Estadísticas

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          "es" => "<p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">Curva de supervivencia de los pacientes con c&#225;ncer de pulm&#243;n en tres per&#237;odos de cuatro a&#241;os &#40;1997 a 2000&#44; 2001 a 2004 y 2005 a 2008&#41;&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><p id="par0005" class="elsevierStylePara elsevierViewall"><elsevierMultimedia ident="tb0005"></elsevierMultimedia></p><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Introducci&#243;n</span><p id="par0025" class="elsevierStylePara elsevierViewall">El carcinoma de pulm&#243;n es la neoplasia m&#225;s frecuente en varones y la primera causa de mortalidad por c&#225;ncer&#46; Durante las &#250;ltimas d&#233;cadas se han producido cambios en la epidemiolog&#237;a&#44; con un incremento de la estirpe adenocarcinoma y de la incidencia en el sexo femenino<a class="elsevierStyleCrossRefs" href="#bib0005"><span class="elsevierStyleSup">1&#44;2</span></a>&#46; Dicha tendencia se ha puesto de manifiesto en los Estados Unidos&#44; pa&#237;ses del &#225;mbito anglosaj&#243;n y norte de Europa&#44; pero no ha ocurrido lo mismo en nuestro pa&#237;s<a class="elsevierStyleCrossRef" href="#bib0015"><span class="elsevierStyleSup">3</span></a> y su entorno&#44; donde se ha estimado que estas modificaciones acontecer&#225;n durante la primera d&#233;cada del presente siglo&#44; acorde con la evoluci&#243;n observada en los registros poblacionales de c&#225;ncer<a class="elsevierStyleCrossRef" href="#bib0020"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0030" class="elsevierStylePara elsevierViewall">Por otro lado y pese al avance manifiesto en los m&#233;todos de diagn&#243;stico y el desarrollo de nuevos f&#225;rmacos&#44; no se ha conseguido alterar sustancialmente el pron&#243;stico de la enfermedad&#44; aunque s&#237; parece apreciarse un incremento de la supervivencia durante los &#250;ltimos a&#241;os<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a>&#46;</p><p id="par0035" class="elsevierStylePara elsevierViewall">En nuestro centro disponemos de un registro de casos de carcinoma broncog&#233;nico que engloba doce a&#241;os&#46; Hemos dise&#241;ado un estudio observacional&#44; retrospectivo&#44; para analizar si se han producido cambios en la epidemiolog&#237;a y en la supervivencia del carcinoma de pulm&#243;n&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="par0040" class="elsevierStylePara elsevierViewall">Se analizaron todos los casos de carcinoma de pulm&#243;n&#44; con confirmaci&#243;n citohistol&#243;gica&#44; diagnosticados entre mayo de 1997 y diciembre de 2008 en el Servicio de Neumolog&#237;a del Hospital Universitario de Canarias&#46; Es &#233;ste un hospital general de tercer nivel que cubre la atenci&#243;n especializada del &#225;rea norte de la Isla de Tenerife&#44; con una poblaci&#243;n aproximada de 290&#46;000 habitantes&#46;</p><p id="par0045" class="elsevierStylePara elsevierViewall">Se recogieron de manera protocolizada por el mismo investigador las siguientes variables&#58; edad&#44; sexo&#44; tabaquismo&#44; comorbilidad de acuerdo con el &#237;ndice de Charlson&#44; tipo histol&#243;gico&#44; estadificaci&#243;n TNM siguiendo la clasificaci&#243;n de Mountain<a class="elsevierStyleCrossRef" href="#bib0035"><span class="elsevierStyleSup">7</span></a>&#44; grado de actividad seg&#250;n ECOG&#44; tratamiento y supervivencia&#46; Para la comparaci&#243;n de las mismas&#44; se dividi&#243; el per&#237;odo de estudio en tres cohortes&#44; comprendidas respectivamente entre los a&#241;os 1997-2000&#44; 2001-2004 y 2005-2008&#46;</p><p id="par0050" class="elsevierStylePara elsevierViewall">Se establecieron las siguientes definiciones&#58; &#171;tratamiento quir&#250;rgico&#187;&#44; cuando se llev&#243; a cabo la extirpaci&#243;n del tumor con intenci&#243;n radical asociado o no a quimioterapia y&#47;o radioterapia&#59; &#171;quimioterapia&#187;&#44; si se administraron al menos dos ciclos de f&#225;rmacos citost&#225;ticos&#44; con sin radioterapia asociada&#59; &#171;radioterapia&#187;&#44; cuando se utilizaba dicho tratamiento como terapia &#250;nica con intenci&#243;n radical&#59; &#171;tratamiento sintom&#225;tico&#187;&#44; considerado como tal aquel que inclu&#237;a tratamiento farmacol&#243;gico&#44; radioterapia o t&#233;cnicas de repermeabilizaci&#243;n endobronquial&#44; con fines exclusivamente paliativos&#59; &#171;supervivencia&#187;&#44; como el tiempo transcurrido&#44; en semanas&#44; entre el diagn&#243;stico y el fallecimiento o la &#250;ltima revisi&#243;n del paciente&#44; estableci&#233;ndose el censor a fecha 31 de diciembre de 2009&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">Todos los enfermos fueron valorados por el comit&#233; oncol&#243;gico de nuestro centro&#44; formado por facultativos de oncolog&#237;a m&#233;dica&#44; radioterapia&#44; neumolog&#237;a y cirug&#237;a tor&#225;cica&#44; para decidir el tratamiento m&#225;s adecuado&#46; Recibieron terapia exclusivamente sintom&#225;tica los enfermos que rechazaron las medidas terap&#233;uticas propuestas o por decisi&#243;n de dicho comit&#233;&#46;</p><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">An&#225;lisis estad&#237;stico</span><p id="par0060" class="elsevierStylePara elsevierViewall">Las variables cuantitativas se expresaron en medias &#177; desviaci&#243;n est&#225;ndar y las cualitativas de manera dicot&#243;mica&#46; Para la comparaci&#243;n de las variables cuantitativas se utiliz&#243; la prueba de la <span class="elsevierStyleItalic">&#171;t&#187;</span> de Student y para las variables cualitativas la distribuci&#243;n Chi-cuadrado&#46; La mediana de supervivencia se calcul&#243; por el m&#233;todo de Kaplan-Meier y la comparaci&#243;n de curvas de supervivencia se realiz&#243; mediante el test de los rangos logar&#237;tmicos&#46; Para el an&#225;lisis de factores pron&#243;sticos independientes relacionados con la supervivencia&#44; se construy&#243; un modelo de regresi&#243;n de Cox con estimaci&#243;n de riesgo proporcional y estratificado por TNM&#44; utilizando las siguientes variables&#58; a&#241;o de diagnostico&#44; edad&#44; sexo&#44; comorbilidad&#44; tratamiento&#44; p&#233;rdida de peso y grado de actividad&#46; Se consider&#243; estad&#237;sticamente significativo un valor de p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#46;</p></span></span><span id="sec0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Resultados</span><span id="sec0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Caracter&#237;sticas generales</span><p id="par0065" class="elsevierStylePara elsevierViewall">Se incluyeron 905 pacientes&#44; 776 varones &#40;85&#44;7&#37;&#41; y 129 mujeres &#40;14&#44;6&#37;&#41;&#44; con una edad media &#40;&#177; DE&#41; de 64&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6 a&#241;os&#46; El antecedente de tabaquismo se recogi&#243; en 816 sujetos &#40;90&#44;2&#37;&#41;&#46; El diagn&#243;stico de c&#225;ncer de pulm&#243;n se obtuvo mediante citolog&#237;a &#40;470 enfermos&#44; 51&#44;9&#37;&#41; o muestras histol&#243;gicas &#40;435 pacientes&#59; 48&#44;1&#37;&#41;&#46; Las estirpes histol&#243;gicas se distribuyeron as&#237;&#58; epidermoide&#44; 359 &#40;39&#44;7&#37;&#41;&#59; adenocarcinoma&#44; 291 &#40;32&#44;0&#37;&#41;&#59; carcinoma indiferenciado de c&#233;lulas grandes&#44; 119 &#40;13&#44;3&#37;&#41;&#59; carcinoma microc&#237;tico&#44; 101 &#40;11&#44;2&#37;&#41;&#59; y otros&#44; 35 &#40;3&#44;8&#37;&#41;&#46; La distribuci&#243;n por estadios TNM se muestran en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><p id="par0070" class="elsevierStylePara elsevierViewall">El 66&#44;2&#37; se econtraban en los estadios IIIb y IV&#46; El tratamiento aplicado fue el siguiente&#58; cirug&#237;a en 181 enfermos &#40;20&#37;&#41;&#44; quimioterapia en 457 &#40;50&#44;5&#37;&#41;&#44; radioterapia en 83 &#40;9&#44;2&#37;&#41; y sintom&#225;tico en 184 &#40;20&#44;3&#37;&#41;&#46;</p></span><span id="sec0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Tendencias epidemiol&#243;gicas</span><p id="par0075" class="elsevierStylePara elsevierViewall">La <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a> muestra c&#243;mo se distribuyen las variables en las tres cohortes del estudio&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">Se apreci&#243; una tendencia&#44; no significativa&#44; a un mayor n&#250;mero de casos en el sexo femenino&#46; Este incremento oscil&#243; desde el 11&#44;2&#37; en el per&#237;odo 1997-2000 hasta el 16&#44;2&#37; en el per&#237;odo 2005-2008&#46; Esta evoluci&#243;n es paralela a la observada en las estirpes histol&#243;gicas&#58; aumento del adenocarcinoma&#44; desde el 29&#44;3 al 34&#44;5&#37; y descenso del carcinoma epidermoide desde el 46&#44;1 al 35&#44;5&#37; &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46; Por sexos&#44; la proporci&#243;n de adenocarcinoma se increment&#243; de manera significativa en los varones&#44; pero no en las mujeres&#44; en las que pr&#225;cticamente no se modific&#243; &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0085" class="elsevierStylePara elsevierViewall">El n&#250;mero de enfermos tratados con quimioterapia aument&#243; progresivamente&#44; alcanzando el 54&#37; en los &#250;ltimos a&#241;os &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;0001&#41;&#46;</p></span><span id="sec0045" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Estudio de supervivencia</span><p id="par0090" class="elsevierStylePara elsevierViewall">Durante el seguimiento se perdieron 100 pacientes &#40;11&#44;1&#37;&#41;&#44; por lo que el an&#225;lisis se realiz&#243; sobre los 805 restantes&#46; La supervivencia a los 5 a&#241;os fue del 9&#44;5&#37;&#46;</p><p id="par0095" class="elsevierStylePara elsevierViewall">La mediana de supervivencia fue de 51 &#40;47-60&#41; semanas&#46; Oscil&#243; entre las 51 &#40;34-67&#41; semanas del per&#237;odo 1997-2000 y las 61 &#40;49-72&#41; semanas del per&#237;odo 2005-2008 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;2&#41;&#46; Esta tendencia fue m&#225;s manifiesta en el sexo femenino&#58; 54 semanas en el primer per&#237;odo y 66 semanas &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;3&#41; en el tercer per&#237;odo&#46; En el an&#225;lisis de regresi&#243;n de Cox mostraron influencia pron&#243;stica las siguientes variables&#58; el grado de actividad&#44; la presencia de p&#233;rdida de peso&#44; el tratamiento con cirug&#237;a o quimioterapia&#44; y la comorbilidad&#44; pero no el a&#241;o en que se formul&#243; el diagn&#243;stico &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46; La <a class="elsevierStyleCrossRef" href="#fig0010">figura 2</a> muestra la curva de supervivencia global&#46;</p><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><elsevierMultimedia ident="fig0010"></elsevierMultimedia></span></span><span id="sec0050" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Discusi&#243;n</span><p id="par0100" class="elsevierStylePara elsevierViewall">En el presente estudio hemos apreciado un aumento del n&#250;mero de casos de carcinoma de pulm&#243;n en la mujer&#44; as&#237; como de la estirpe adenocarcinoma&#46; Dichos cambios se han observado en otras zonas de nuestro pa&#237;s&#59; as&#237; Santos-Mart&#237;nez et al&#46;<a class="elsevierStyleCrossRef" href="#bib0040"><span class="elsevierStyleSup">8</span></a> observaron un aumento del 6 y del 22&#37; en el porcentaje de casos en la mujer y de adenocarcinoma respectivamente&#44; con respecto a una serie hist&#243;rica&#46; Igualmente en otro estudio en la provincia de &#193;vila<a class="elsevierStyleCrossRef" href="#bib0045"><span class="elsevierStyleSup">9</span></a> se constat&#243; tambi&#233;n id&#233;ntica tendencia y en otra serie recogida entre 2005 y 2006&#44; el adenocarcinoma ya representaba la segunda estirpe en frecuencia<a class="elsevierStyleCrossRef" href="#bib0050"><span class="elsevierStyleSup">10</span></a>&#46; En cambio&#44; Miravet et al&#46;<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">11</span></a>&#44; en un intervalo de 10 a&#241;os&#44; si bien objetivaron un aumento del adenocarcinoma&#44; la incidencia en mujeres descendi&#243;&#46; Estas diferencias regionales se manifiestan en un estudio multic&#233;ntrico<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">12</span></a> en el que la proporci&#243;n de casos en el sexo femenino tambi&#233;n aument&#243; un 3&#44;7&#37;&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">Por otro lado&#44; aunque la relaci&#243;n var&#243;n&#47;mujer en el &#250;ltimo per&#237;odo es de las menores de nuestro pa&#237;s&#44; todav&#237;a es sustancialmente mayor que en otros pa&#237;ses occidentales<a class="elsevierStyleCrossRefs" href="#bib0065"><span class="elsevierStyleSup">13&#8211;15</span></a>&#46; No obstante&#44; esta observaci&#243;n podr&#237;a suponer el avance de las tendencias epidemiol&#243;gicas teorizadas&#44; ya que como refleja la Encuesta Nacional de Salud&#44; el consumo de tabaco ha descendido en los varones y aumenta o se mantiene en las mujeres&#44; en las que la mayor prevalencia se sit&#250;a entre los 25 y 44 a&#241;os<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">16</span></a>&#59; y a&#250;n m&#225;s&#44; si analizamos la informaci&#243;n aportada por estudios epidemiol&#243;gicos&#44; poblacionales y multinacionales<a class="elsevierStyleCrossRefs" href="#bib0010"><span class="elsevierStyleSup">2&#44;17</span></a>&#44; en los que Espa&#241;a parece ser el pa&#237;s con un mayor incremento porcentual del n&#250;mero de casos en el sexo femenino&#46;</p><p id="par0110" class="elsevierStylePara elsevierViewall">El aumento del adenocarcinoma podr&#237;a estar motivado por el incremento de casos en la mujer&#44; cambios en el h&#225;bito tab&#225;quico y el avance en los m&#233;todos diagn&#243;sticos con el desarrollo de t&#233;cnicas inmunohistoqu&#237;micas y el mayor empleo de la broncoscopia y la punci&#243;n aspirativa transtor&#225;cica&#44; las cuales nos permiten alcanzar la periferia del pulm&#243;n&#44; donde asienta con frecuencia dicho tumor&#46;</p><p id="par0115" class="elsevierStylePara elsevierViewall">Otro aspecto de inter&#233;s en nuestra serie es una ligera mejor&#237;a de la supervivencia&#46; Este hallazgo es concordante con lo apreciado en Espa&#241;a en estudios anteriores<a class="elsevierStyleCrossRefs" href="#bib0025"><span class="elsevierStyleSup">5&#44;6</span></a>&#46; Igualmente&#44; un estudio poblacional<a class="elsevierStyleCrossRef" href="#bib0090"><span class="elsevierStyleSup">18</span></a> y otra serie hospitalaria<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">19</span></a> muestran un aumento significativo de la supervivencia en estadios avanzados&#59; en ambos el empleo de los nuevos citost&#225;ticos de tercera generaci&#243;n condicion&#243; el pron&#243;stico favorable&#46; En nuestro caso aunque no es posible extraer conclusiones definitivas&#44; tambi&#233;n podr&#237;amos teorizar que la mayor supervivencia en los &#250;ltimos a&#241;os estar&#237;a motivada por los citados avances terap&#233;uticos&#44; bas&#225;ndonos en dos aspectos&#58; en primer lugar hemos evidenciado un aumento progresivo del empleo de la quimioterapia que ha mostrado implicaci&#243;n pron&#243;stica&#44; y por &#250;ltimo&#44; el estudio transcurre durante un largo per&#237;odo en el cual se han desarrollado nuevos f&#225;rmacos que han mejorado la respuesta y la supervivencia en estadios avanzados<a class="elsevierStyleCrossRefs" href="#bib0100"><span class="elsevierStyleSup">20&#44;21</span></a>&#46; La aparici&#243;n de nuevas t&#233;cnicas de imagen que permiten una estadificaci&#243;n m&#225;s precisa y elegir la opci&#243;n terap&#233;utica m&#225;s adecuada podr&#237;an influir tambi&#233;n en esta evoluci&#243;n de la supervivencia&#46;</p><p id="par0120" class="elsevierStylePara elsevierViewall">Una limitaci&#243;n potencial de nuestro estudio&#44; por su dise&#241;o&#44; es la posibilidad de un sesgo de selecci&#243;n&#44; aunque pensamos que su influencia es escasa&#44; ya que las variables se recogieron de manera protocolizada por el mismo facultativo&#46; Por otro lado&#44; al tratarse de un registro hospitalario podr&#237;a no reflejar fielmente la realidad de nuestra &#225;rea&#44; pero creemos que esto no es as&#237;&#44; ya que de acuerdo con datos de incidencia recientes<a class="elsevierStyleCrossRef" href="#bib0110"><span class="elsevierStyleSup">22</span></a>&#44; el n&#250;mero de casos incluidos es superior al 80&#37; de los esperados&#46; Finalmente&#44; el empleo del sistema TNM 1997&#44; afectar&#237;a a la distribuci&#243;n de estadios de acuerdo con las modificaciones que se han realizado en la nueva clasificaci&#243;n recientemente publicada<a class="elsevierStyleCrossRef" href="#bib0115"><span class="elsevierStyleSup">23</span></a>&#44; lo que cambiar&#237;a la orientaci&#243;n terap&#233;utica y podr&#237;a influir en la supervivencia&#44; pero es posible que su repercusi&#243;n no sea significativa&#44; ya que no afectar&#237;a a un n&#250;mero importante de casos&#46;</p><p id="par0125" class="elsevierStylePara elsevierViewall">Concluimos&#44; que en nuestro entorno se ha producido un incremento del n&#250;mero de casos de c&#225;ncer de pulm&#243;n en el sexo femenino y de la estirpe adenocarcinoma&#44; en consonancia con las tendencias epidemiol&#243;gicas teorizadas&#44; as&#237; como un ligero aumento de la supervivencia&#46; Estos resultados pueden ser de inter&#233;s a la hora de considerar la presentaci&#243;n del carcinoma de pulm&#243;n en nuestro medio<a class="elsevierStyleCrossRef" href="#bib0120"><span class="elsevierStyleSup">24</span></a>&#46;</p></span><span id="sec0055" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">Conflicto de intereses</span><p id="par0130" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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              "titulo" => "Caracter&#237;sticas generales"
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              "titulo" => "Tendencias epidemiol&#243;gicas"
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            2 => "Supervivencia"
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      "en" => array:1 [
        0 => array:4 [
          "clase" => "keyword"
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            0 => "Lung cancer"
            1 => "Epidemiology"
            2 => "Survival"
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    "resumen" => array:2 [
      "es" => array:2 [
        "titulo" => "Resumen"
        "resumen" => "<span class="elsevierStyleSectionTitle">Antecedentes y objetivo</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">En las &#250;ltimas d&#233;cadas se han descrito variaciones en la epidemiolog&#237;a del carcinoma de pulm&#243;n&#46; Hemos analizado si se han producido cambios en la epidemiolog&#237;a y la supervivencia del carcinoma de pulm&#243;n&#46;</p> <span class="elsevierStyleSectionTitle">Pacientes y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron todos los casos con el diagn&#243;stico de carcinoma de pulm&#243;n&#44; con confirmaci&#243;n citohistol&#243;gica entre mayo de 1997 y diciembre de 2008&#46; Para comparar las variables analizadas se dividi&#243; el per&#237;odo de estudio en tres cohortes comprendidas respectivamente entre los a&#241;os 1997-2000&#44; 2001-2004 y 2005-2008&#46;</p> <span class="elsevierStyleSectionTitle">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Se incluyeron 905 pacientes&#44; 776 varones &#40;85&#44;7&#37;&#41;&#44; con una edad media &#40;&#177; DE&#41; de 64&#44;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;6 a&#241;os&#46; El n&#250;mero de mujeres se increment&#243; desde el 11&#44;2&#37; en 1997-2000 hasta el 16&#44;2&#37; en 2005-2008&#46; La estirpe adenocarcinoma aument&#243; desde el 29&#44;3&#37; en 1997-2000 hasta el 34&#44;5&#37; en 2005-2008 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;02&#41;&#46; La mediana de supervivencia se increment&#243; en 10 semanas&#58; 51 semanas en 1997-2000 y 61 semanas en 2005-2008 &#40;p<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>0&#44;2&#41;&#46; La supervivencia se asoci&#243; de forma independiente con el grado de actividad&#44; tratamiento recibido&#44; comorbilidad y p&#233;rdida de peso&#46;</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">En nuestra &#225;rea se ha producido un incremento del n&#250;mero de casos de c&#225;ncer de pulm&#243;n en las mujeres&#46; Ha aumentado el tipo histol&#243;gico de adenocarcinoma&#44; y apreciamos un leve aumento de la supervivencia&#46;</p>"
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        "resumen" => "<span class="elsevierStyleSectionTitle">Background and objective</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">In the last decades&#44; variations have been described in the epidemiology of lung cancer&#46; In our study&#44; we have analyzed if changes have occurred in the epidemiology and survival of lung cancer&#46;</p> <span class="elsevierStyleSectionTitle">Patients and methods</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">All the cases with the diagnosis of lung cancer having cytohistological confirmation between May 1997 and December 2008 were included&#46; To compare the variables&#44; the study period was divided into three cohorts&#44; respectively including the years 1997-2000&#44; 2001-2004 and 2005-2008&#46;</p> <span class="elsevierStyleSectionTitle">Results</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">A total of 905 patients&#44; 776 males &#40;85&#46;7&#37;&#41; were included with a mean age &#40;&#177; SD&#41; of 64&#46;4<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#46;6 years&#46; The number of cases in females went from 11&#46;2&#37; in 1997-2000 to 16&#46;2&#37; in 2005-2008&#44; and adenocarcinoma from 29&#46;3&#37; to 34&#46;5&#37; &#40;<span class="elsevierStyleItalic">P</span>&#61;&#46;2&#41;&#46; Survival was associated independently with the performance status&#44; treatment&#44; comorbidity and weight loss&#46;</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">In our area&#44; there is been an increasing number of cases of lung cancer in females&#46; The histological type of adenocarcinoma has increased and we have observed a slight increase in survival&#46;</p>"
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                  \t\t\t\t">64&#44;67<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>11&#44;5&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#8805; 2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ref&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">P&#233;rdida de peso</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;61&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;16-2&#44;47&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ref&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Tratamiento</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Cirug&#237;a&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;13&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;07-0&#44;24&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;0001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Quimioterapia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;52&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;35-0&#44;76&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;001&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Radioterapia&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;92&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;21-1&#44;22&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;3&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Sintom&#225;tico&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ref&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Comorbilidad</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>S&#237;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;45&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">1&#44;04-2&#44;01&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;02&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>No&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ref&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Sexo</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Mujer&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;9&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;69-1&#44;09&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Var&#243;n&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Ref&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Edad</span>&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " colspan="4" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleVsp" style="height:0.5px"></span></td></tr><tr title="table-row"><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>&#60;70&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;96&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="right" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">0&#44;71-1&#44;30&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">Ref&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">A&#241;o diagn&#243;stico</span>&nbsp;\t\t\t\t\t\t\n
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          "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">&#191;Qu&#233; sab&#237;amos antes de realizar este estudio&#63;</span><p id="par0010" class="elsevierStylePara elsevierViewall">La epidemiolog&#237;a del c&#225;ncer de pulm&#243;n est&#225; variando&#44; en gran medida por los diferentes h&#225;bitos relacionados con el tabaco&#46;</p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle">&#191;Qu&#233; hemos aprendido&#63;</span><p id="par0015" class="elsevierStylePara elsevierViewall">En Canarias se aprecia un incremento significativo de la incidencia del c&#225;ncer de pulm&#243;n en mujeres &#40;per&#237;odo 1997-2000 en comparaci&#243;n con el per&#237;odo 2005-2008&#41;&#46; El tipo histol&#243;gico predominante es el adenocarcinoma&#46; La supervivencia ha aumentado un promedio de 10 semanas&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Los editores</p></span></span>"
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                        0 => array:2 [
                          "etal" => false
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                            2 => "S&#46; Pel&#225;ez"
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                            4 => "F&#46; Cabad&#233;s"
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