Artículo especial
Factores de riesgo para los tumores óseos malignos pediátricos
Risk factors for pediatric malignant bone tumors
J. Ferrís i Tortajadaa,b,
, O. Berbel Torneroa, J.A. Ortega Garcíaa, L. Claudio-Moralesd, J. García i Castelle, V. Martí Peralesf, L. Miranda Casasf
Corresponding author
ferris_jos@gva.es
http://www.pehsu.org
Correspondencia: Dr. J. Ferrís i Tortajada. Unidad de Salud Medioambiental. Sección de Oncología Pediátrica. Hospital Universitario Materno-Infantil La Fe. Avda. Campanar, 21. 46009 Valencia. España.
http://www.pehsu.org
Correspondencia: Dr. J. Ferrís i Tortajada. Unidad de Salud Medioambiental. Sección de Oncología Pediátrica. Hospital Universitario Materno-Infantil La Fe. Avda. Campanar, 21. 46009 Valencia. España.
a Unidad de Salud Medioambiental Pediátrica. Hospital Universitario Virgen de la Arrixaca. Murcia. España
b Sección de Oncología Pediátrica. Hospital Materno-Infantil Universitario La Fe. Valencia. Unidad de Salud Medicoambiental Pediátrica. Hospital Universitario Virgen de la Arrixaca. Murcia. España
d Department of Community and Preventive Medicine. Mount Sinai School of Medicine. Nueva York. EE.UU. España
e Servicio de Anatomía Patológica. Hospital de Sagunto. Valencia. España
f Sección de Traumatología y Ortopedia Pediátrica. Hospital Materno-Infantil Universitario La Fe. Valencia. España
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España." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Risk factors for pediatric malignant bone tumors" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2005-06-30" "fechaAceptado" => "2005-06-30" "PalabrasClave" => array:2 [ "es" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Palabras clave" "identificador" => "xpalclavsec186292" "palabras" => array:4 [ 0 => "Tumores óseos malignos pediátricos" 1 => "Osteosarcoma" 2 => "Sarcoma de Ewing" 3 => "Factores de riesgo" ] ] ] "en" => array:1 [ 0 => array:4 [ "clase" => "keyword" "titulo" => "Key words" "identificador" => "xpalclavsec186291" "palabras" => array:4 [ 0 => "Pediatric malignant bone tumour" 1 => "Osteosarcoma" 2 => "Ewing's sarcoma" 3 => "Risk factor" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "es" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introducción</span><p class="elsevierStyleSimplePara elsevierViewall">El cáncer es el resultado final de la interacción multifactorial de dos clases de determinantes, el genético (endógeno) y el ambiental (exógeno). El progreso evidenciado por la oncología pediátrica, durante las últimas décadas, también se ha reflejado en los tumores óseos malignos (TOM). Estos avances se centran en los aspectos diagnósticos y terapéuticos, pero no en los factores de riesgo (FR) implicados en su etiopatogenia.</p> <span class="elsevierStyleSectionTitle">Objetivo</span><p class="elsevierStyleSimplePara elsevierViewall">La presente revisión tiene tres objetivos: <span class="elsevierStyleItalic">a)</span> actualizar el conocimiento de los FR asociados con los TOM durante la época pediátrica y adulta; <span class="elsevierStyleItalic">b)</span> divulgar entre todos nuestros compañeros los principales FR relacionados a los TOM, para fomentar su investigación, diagnóstico y futura prevención, y <span class="elsevierStyleItalic">c)</span> solicitar la ayuda de nuestros colegas para el proyecto de investigación <span class="elsevierStyleItalic">Medio ambiente y cáncer pediátrico</span>.</p> <span class="elsevierStyleSectionTitle">Material y métodos</span><p class="elsevierStyleSimplePara elsevierViewall">Revisión bibliográfica sistemática, de los últimos 30 años, de los FR implicados en la etiopatogenia de los TOM, obtenida del Medline, Cancerlit, Index Citation Science y Embase. Los perfiles de búsqueda utilizados han sido: <span class="elsevierStyleItalic">pediatric/ childhood malignant bone tumors, pediatric/childhood bone cancer/neoplasm, osteosarcoma/bone sarcoma/ Ewing's sarcoma and risk factors/etiology/epidemiology</span>. Se han seleccionado los artículos más interesantes y de sus referencias, las más relevantes.</p> <span class="elsevierStyleSectionTitle">Resultados</span><p class="elsevierStyleSimplePara elsevierViewall">Los TOM constituyen el 6-7% de los cánceres pediátricos. Las dos variedades más frecuentes son el osteosarcoma (OTS) y el sarcoma de Ewing (SE), con el 56 y el 34% de los casos, respectivamente. Los FR asociados con el OTS son los siguientes: <span class="elsevierStyleItalic">a)</span> patologías óseas preexistentes (enfermedad de Paget); <span class="elsevierStyleItalic">b)</span> factores genético-familiares (retinoblastoma hereditario, síndrome de Li-Fraumeni, syndrome de Rothmund-Thompson, síndrome de Bloom, OTS familiar y anemia de Diamond-Blackfan); <span class="elsevierStyleItalic">c)</span> factores químicos (sustancias antineoplásicas); <span class="elsevierStyleItalic">d)</span> factores físicos (radiación ionizante); <span class="elsevierStyleItalic">e)</span> factores biológicos; <span class="elsevierStyleItalic">f)</span> ocupaciones parentales, y <span class="elsevierStyleItalic">g)</span> otros factores (implantes óseos artificiales y traumatismos). Los FR asociados con el SE son los siguientes: <span class="elsevierStyleItalic">a)</span> étnico-culturales (raza blanca); <span class="elsevierStyleItalic">b)</span> factores genéticos; <span class="elsevierStyleItalic">c)</span> ocupaciones parentales (exposiciones laborables a herbicidas, pesticidas y fertilizantes); <span class="elsevierStyleItalic">d)</span> antecedents obstétricos maternos, y <span class="elsevierStyleItalic">e)</span> otros factores (tabaquismo parental y hernias inguinales).</p> <span class="elsevierStyleSectionTitle">Conclusiones</span><p class="elsevierStyleSimplePara elsevierViewall">La mayoría de las causas de los TOM son desconocidas. Los principales FR implicados, con mayor o menor evidencia científica, en la etiopatogenia del OTS son: enfermedad de Paget, retinoblastoma hereditario, síndrome de Li-Fraumeni, sustancias antineoplásicas y radiación ionizante. Los principales FR asociados al SE son: raza blanca, exposiciones ocupacionales parentales, tabaquismo parental y antecedente de hernia inguinal intervenida. Las principales dificultades para avanzar en el conocimiento de los FR relacionados con el desarrollo de los TOM son: <span class="elsevierStyleItalic">a)</span> su origen multifactorial; <span class="elsevierStyleItalic">b)</span> la baja prevalencia poblacional; <span class="elsevierStyleItalic">c)</span> la inexistente formación en salud medioambiental pediátrica, y <span class="elsevierStyleItalic">d)</span> los escasos presupuestos económicos públicos o privados destinados a tal finalidad.</p>" ] "en" => array:1 [ "resumen" => "<span class="elsevierStyleSectionTitle">Introduction</span><p class="elsevierStyleSimplePara elsevierViewall">Cancer is the result of the interaction of two kinds of determinants: genetic (endogenous) and environmental (exogenous). In the last few decades, pediatric oncology as a whole has progressed, including knowledge of malignant osseous tumors (MOT). Although advances have been made in diagnostic and therapeutic aspects, little progress has taken place in our knowledge of the risk factors involved in their etiopathogenesis.</p> <span class="elsevierStyleSectionTitle">Objective</span><p class="elsevierStyleSimplePara elsevierViewall">This review has three objectives: <span class="elsevierStyleItalic">a)</span> to provide an update on MOT-related risk factors in the child and adult population; <span class="elsevierStyleItalic">b)</span> to disseminate knowledge of the main MOT-related risk factors among our colleagues in order to promote research into these factors, diagnosis and future prevention, and <span class="elsevierStyleItalic">c)</span> to request help from our colleagues in the <span class="elsevierStyleItalic">Environment and Pediatric Cancer</span> research project.</p> <span class="elsevierStyleSectionTitle">Material and methods</span><p class="elsevierStyleSimplePara elsevierViewall">We performed a systematic review of the literature published in the last 30 years on risk factors implicated in the etiopathogenesis of MOT, using Medline, Cancerlit, Science Citation Index and Embase. The search profiles used were: <span class="elsevierStyleItalic">pediatric/childhood malignant bone tumors, pediatric/ childhood bone cancer/neoplasm, osteosarcoma/bone sarcoma/Ewing's sarcoma and risk factors/etiology/epidemiology</span>. The most interesting articles were selected and the most relevant references contained therein were retrieved.</p> <span class="elsevierStyleSectionTitle">Results</span><p class="elsevierStyleSimplePara elsevierViewall">MOT represent 6-7% of all pediatric neoplasms. The most frequent types are osteosarcoma (OS) and Ewing's sarcoma (ES), representing 56 % and 34 % respectively. OS-related risk factors are the following: <span class="elsevierStyleItalic">a)</span> previous osseous disease (Paget's disease); <span class="elsevierStyleItalic">b)</span> familial-genetic factors (hereditary retinoblastoma, Li-Fraumeni syndrome, Rothmund- Thompson syndrome, Bloom syndrome, familial OS, Diamond-Blackfan anemia); <span class="elsevierStyleItalic">c)</span> chemical factors (antineoplastic drugs); <span class="elsevierStyleItalic">d)</span> physical factors (ionizing radiation); <span class="elsevierStyleItalic">e)</span> biologic factors; <span class="elsevierStyleItalic">f)</span> parental occupation, and g) other factors (artificial osseous implants and traumatisms). ES-related risk factors are the following: <span class="elsevierStyleItalic">a)</span> ethnic-cultural (Caucasian race); <span class="elsevierStyleItalic">b)</span> genetic factors; <span class="elsevierStyleItalic">c)</span> parental occupation (herbicide, pesticide ad fertilizer exposure); <span class="elsevierStyleItalic">d)</span> maternal obstetric history, and <span class="elsevierStyleItalic">e)</span> other factors (parental smoking and inguinal hernia).</p> <span class="elsevierStyleSectionTitle">Conclusions</span><p class="elsevierStyleSimplePara elsevierViewall">Most causes of MOT are unknown. Based on different levels of scientific evidence, the main factors implicated in the etiopathogenesis of OS are: Paget's disease, hereditary retinoblastoma, Li-Fraumeni syndrome, antineoplastic drugs, and ionizing radiation. The main factors related to ES are: Caucasian race, parental occupation, parental smoking, and surgery for inguinal hernia. The main obstacles to greater knowledge of MOT-related factors are: <span class="elsevierStyleItalic">a)</span> their multiple origin; <span class="elsevierStyleItalic">b)</span> the low prevalence in the population; <span class="elsevierStyleItalic">c)</span> lack of environmental health training in pediatrics, and <span class="elsevierStyleItalic">d)</span> the low public and private investment in this research field.</p>" ] ] "NotaPie" => array:1 [ 0 => array:2 [ "etiqueta" => "☆" "nota" => "<p class="elsevierStyleNotepara">Trabajo financiado parcialmente por la Fundación Científica de la AECC (MAPACE-2004) y por el Programa de Capacitación en Salud Ambiental y Ocupacional del Mount Sinai Medical Center, con el apoyo del Fogarty International Center (NIH TW00640).</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:59 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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| Year/Month | Html | Total | |
|---|---|---|---|
| 2024 November | 10 | 11 | 21 |
| 2024 October | 62 | 66 | 128 |
| 2024 September | 71 | 103 | 174 |
| 2024 August | 74 | 109 | 183 |
| 2024 July | 57 | 75 | 132 |
| 2024 June | 63 | 63 | 126 |
| 2024 May | 72 | 82 | 154 |
| 2024 April | 60 | 82 | 142 |
| 2024 March | 44 | 77 | 121 |
| 2024 February | 63 | 71 | 134 |
| 2024 January | 41 | 62 | 103 |
| 2023 December | 39 | 42 | 81 |
| 2023 November | 39 | 54 | 93 |
| 2023 October | 44 | 44 | 88 |
| 2023 September | 44 | 53 | 97 |
| 2023 August | 56 | 38 | 94 |
| 2023 July | 44 | 37 | 81 |
| 2023 June | 38 | 43 | 81 |
| 2023 May | 49 | 31 | 80 |
| 2023 April | 28 | 29 | 57 |
| 2023 March | 46 | 43 | 89 |
| 2023 February | 27 | 27 | 54 |
| 2023 January | 30 | 38 | 68 |
| 2022 December | 44 | 52 | 96 |
| 2022 November | 43 | 47 | 90 |
| 2022 October | 44 | 51 | 95 |
| 2022 September | 41 | 95 | 136 |
| 2022 August | 47 | 69 | 116 |
| 2022 July | 26 | 76 | 102 |
| 2022 June | 27 | 79 | 106 |
| 2022 May | 37 | 40 | 77 |
| 2022 April | 41 | 56 | 97 |
| 2022 March | 39 | 67 | 106 |
| 2022 February | 23 | 57 | 80 |
| 2022 January | 30 | 46 | 76 |
| 2021 December | 22 | 78 | 100 |
| 2021 November | 38 | 76 | 114 |
| 2021 October | 53 | 90 | 143 |
| 2021 September | 41 | 56 | 97 |
| 2021 August | 50 | 38 | 88 |
| 2021 July | 66 | 40 | 106 |
| 2021 June | 42 | 46 | 88 |
| 2021 May | 36 | 43 | 79 |
| 2021 April | 70 | 78 | 148 |
| 2021 March | 105 | 35 | 140 |
| 2021 February | 98 | 29 | 127 |
| 2021 January | 99 | 21 | 120 |
| 2020 December | 73 | 38 | 111 |
| 2020 November | 84 | 30 | 114 |
| 2020 October | 37 | 12 | 49 |
| 2020 September | 17 | 19 | 36 |
| 2020 August | 18 | 12 | 30 |
| 2020 July | 34 | 15 | 49 |
| 2020 June | 26 | 12 | 38 |
| 2020 May | 44 | 22 | 66 |
| 2020 April | 35 | 28 | 63 |
| 2020 March | 25 | 12 | 37 |
| 2020 February | 23 | 17 | 40 |
| 2020 January | 26 | 27 | 53 |
| 2019 December | 62 | 24 | 86 |
| 2019 November | 54 | 25 | 79 |
| 2019 October | 21 | 36 | 57 |
| 2019 September | 17 | 31 | 48 |
| 2019 August | 23 | 22 | 45 |
| 2019 July | 34 | 50 | 84 |
| 2019 June | 36 | 35 | 71 |
| 2019 May | 62 | 39 | 101 |
| 2019 April | 76 | 58 | 134 |
| 2019 March | 16 | 14 | 30 |
| 2019 February | 23 | 13 | 36 |
| 2019 January | 22 | 12 | 34 |
| 2018 December | 18 | 23 | 41 |
| 2018 November | 64 | 20 | 84 |
| 2018 October | 47 | 22 | 69 |
| 2018 September | 20 | 9 | 29 |
| 2018 August | 1 | 0 | 1 |
| 2018 July | 3 | 0 | 3 |
| 2018 June | 1 | 0 | 1 |
| 2018 May | 4 | 0 | 4 |
| 2018 April | 11 | 0 | 11 |
| 2018 March | 6 | 0 | 6 |
| 2018 February | 13 | 0 | 13 |
| 2018 January | 10 | 0 | 10 |
| 2017 December | 11 | 0 | 11 |
| 2017 November | 10 | 0 | 10 |
| 2017 October | 5 | 0 | 5 |
| 2017 September | 13 | 0 | 13 |
| 2017 August | 7 | 0 | 7 |
| 2017 July | 9 | 1 | 10 |
| 2017 June | 16 | 33 | 49 |
| 2017 May | 22 | 23 | 45 |
| 2017 April | 13 | 20 | 33 |
| 2017 March | 18 | 25 | 43 |
| 2017 February | 15 | 24 | 39 |
| 2017 January | 18 | 13 | 31 |
| 2016 December | 28 | 9 | 37 |
| 2016 November | 34 | 21 | 55 |
| 2016 October | 34 | 16 | 50 |
| 2016 September | 22 | 21 | 43 |
| 2016 August | 21 | 9 | 30 |
| 2016 July | 21 | 15 | 36 |
| 2016 June | 3 | 14 | 17 |
| 2016 May | 4 | 18 | 22 |
| 2016 April | 3 | 0 | 3 |
| 2016 March | 6 | 0 | 6 |
| 2016 February | 1 | 24 | 25 |
| 2016 January | 1 | 28 | 29 |
| 2015 December | 6 | 24 | 30 |
| 2015 November | 2 | 24 | 26 |
| 2015 October | 6 | 13 | 19 |
| 2015 September | 12 | 0 | 12 |
| 2015 August | 5 | 11 | 16 |
| 2015 July | 16 | 8 | 24 |
| 2015 June | 15 | 5 | 20 |
| 2015 May | 21 | 16 | 37 |
| 2015 April | 14 | 13 | 27 |
| 2015 March | 20 | 17 | 37 |
| 2015 February | 19 | 17 | 36 |
| 2015 January | 23 | 1 | 24 |
| 2014 December | 25 | 3 | 28 |
| 2014 November | 24 | 2 | 26 |
| 2014 October | 27 | 3 | 30 |
| 2014 September | 31 | 4 | 35 |
| 2014 August | 42 | 2 | 44 |
| 2014 July | 42 | 2 | 44 |
| 2014 June | 74 | 4 | 78 |
| 2014 May | 90 | 3 | 93 |
| 2014 April | 65 | 4 | 69 |
| 2014 March | 77 | 13 | 90 |
| 2014 February | 55 | 12 | 67 |
| 2014 January | 75 | 8 | 83 |
| 2013 December | 76 | 7 | 83 |
| 2013 November | 95 | 7 | 102 |
| 2013 October | 63 | 6 | 69 |
| 2013 September | 69 | 12 | 81 |
| 2013 August | 97 | 13 | 110 |
| 2013 July | 44 | 11 | 55 |
| 2013 June | 4 | 4 | 8 |
| 2013 May | 4 | 9 | 13 |
| 2013 April | 9 | 3 | 12 |
| 2013 March | 8 | 1 | 9 |
| 2013 February | 27 | 1 | 28 |
| 2013 January | 28 | 1 | 29 |
| 2012 December | 19 | 0 | 19 |
| 2012 November | 18 | 0 | 18 |
| 2012 October | 8 | 2 | 10 |
| 2012 September | 3 | 1 | 4 |
| 2005 December | 4806 | 0 | 4806 |
Show all
