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Organo Oficial de la Sociedad Mexicana de Urología

2021, Número 6

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Rev Mex Urol 2021; 81 (6)


Cáncer de vejiga en mujeres, ¿población vulnerable en el sistema de salud o en desventaja biológica?

Barragán-Carrillo R, Remolina-Bonilla YA, Caballero-Landinez RE, Bourlon RMT

Idioma: Ingles.
Referencias bibliográficas: 44
Paginas:
Archivo PDF: 218.35 Kb.


RESUMEN

A pesar de que los hombres se diagnostican cuatro veces más frecuentemente con cáncer urotelial de vejiga, las mujeres presentan una mayor tasa de letalidad y menor expectativa de vida. Al diagnóstico, las mujeres se presentan con etapas clínicas más avanzadas, lo cual ha llevado a múltiples esfuerzos para elucidar los determinantes sociales y biológicos relacionados. Las mujeres se enfrentan a retos diferentes, asociados con el retraso tanto al diagnóstico como al inicio de tratamiento, acceso más limitado a tratamiento sistémico y menores respuestas con el uso de inmunoterapia. En los principales ensayos clínicos de uso de quimioterapia, inmunoterapia y otras estrategias de tratamiento sistémico, las mujeres están subrepresentadas dado que conforman del 15 al 25% de la población, limitando la generación de conclusiones definitivas. Adicionalmente, a través de análisis de expresión génica, las mujeres se han asociado a un subtipo biológico más agresivo de cáncer (basal), una mayor tasa de tumores FGFR 1-4 mutados, una menor expresión de NECTINA 4 y una mayor prevalencia de mutaciones germinales. A pesar del peor pronóstico, no se han desarrollado recomendaciones basadas en género. Los equipos dedicados al cuidado de cáncer no deben retrasar el acceso a las opciones de tratamiento basados en género, y deben procurar un tratamiento de cáncer equitativo.


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