESCENDENTESIGMOIDESRECTOANOINCIPIENTEINTERMEDIOAVANZADOINCIPENTEAVANZADO (B)T. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALNUMERO TOTALPOSITIVOSMAYORMENORVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALQUIMIORADIO

11139840ABH65M282512111B II110000001600

40142864COC69F445997111B II11101000301

42143049AGP65F4460201111000000000

51144067GMF69F60421111B II111110022501

55143190FQM78F607123111B I11000000130

61143286MDI56F68219111B I110000001120

7114510062M609920111B II11110000131

7214511533F610890111B II1111100000161

7914520666F612.76511B I11000000

8914533154F615.431111B II11110000212

9314538267M337586111B II110000003130

9914541281F618063111B II11100000070

10614903367M122234111B II1110000071

11114911269M177175111B II11000000230

11514915263F624527111B II1111000012900

12514922724M629407111B III1111010002110

13714933874M427056111B II11000000290

13814935828F630535111B I111000000150

146149414LME65M629165111B II110000002091

156149491RCA47M637203111#1#1I #B I2#11#10000002100

216149970JRA66M653187111B II111100000132

218149984JSR74M637880111#1"I #B I"2#"1#1"00000700

256155329GGM76F636440111B III11000000600000

268155414EC73F675171111B II111000002810

284161141LGJ67F683877111B I1100000080

285161139SGM56M666045111B II11100000038000

290161354NS67FNC111BII110000002500

7745946-02BDA82F745775111B I1100000000

7755947-02CPB67M851142111B III1100000080

7766150-02AEE71M852579111B II11000000700

7806490-02VRVNCNCNC111B III1100100010000

7907583-02MJV65F857605111B II111000002611

7927444-02FPL75M858287111B III1110000037371

7968427-02DSU67F8489221111B I110000101900

7978474-02SMM74M8494051111B I111000001100

7987980-02RCA53M637203111B I1100000060Ca urot

8079090-02YG70F861362111B III1100000019100

8099095-02MGA77F863663111BIII110000002200

8129346-02CUM91F4275231111100000020

8189736-02GP71M862615111B I111100000122

8199804-02MRM40F865507111II c L1100000050

8209852-02MPD66F327147111B III11000000155011

8230165-03AAL70F433797111B II11000001152

8240199-03EOA69F865693111BII111110003120

8250244-03LRT44M868470111B III1111100115500

8260295-03LGP63F867247111B II11100000190

A1139868FYB53M436586111BII1100000016000

A14133579PAF49M275597111B II110000001120

A15133577RRS59F281815111B II111110001211

A16133576OLL65F426801111BII1101000090

A17133574MMM86F420535111B II110000007200

A 27133837DIB71F431625111B III111000004300

A 29133843EMA68M433847111B II1111000090

A32133856CB56M133856111B II1100000080

A36133791MMA55F392237111B II110000001730

A43133821AF71M27303111B III1100000010000

A46133825JSC87M434543111B II11111100090

A48133833MLP69M434851111B II11000000141

A50154883YUS40F653921111B III1111100001711020

A51143036MCM23F441194111B IV11001001254011

TRABAJO PIEZAS DIGESTIVAS WHIPPLE

DATOS GENERALES DEL PACIENTETIPO DE CIRUGIAORGANODIAGNOSTICO MACROSCOPICOTIPO MACROSCOPICOTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARGENESGANGLIOSCOMPROMISO EPIPLONORGANOS VECINOSTRATAMIENTO ADICIONAL

CASO NBIOPSIANOMBREEDADSEXO M/FRUTFICHAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLEDUODENOINCIPIENTEINTERMEDIOAVANZADOINCIPENTEAVANZADO (B)T. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALNUMERO TOTALPOSITIVOSMAYORMENORORG VECINOSVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALQUIMIORADIO

2133826JMC70M434541111BI11000000001

11714916158F1146231B II1111000002630

13414930350F621679111110100042

275155476MOFF669425111000000110000

8048870-02ISR70F86321611adeno ducpancreas1101000400DUCTAL

A11133608GRU57F425177111II c1100000011000

A42133818FCJ71M434234111B II11000000221001

A19133530AR55MNC1001002340ADENOCACOLEDOCO

TRABAJO PIEZAS DIGESTIVAS OTROS

DATOS GENERALES DEL PACIENTETIPO DE CIRUGIAESOFAGOESTOMAGODUODENOCOLONDIAGNOSTICO MACROSCOPICOTIPO MACROSCOPICOTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARGENESGANGLIOSCOMPROMISO EPIPLONORGANOS VECINOSTRATAMIENTO ADICIONAL

CASO NBIOPSIANOMBREEDADSEXO M/FRUTFICHAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLETERCIO MEDIOTERCIO INFERU. GA-ESOFCARDIALFONDOANTROC. MENORC. MAYORDUODENOCIEGOASCENDENTETRANSVERSODESCENDENTESIGMOIDESRECTOANOINCIPIENTEINTERMEDIOAVANZADOINCIPENTEAVANZADO (B)T. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALNUMERO TOTALPOSITIVOSMAYORMENORVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALQUIMIORADIO

259155330CH73M6680861 + IDID11110000000000

8169590-02ABM84M657248111B V11100000700

Grfico3

62

9

MAESTRA

PLANILLA MAESTRA PIEZAS DIGESTIVAS

CASO NBIOPSIANOMBREEDADSEXO M/FRUTFICHATIPO CIRUGIAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLEESOFAGOTERCIO MEDIOTERCIO INFERESTOMAGOU. GA-ESOFCARDIALFONDOANTROC. MENORC. MAYORDUODENOCOLONCIEGOASCENDENTETRANSVERSODESCENDENTESIGMOIDESRECTOANODG MACROINCIPIENTEINTERMEDIOAVANZADOTIPO MACROINCIPENTEAVANZADO (B)TIPO HISTOGICOT. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAINV. PAREDMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIACOMPROMISOLINFATICOSANGUINEOPERINEURALMARGENES QUIRPROXIMALDISTALRADIALGANGLIOSNUMERO TOTALPOSITIVOSCOMPR EPIPLONMAYORMENORORG VECINOSVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALTTO ADICIONALQUIMIORADIO

7133.92LSM62M4366211111II c L11000000113000

8133.932LFP67M4295191111II a+ II c11000000130000

9139.786RAA57M4397861111B II111000000330000

10133945DPR75M440506111B III1100000072000

12133944ACS76F62683111B III11000000255000

2014059864M439987111B IV1100000051000001

2114059743M442361111B II1110000005000

2214096364M600215111B II110000007200

2414091876M443276111I1100000016000

25141605PPR60M443285111B III11110000225110

43143064CNC60M44610411#"1"1"1#3"""1#II c+III"""B III#41"2""1#1#1#1#0002817010

46143092JMG67M409736111II c+ III L110000002100000

47143117MIH37F6042201111B II11000000251010

48143135MCF62F4273771111B III110000005320000

49143.13LRM67F42695811110000004000

50143.131IAH50F4467281111B III11100001201210

52143295CSM20M6062741111B II1111000023120000

54143.202LAM61M6048771111II a+ II c1100000032000

56143.217JHH70M446375111II c110000001200

57143.227AMD67M604816111B III11111000198000

58143.234NBG45F446946111I110000002000

59143251FARNCM11357311B IV11000000200000

62145011FMS55M6048761111B II1110000028140011

63145.09HFP65M336869111B III110000001700011

66145.067HRC62M4335101111B II111100007200

67145.075RER53M605693111B II11000000312001

68145.076CRH74M608929111B II111100000201200

7014509965M3368691111B III110000001700000

76145.17581M611812111B II110000002000

7714519155M447252111B III111111100022150

78145.20279F447.294111B III1111100013400

81145.24869M447.32811NC1B III11010000112000

82145.25573F192.977111BIII1110000002470011

87145.31537M203.1151111BII11100000499001

90145.34556M616071111B II1111000022120

91145.35726F615006111B III1101000010800

92145.35842M447392111B V11110010000000

9414538127M1352101111B V110000005470000

9614540168M4474451 (ID)1B V11000000

98145.411159M613333111IIC1100000000

10114544958M355791111B III111100000000

10214545074M6047301111BIII11000000112000

108149.04646F61815111111100000032000

109149.07672M622343111B IV111110002010

113149.14343M623974111B III11000000246000

114149.14984M621900111B II110000005000

118149.20775F3212341111B III1110100038100

119149.18157M6254351111111110003018000

120149.18774M613387111B III11010000200000

12314919868M227300111B I1111000002700000

128149.23684F616357111B III1100001011000

131149.26767F140587111B III1100000060000

132149.28948F626787111IIC+III like1111101000321000

133149.29763F631803111B III1100000029140000

147149.419FHP77M635195111B III11100001112

149149.435HRA63M635573111I1100000010000

150149.45PMM69M633207111B III11000000200001

151149.458MSS66F635945111B II11111100016000

153149.462RRY50M6333351111B III1111100129260000

157149490HCN48M634727111BII111100003811100

211149942JRA72M15191111B III11100000152000

215149951AZ68F64964211111B II1111110002651010

217149983NRR52FNC111II c110000004000

219149996EJ51F6537761111II c110000014000

254155256JAJ59M66444511#1111B II110000002820000

276155475JOC60M6634571111BII11000000180000

282160799RBB70M436440111#1B III11#1110000290010

283160800MSA74F68049811#1"1#1"2#"BII#;B I"1#"1#"1#1"1000004316000

286161140FGF57F8609011111BII1111100012001

287161258FCC63F6900981111BIII11000000471000

291161488LUG83MNC111II b1100000080000

292161683JUP42M686477111B III1110000001360

7735825-02LMG48F7654801I DELG1000000NCNC

7786341-02ARA64F8372611111B V11000001563100

7796342-02AFS40F853290111B III111000005013000

7836997-02IMR51M629514111B III111000005611000

7846899-02ELE58F409281111B I111110008401

7857342-02LLI76M604811111B III1100000118001

7937661-02ESG59F389784111IIc+III1110000016100

8028778-02YAP69F862076111B III1111100063100

8038788-02JIA61M860808111B III111000003610000

8069014-02HJV51F8609811111B II11000000390000

8109282-02AJM47F8631041I DELG100000

8119345-02ACR81F844094111100000

8149399-02JFZ50M8612241111B II11000000263000

8220098-03CLA62M8643741111B V111001001359000

A2133.756AGS79F423664111II c like1100000027000

A3133.755JTM51M2427301111I V1111000000121100

A4133.744CVL73M14396111#11#1#1II a #I+ II a L1#11#1000000192000

A5133.732SVL51M427023111BI110000002770000

A6133.668DANCFNC111II c11000000900

A7133.668SGG78M1565291111II c1100000011000

A8133.655SHR64F424829111II a11000000210000

A10133.625MFC76F4094211111B III1100000032000

A12133.607FS40F424366111II c+ II b110000001200

A13133.592FSS66MNC111B III111000001010000

A18133.541HMC69M4230451111B III1111100001461011

A20133714EGP74F103121111B II11000000341001

A21133768JUR65M4089981111B III1100000017000

A22133769LSV71M3561261111B I1100000080001

A23133772MVS57F244021111B II111101000001

A24133776FJE67FJE4299781111B III11000000315001

A 25133835PCC75M131459111B III110000001910000

A 26133836MA66F434792111B II111010003331100

A 28133841VMB63M436178111B III111111110004828000

A30133854HRS48F436531111B II110000002550000

A33133871JOM70M1111II a+ II b11000000401000

A34133911BHH66F439197111B III111000000311000

A35133767TVR60F7178611#1"1%2"%1#I"/ II a%B I#1%1#1"10000002310000

A37133194ASS46M432097432097111B I110000002540000

A39133809RRR38M848161111III110000005700000

A40133815NCC62F421949111B III1101100000

A41133817LCE29M4332171111100000090

ESTOMAGO

PLANILLA PATOLOGIA GASTRICATIPO MACROSCOPICO

INCIPIENTEAVANZADO

DATOS GENERALES PACIENTETIPO DE CIRUGIAUBICACIN DEL TUMORDUODENODIAGNOSTICO MACROSCOPICOTIPO ITIPO IITIPO IIICOMBINACIONESINCIPENTEBORRMANNTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARG QUIRURGICOSGANGLIOSCOMPROMISO EPIPLONCOMPROMISO ORGANOS VECINOSTRATAMIENTO ADICIONAL

numerarCASO NBIOPSIANOMBREEDADSEXOFICHAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLEU. GA-ESOFCARDIALFONDOANTROC. MENORC. MAYORDUODENOINCIPIENTEINTERMEDIOAVANZADOIIIaIIbIIcIIIIIa + IIcIIa + IIbIIc + IIIIIc + IIbtotalIIIIIIIVVLtotalTUB BDTUB MDTUB PDTUBULO PAPILPAPILARANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAM PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALN TOTALPOSITIVOSMAYORMENORVESICULAPANCRBAZOHIGRIUTEOVVAGP ABDAP CECQUIMIORADIO

17133920LSM62M4366211111IIcII c L11000000113000

28133932LFP67M42951911111II a+ II c11000000130000

39139786RAA57M43978611111B II111000000330000

410133945DPR75M4405061111B III1100000072000

512133944ACS76F626831111B III11000000255000

62014059864M4399871111B IV1100000051000001

72114059743M4423611111B II1110000005000

82214096364M6002151111B II110000007200

92414091876M4432761111I1100000016000

1025141605PPR60M4432851111B III11110000225110

1127141271JGP77MNC1111B III110001500

1229141317NRS53M44427011111B II111000007000

1330141322NLG32F4450101111II c1110100013300

1431141323CAV49M4450131111II c1110000010200

1533141335FRQ78M1413971111B III11000000201000

1634141427DSMO67M44503311111B IV1100016000

1735141406JGG59F4332361111B II1110100026600

1843143064CNC60M44610411#"1"1"1#3"""1#II c+III"""B III#41"2""1#1#1#1#0002817010

1946143092JMG67M409736111Iic + IIIII c+ III L110000002100000

2047143117MIH37F60422011111B II11000000251010

2148143135MCF62F42737711111B III110000005320000

2249143130LRM67F42695811110000004000

2350143131IAH50F44672811111B III11100001201210

2452143295CSM20M60627411111B II1111000023120000

2554143202LAM61M60487711111II a+ II c1100000032000

2656143217JHH70M4463751111II c110000001200

2757143227AMD67M6048161111B III11111000198000

2858143234NBG45F4469461111I110000002000

2959143251FARNCM113573111B IV11000000200000

3062145011FMS55M60487611111B II1110000028140011

3163145090HFP65M3368691111B III110000001700011

3266145067HRC62M43351011111B II111100007200

3367145075RER53M6056931111B II11000000312001

3468145076CRH74M6089291111B II111100000201200

3570145099HFP65M33686911111B III110000001700000

3676145175JMA81M6118121111B II110000002000

3777145191PVO55M4472521111B III111111100022150

3878145202RMC79F447.2941111B III1111100013400

3981145248JRR69M447.3281111B III11010000112000

4082145255ESF73F192.9771111B III1110000002470011

4187145315LCF37M203.11511111B II11100000499001

4290145345SAS56M6160711111B II1111000022120

4391145357ESR26F6150061111B III1101000010800

4492145358FC42M4473921111B V11110010000000

4594145381RPF27M13521011111B V110000005470000

4696145401LJ68M4474451 (ID)11B V11000000

4798145411LLB59M6133331111IIC1100000000

48101145449OJM58M3557911111B III111100000000

49102145450GTC74M60473011111B III11000000112000

50108149046EVL46F61815111111100000032000

51109149076JCA72M6223431111B IV111110002010

52113149143JF43M6239741111B III11000000246000

53114149149MHA84M6219001111B II110000005000

54118149207MRA75F32123411111B III1110100038100

55119149181ORG57M6254351111111110003018000

56120149187DCR74M6133871111B III11010000200000

57123149198JMM68M2273001111B I1111000002700000

58128149236BCC84F6163571111B III1100001011000

59131149267MCC67F1405871111B III1100000060000

60132149289EDRDR48F626787111Iic + iiiIIC+III like1111101000321000

61133149297ALA63F6318031111B III1100000029140000

62147149419FHP77M6351951111B III11100001112

63149149435HRA63M6355731111I1100000010000

64150149450PMM69M6332071111B III11000000200001

65151149458MSS66F6359451111B II11111100016000

66153149462RRY50M63333511111B III1111100129260000

67157149490HCN48M6347271111B II111100003811100

68211149942JRA72M151911111B III11100000152000

69215149951AZ68F649642111111B II1111110002651010

70217149983NRR52FNC1111II c110000004000

71219149996EJ51F65377611111II c110000014000

72254155256JAJ59M66444511#11111B II110000002820000

73276155475JOC60M66345711111B II11000000180000

74282160799RBB70M436440111#11B III11#1110000290010

75283160800MSA74F68049811#1"1#1"2#"BII#;B I"1#"1#"1#1"1000004316000

76286161140FGF57F86090111111B II1111100012001

77287161258FCC63F69009811111B III11000000471000

78291161488LUG83MNC1111II b1100000080000

79292161683JUP42M6864771111B III1110000001360

80296162148JMV50M6856461111B V11000190

81304162754EPV75F6885921111B III110001740

82305162775MOC67M68639711111B III1100023130100

83307162909LSR34F6895161111II c100043000

84308163054JCM68F6878731111111B IV111100036171000

85311163191IGM26F666547111111II c + III1100022000

86312163332RMM56M6893371111B V1111000442100

87321164026SFC61M6974541111B II1100090000

88331164889CCG41F69299311111II c11000272000

89332164893RNQ75F6760321111B III11000300000

90335165143GI60M6595611111B III111000302401

91336165144CGR68M4168431111B III111110001750

92346166018MTV65F3048941111B III11004510000

93349166022MVR44M701288111111B V11003820000

94353166197BAB60M7085211111B III11101002828010

95356166267JOE62M7004031111B II110000020000

96358166579CLI52M69672611111B IV110056810

97359166843MBL36F71123611111B II1110019100

98362167051RdFC26F697921111PLIEGUES GRUESOS1100000145000

99363167108MDT75F62015811111B III110050000

100368167510ASA66M71032311111B III1111100015301

101369167511KCE62F71559611111B II1100000040000

102371167608JAV71M6926721111B II1100100059001000

103372167596JPP66M2900621111B III110001510010

104373167644MCG35F7091671111B II110002930

105378168024MVC70M3268651111B IV110003924000

106379168112PSCM38M7150121111B III111110002790100

107384168236EVD63F65527311111B III111110001910

108386168765HSM56M3654181111B III110002131

109388168768MLY49F28934111111B II11111000231510

110392169428MVG62F712520111#11B I1#111900

111393169435VSA68M6197211tercio medio del estmago11B I110003500100

112395169434JBG55M681313111111B IV111111??29261

113398169553GCP70M712241111B III110004310100

114399169729AAV61M7274481111II c11100080000

115404169876RLV67M60326011111B III11000313000

116406170172MHC69M72893511111B IV110002015010

117408170181RGV50M7217321111III11100000220

118410170663MBI63M7255031CUERPO11B III1110001040000

119421163564SBM70M355616111#1 - 1#1-1#B II1100035140100

1207393168-02JMC77M8320901111B III111010002311010

1217413349-02CDD76M6771341111B I11000000317100

1227614887-02HMB62M8409711111B III11001000373010

1237666312-02GZG71F8489531111II c11000000260000

1247675278-02RCC62M8451571111B III11001000511110

1257705331-02MMH50F84472511111II b + II c1100000021000

1267735825-02LMG48F7654801I DELG1000000NCNC

1277786341-02ARA64F83726111111B V11000001563100

1287796342-02AFS40F8532901111B III111000005013000

1297836997-02IMR51M6295141111B III111000005611000

1307846899-02ELE58F4092811111B I111110008401

1317857342-02LLI76M6048111111B III1100000118001

1327937661-02ESG59F3897841111IIc+III1110000016100

1338028778-02YAP69F8620761111B III1111100063100

1348038788-02JIA61M8608081111B III111000003610000

1358069014-02HJV51F86098111111B II11000000390000

1368109282-02AJM47F8631041I DELG100000

1378119345-02ACR81F84409411100000

1388149399-02JFZ50M86122411111B II11000000263000

1398220098-03CLA62M86437411111B V111001001359000

140A2133756AGS79F423664111IicII c like1100000027000

141A3133755JTM51M24273011111I V1111000000121100

142A4133744CVL73M14396111#11#1#1II a #I + IiaI+ II a L1#11#1000000192000

143A5133732SVL51M4270231111B II110000002770000

144A6133668DANCFNC1111II c11000000900

145A7133668SGG78M15652911111II c1100000011000

146A8133655SHR64F4248291111II a11000000210000

147A10133625MFC76F40942111111B III1100000032000

148A12133607FS40F4243661111II c+ II b110000001200

149A13133592FSS66MNC1111B III111000001010000

150A18133541HMC69M42304511111B III1111100001461011

151A20133714EGP74F1031211111B II11000000341001

152A21133768JUR65M40899811111B III1100000017000

153A22133769LSV71M35612611111B I1100000080001

154A23133772MVS57F2440211111B II111101000001

155A24133776FJE67FJE42997811111B III11000000315001

156A 25133835PCC75M1314591111B III110000001910000

157A 26133836MA66F4347921111B II111010003331100

158A 28133841VMB63M4361781111B III111111110004828000

159A30133854HRS48F4365311111B II110000002550000

160A33133871JOM70M11111II a+ II b11000000401000

161A34133911BHH66F4391971111B III111000000311000

162A35133767TVR60F7178611#1"100%2"%1#I"/ II a%B I#1%1#1"10000002310000

163A37133194ASS46M4320971111B I110000002540000

164A39133809RRR38M8481611111III110000005700000

165A40133815NCC62F4219491111B III1101100000

166A41133817LCE29M4332171111100000090

167A42162639JDSch72M60396911111B V111110001571

total60.3090909091113922100002101938355962922781243121432121290834631090124037.012929230227100273050713313945551691563233116367476813243311200000000

ESTOMAGO

0

0

LOCALIZACION DE CARCINOMAS GASTRICOS

ESOFAGO

0

0

0

0

0

0

0

0

0

Tipo macroscpico

Nmero

Distribucin Cncer Gstrico Incipiente

COLON

0

0

0

0

0

Tipo Macroscpico

Nmero

Distribucin Cncer Gstrico Avanzado

WHIPPLE

37.01

29

29

23

0

22

7

1

0

0

27

3

0

5

0

7

Tipo Histolgico

Nmero

Tipo Histolgico en Cnceres Gstricos

OTROS

PLANILLA PIEZAS DE ESOFAGO

TIPO DE CIRUGIAESOFAGODIAGNOSTICO MACROSCOPICOTIPO MACROSCOPICOTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARGENESGANGLIOSCOMPROMISO EPIPLONORGANOS VECINOSTRATAMIENTO ADICIONAL

CASO NBIOPSIANOMBREEDADSEXO M/FFICHATIPO CIRUGIAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLETERCIO MEDIOTERCIO INFERINCIPIENTEINTERMEDIOAVANZADOINCIPENTEAVANZADO (B)T. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALNUMERO TOTALPOSITIVOSMAYORMENORVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALQUIMIORADIO

11614916046M62346811B I11000000180

148149434ECF68M628282111B II11111000125C Claras

A9133626MPR45M424172111B III1100000000

A31133855ISR66F133855111B II110000001400

A38133806HYV65M430818111B II110000005000

A44133822SCS63M434248111B II1100000015000

A45133824EC54MNC111II c+ III11100000390000

A49149947EM67F64868811B II1100000151

PIEZAS DIGESTIVAS DE COLON

TIPO DE CIRUGIASEGMENTO RESECADODIAGNOSTICO MACROSCOPICOTIPO MACROSCOPICOTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARGENESGANGLIOSCOMPROMISO EPIPLONORGANOS VECINOSTRATAMIENTO ADICIONAL

CASO NBIOPSIANOMBREEDADSEXO M/FFICHAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLECIEGOASCENDENTETRANSVERSODESCENDENTESIGMOIDESRECTOANOINCIPIENTEINTERMEDIOAVANZADOINCIPENTEAVANZADO (B)T. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALNUMERO TOTALPOSITIVOSMAYORMENORVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALQUIMIORADIO

11139840ABH65M282512111B II110000001600

40142864COC69F445997111B II11101000301

42143049AGP65F4460201111000000000

51144067GMF69F60421111B II111110022501

55143190FQM78F607123111B I11000000130

61143286MDI56F68219111B I110000001120

7114510062M609920111B II11110000131

7214511533F610890111B II1111100000161

7914520666F612.76511B I11000000

8914533154F615.431111B II11110000212

9314538267M337586111B II110000003130

9914541281F618063111B II11100000070

10614903367M122234111B II1110000071

11114911269M177175111B II11000000230

11514915263F624527111B II1111000012900

12514922724M629407111B III1111010002110

13714933874M427056111B II11000000290

13814935828F630535111B I111000000150

146149414LME65M629165111B II110000002091

156149491RCA47M637203111#1#1I #B I2#11#10000002100

216149970JRA66M653187111B II111100000132

218149984JSR74M637880111#1"I #B I"2#"1#1"00000700

256155329GGM76F636440111B III11000000600000

268155414EC73F675171111B II111000002810

284161141LGJ67F683877111B I1100000080

285161139SGM56M666045111B II11100000038000

290161354NS67FNC111BII110000002500

7745946-02BDA82F745775111B I1100000000

7755947-02CPB67M851142111B III1100000080

7766150-02AEE71M852579111B II11000000700

7806490-02VRVNCNCNC111B III1100100010000

7907583-02MJV65F857605111B II111000002611

7927444-02FPL75M858287111B III1110000037371

7968427-02DSU67F8489221111B I110000101900

7978474-02SMM74M8494051111B I111000001100

7987980-02RCA53M637203111B I1100000060Ca urot

8079090-02YG70F861362111B III1100000019100

8099095-02MGA77F863663111BIII110000002200

8129346-02CUM91F4275231111100000020

8189736-02GP71M862615111B I111100000122

8199804-02MRM40F865507111II c L1100000050

8209852-02MPD66F327147111B III11000000155011

8230165-03AAL70F433797111B II11000001152

8240199-03EOA69F865693111BII111110003120

8250244-03LRT44M868470111B III1111100115500

8260295-03LGP63F867247111B II11100000190

A1139868FYB53M436586111BII1100000016000

A14133579PAF49M275597111B II110000001120

A15133577RRS59F281815111B II111110001211

A16133576OLL65F426801111BII1101000090

A17133574MMM86F420535111B II110000007200

A 27133837DIB71F431625111B III111000004300

A 29133843EMA68M433847111B II1111000090

A32133856CB56M133856111B II1100000080

A36133791MMA55F392237111B II110000001730

A43133821AF71M27303111B III1100000010000

A46133825JSC87M434543111B II11111100090

A48133833MLP69M434851111B II11000000141

A50154883YUS40F653921111B III1111100001711020

A51143036MCM23F441194111B IV11001001254011

TRABAJO PIEZAS DIGESTIVAS WHIPPLE

DATOS GENERALES DEL PACIENTETIPO DE CIRUGIAORGANODIAGNOSTICO MACROSCOPICOTIPO MACROSCOPICOTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARGENESGANGLIOSCOMPROMISO EPIPLONORGANOS VECINOSTRATAMIENTO ADICIONAL

CASO NBIOPSIANOMBREEDADSEXO M/FRUTFICHAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLEDUODENOINCIPIENTEINTERMEDIOAVANZADOINCIPENTEAVANZADO (B)T. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALNUMERO TOTALPOSITIVOSMAYORMENORORG VECINOSVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALQUIMIORADIO

2133826JMC70M434541111BI11000000001

11714916158F1146231B II1111000002630

13414930350F621679111110100042

275155476MOFF669425111000000110000

8048870-02ISR70F86321611adeno ducpancreas1101000400DUCTAL

A11133608GRU57F425177111II c1100000011000

A42133818FCJ71M434234111B II11000000221001

A19133530AR55MNC1001002340ADENOCACOLEDOCO

TRABAJO PIEZAS DIGESTIVAS OTROS

DATOS GENERALES DEL PACIENTETIPO DE CIRUGIAESOFAGOESTOMAGODUODENOCOLONDIAGNOSTICO MACROSCOPICOTIPO MACROSCOPICOTIPO HISTOLOGICOINVASION DE LA PAREDCOMPROMISOMARGENESGANGLIOSCOMPROMISO EPIPLONORGANOS VECINOSTRATAMIENTO ADICIONAL

CASO NBIOPSIANOMBREEDADSEXO M/FRUTFICHAESOF+EST PROXG. TOTALG.SUBTOTALANTRECTOMIACOLEC. PARCIALCOLEC. TOTALREC- SIGMOIDEPROCTECTOMIATUMOR-POLIPOI DELGADOWHIPPLETERCIO MEDIOTERCIO INFERU. GA-ESOFCARDIALFONDOANTROC. MENORC. MAYORDUODENOCIEGOASCENDENTETRANSVERSODESCENDENTESIGMOIDESRECTOANOINCIPIENTEINTERMEDIOAVANZADOINCIPENTEAVANZADO (B)T. BIEN DIF.T.MOD DIF.T.POBRE DIFTUBULO PAPILPAPILARC. ANILLO SELLOMUCINOSOCARCINOIDEADENOESCAMESCAMOSOINDIFERENCIADOLEIOMIOSARCOMLIPOMAGISTLEIOMIOMALINFOMAMUCOSALAMINA PROPIASUBMUCOSAMUSCULARSUBSEROSASEROSAT. ADIPOSOPERITONEOADVENTICIALINFATICOSANGUINEOPERINEURALPROXIMALDISTALRADIALNUMERO TOTALPOSITIVOSMAYORMENORVESICULAPANCREASBAZOHIGADORIONUTEROOVARIOVAGINAPARED ABDA. CECALQUIMIORADIO

259155330CH73M6680861 + IDID11110000000000

8169590-02ABM84M657248111B V11100000700

SINTOMAS

CUADRO CLNICOETAPA INICIAL:Sntomas inespecficosAsintomtico ( 80 % )

ETAPA AVANZADA:Sintomtico ( 90 % )ROBERT B. CAMERON., PROCESOS MALIGNOS DEL ESTOMAGO, EN: ONCOLOGIA PRACTICA, 2000, Pp:254-264.

SINTOMAS(After Meyer WC, Damiano RJ, Postlethwait RW, Rotolo FS. Adenocarcinoma of the stomach: changing patterns over the past four decades. Ann Surg 1999;205:18)

SINTOMAS SOLCA QUITORomero, Peralta, Morejn, Cncer Gstrico: experiencia de 5 aos de Solca Quito, Revista Ecuatoriana de Cancerologa ao 4, # 2 Dic. 1997 Quito- Ecuador

ALGORITMO DIAGNOSTICO

ENDOSCOPIA DIGESTIVA ALTA

DIAGNSTICOLA TAC PRESENTA PRECISIN DEL 90% PARA ENFERMEDAD HEPTICA

60% PARA DETECCIN DE ADENOPATAS

50% PARA LA AFECTACIN PERITONEAL

COOK AND COLS. DEMOSTRARON QUE EL 61% DE LOS PACIENTES ESTADIFICADOS PREQUIRURGICAMENTE NICAMENTE POR TAC FUERON SUBESTADIADOS

TAC 67% SENSIBILIDAD Y 61% ESPECIFICIDAD PARA GANGLIOS REGIONALES.ROBERT B. CAMERON., PROCESOS MALIGNOS DEL ESTOMAGO, EN: ONCOLOGIA PRACTICA, 2000, Pp:254-264.

DIAGNSTICOLIMITACIN DE TAC Y EE ES EVALUAR ENFERMEDAD PERITONEAL POR LO QUE SE EST UTILIZANDO LA LAPAROSCOPA DIAGNSTICA.

LOWY ET AL. INDICO QUE EL 23% DE PACIENTES VALORADOS CON TAC TENAN ENFERMEDAD METSTASICA TAL COMO LO REVEL LA LAPAROSCOPA. 1,5% SE PUDO REALIZAR PALIACIN.

TNM 7ma EDICIN 2009 Y CLASIFICACIN JAPONESA 2010 EN CNCER GASTRICO

TRATAMIENTO

TNM 7ma EDICIN 2009 Y CLASIFICACIN JAPONESA 2010 EN CNCER GASTRICO

GRACIAS!GRACIAS Amado, yo deseo que t seas prosperado en todas las cosas, y que tengas salud, as como prospera tu alma. 3 S. Juan - 2

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