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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n y objetivos</span><p id="par0005" class="elsevierStylePara elsevierViewall">El c&#225;ncer infantil comprende los tumores diagnosticados en ni&#241;os y adolescentes menores de 15 a&#241;os de edad&#44; si bien algunas clasificaciones incluyen los tumores que aparecen hasta los 19 a&#241;os<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46; Aunque en este periodo de la vida la frecuencia de c&#225;ncer es muy baja&#44; la disminuci&#243;n de la morbimortalidad por enfermedades infecciosas ha hecho que los tumores infantiles est&#233;n cobrando cada d&#237;a mayor relevancia dentro de la patolog&#237;a pedi&#225;trica&#46; El c&#225;ncer infantil tiene una incidencia de 300&#46;000 casos nuevos al a&#241;o en todo el mundo<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46; En Espa&#241;a&#44; la incidencia es de 155&#44;5 casos nuevos anuales por mill&#243;n de ni&#241;os&#47;as en edades comprendidas entre los 0 y 14 a&#241;os de vida&#46; La probabilidad de desarrollar un c&#225;ncer en este grupo de edad es de 0&#44;29 en ni&#241;os y 0&#44;23 en ni&#241;as<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Seg&#250;n los datos basados en las &#225;reas de cobertura poblacional del Registro Espa&#241;ol de Tumores Infantiles &#40;RETI-SEHOP&#41; &#40;Arag&#243;n&#44; Catalu&#241;a&#44; Madrid&#44; Navarra y Pa&#237;s Vasco&#41;&#44; que cubre un 39&#37; de la poblaci&#243;n en la edad infantil espa&#241;ola&#44; la tasa bruta de incidencia del c&#225;ncer infantil &#40;0-14 a&#241;os de edad&#41; para el periodo 2000-2012 se situ&#243; en 153 casos por mill&#243;n de ni&#241;os&#47;as y la tasa ajustada a la poblaci&#243;n est&#225;ndar mundial en 155 casos &#40;IC 95&#37;&#58; 151-159&#41;&#46; Los tumores infantiles difieren en muchos aspectos de los tumores de los adultos &#40;epidemiol&#243;gicos&#44; cl&#237;nicos&#44; topofiguras&#44; histol&#243;gicos&#44; terap&#233;uticos y pron&#243;sticos&#41;&#46; A veces es dif&#237;cil ubicarlos dentro del rango de edad infantil debido a que tumores considerados pedi&#225;tricos&#44; como el sarcoma de Ewing&#44; se inician en edades que se alejan del periodo de la infancia y la adolescencia&#44; como los 19 e incluso los 21 a&#241;os&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A pesar de los enormes avances que se han producido en los &#250;ltimos a&#241;os&#44; los tumores infantiles constituyen la segunda causa de muerte en este sector de poblaci&#243;n por detr&#225;s de los accidentes y la primera causa de muerte por enfermedad en la infancia y adolescencia a partir del primer a&#241;o de vida<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46; Las estad&#237;sticas de la OMS indican que&#44; en los pa&#237;ses desarrollados&#44; el 80&#37; de los ni&#241;os con c&#225;ncer se curan&#44; mientras que en los pa&#237;ses de medio y bajo desarrollo solo sobrevive el 20&#37;&#44; debido a la dificultad de acceso a los tratamientos&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Nuestro hospital atiende un volumen importante de tumores en poblaci&#243;n pedi&#225;trica&#46; Los objetivos de este estudio son&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Cuantificar la incidencia observada de tumores infantiles en el periodo 1999-2016&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Presentar la distribuci&#243;n tumoral agrupada por categor&#237;as diagn&#243;sticas y determinar su incidencia&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0035" class="elsevierStylePara elsevierViewall">Analizar la supervivencia de los pacientes al quinto a&#241;o del diagn&#243;stico &#40;cohorte 1999-2010&#41;&#44; global y por categor&#237;as diagn&#243;sticas&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Comparar la evoluci&#243;n de la supervivencia seg&#250;n cohortes de a&#241;os de diagn&#243;stico &#40;1999-2004 y 2005-2010&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Comparar los &#250;ltimos datos publicados por el Registro Espa&#241;ol de Tumores Infantiles &#40;RETI-SEHOP&#41; con los resultados de la supervivencia de nuestros pacientes en la misma cohorte&#46;</p></li></ul></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se dise&#241;&#243; un estudio observacional&#44; longitudinal&#44; de cohorte&#44; con datos retrospectivos y anal&#237;tico&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">La fuente de informaci&#243;n utilizada fue el Registro de Tumores del Hospital &#40;RTH&#41;&#46; Se analizaron los tumores malignos y todos los tumores &#40;malignos&#44; benignos e inciertos&#41; del sistema nervioso central &#40;SNC&#41; e intracraneales&#44; diagnosticados y&#47;o tratados entre el 1 de enero de 1999 y el 31 de diciembre de 2016&#44; en la edad infantil&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Se registra todo tumor distinto que pueda presentar un paciente&#46; Cada caso es registrado por separado y constituye la unidad de an&#225;lisis contable de las estad&#237;sticas que se calculan&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Los datos del RTH se definieron siguiendo las recomendaciones de la <span class="elsevierStyleItalic">International Agency for Research on Cancer</span> &#40;IARC&#41;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> y la <span class="elsevierStyleItalic">International Association of Cancer Registries</span> &#40;IACR&#41;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Para clasificar los tumores se utiliz&#243; el primer nivel de la Clasificaci&#243;n Internacional para C&#225;ncer Infantil basada en la CIE-O-3&#44; que agrupa los tumores infantiles en 12 categor&#237;as diagn&#243;sticas<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Se describi&#243; la informaci&#243;n a trav&#233;s de la frecuencia absoluta y relativa&#44; o media y desviaci&#243;n est&#225;ndar seg&#250;n la naturaleza de dicha informaci&#243;n&#46; La comparaci&#243;n entre grupos de la muestra se estim&#243; mediante el test chi-cuadrado o test exacto de Fisher y la t de Student&#44; dependiendo de la naturaleza de las variables&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">El tiempo de seguimiento de los pacientes se defini&#243; como el tiempo transcurrido desde la fecha de diagn&#243;stico hasta la fecha de fallecimiento &#40;recogida del &#205;ndice Nacional de Defunciones&#41; o la fecha del &#250;ltimo contacto obtenida de la &#250;ltima frecuentaci&#243;n hospitalaria del paciente &#40;consultas&#44; ingresos&#44; urgencias&#44; otros&#41;&#46; Se analiz&#243; la mediana de seguimiento empleando a todos los sujetos&#46; La supervivencia se estim&#243; a 1&#44; 3 y 5 a&#241;os del diagn&#243;stico mediante el m&#233;todo de Kaplan-Meier&#44; con un intervalo de confianza del 95&#37;&#46; Para el an&#225;lisis de la supervivencia se consideraron solo los pacientes diagnosticados entre los a&#241;os 1999 y 2010 para poder disponer de 5 a&#241;os completos de seguimiento&#46; Se realizaron an&#225;lisis por subgrupos en funci&#243;n de la edad&#44; el sexo&#44; la extensi&#243;n del tumor y por cohortes de a&#241;os de diagn&#243;stico &#40;1999-2004 y 2005-2010&#41;&#46; La supervivencia observada se compar&#243; entre los subgrupos utilizando una prueba de log-rank&#46; Para cuantificar ese cambio se emple&#243; el <span class="elsevierStyleItalic">hazard ratio</span> con el IC 95&#37; correspondiente entre los subgrupos mediante un modelo de regresi&#243;n de Cox a los 5 a&#241;os del diagn&#243;stico&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">No se calcularon las curvas de supervivencia cuando el n&#250;mero de casos presente en las cohortes fue inferior a 20&#44; n&#250;mero m&#237;nimo para que los resultados sean interpretables<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">El an&#225;lisis de los datos se realiz&#243; mediante el paquete estad&#237;stico SPSS&#44; versi&#243;n 22&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0095" class="elsevierStylePara elsevierViewall">En el periodo 1999-2016 se registraron 59&#46;023 tumores&#44; de los cuales 769 &#40;1&#44;3&#37;&#41; correspondieron a pacientes menores de 15 a&#241;os&#46; Estos tumores fueron m&#225;s frecuentes en ni&#241;os &#40;431&#59; 56&#37;&#41; que en ni&#241;as &#40;338&#59; 44&#37;&#41;&#44; con una raz&#243;n de 1&#44;3 y una media de edad al diagn&#243;stico de 6&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;6 a&#241;os para los ni&#241;os y 7&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;8 a&#241;os para las ni&#241;as&#44; sin significaci&#243;n estad&#237;stica&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">La base de diagn&#243;stico fue citohistol&#243;gica en el 94&#44;6&#37; de los casos&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">La edad de aparici&#243;n m&#225;s frecuente en el global de tumores fue dentro de los 5 primeros a&#241;os de vida para ambos sexos &#40;42&#44;7&#37; del total&#41;&#46; Hasta los 10 a&#241;os los tumores fueron m&#225;s frecuentes en ni&#241;os y a partir de esa edad se igualaron &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#59; sin embargo&#44; no existieron diferencias significativas por grupos de edad y sexo&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">La distribuci&#243;n de casos por categor&#237;as diagn&#243;sticas&#44; sexo y grupos de edad se muestra en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; La mayor&#237;a de los tumores se diagnosticaron localizados en el &#243;rgano de origen &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Los grupos de tumores m&#225;s frecuentes en edad infantil fueron&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">1&#41;</span><p id="par0120" class="elsevierStylePara elsevierViewall">Tumores del SNC y otras neoplasias intracraneales e intraespinales &#40;32&#44;5&#37;&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">2&#41;</span><p id="par0125" class="elsevierStylePara elsevierViewall">Leucemias&#44; s&#237;ndromes mielodispl&#225;sicos &#40;SMD&#41; y s&#237;ndromes mieloproliferativos &#40;SMP&#41; &#40;19&#37;&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">3&#41;</span><p id="par0130" class="elsevierStylePara elsevierViewall">Linfomas y neoplasias reticuloendoteliales &#40;15&#37;&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">4&#41;</span><p id="par0135" class="elsevierStylePara elsevierViewall">Neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas &#40;7&#44;5&#37;&#41;&#46;</p></li></ul></p><p id="par0140" class="elsevierStylePara elsevierViewall">En cuanto a la distribuci&#243;n seg&#250;n el sexo&#44; observamos que el orden de frecuencia fue el mismo&#44; con mayor volumen en ni&#241;os que en ni&#241;as excepto en retinoblastomas y en la categor&#237;a melanomas-otras neoplasias epiteliales&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Por segmentos de edad&#44; la mayor&#237;a de los tumores &#40;excepto los linfomas y neoplasias reticuloendoteliales&#44; los tumores &#243;seos y los melanomas malignos-otras neoplasias epiteliales malignas&#41; fueron m&#225;s frecuentes en los pacientes menores de 5 a&#241;os &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">En el grupo de pacientes diagnosticados entre los a&#241;os 1999 y 2010&#44; la supervivencia a los 5 a&#241;os del diagn&#243;stico para el global de tumores &#40;IC 95&#37;&#41; fue del 78&#37; &#40;74-82&#37;&#41;&#44; con una mediana de seguimiento de 85 meses&#46; No existieron diferencias significativas en la supervivencia seg&#250;n el sexo &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">La supervivencia a los 5 a&#241;os de las categor&#237;as diagn&#243;sticas m&#225;s frecuentes fue del 74&#37; &#40;67-81&#37;&#41; para los tumores del SNC&#59; del 80&#37; &#40;72-88&#37;&#41; para las leucemias&#44; SMD y SMP&#59; del 87&#37; &#40;80-95&#37;&#41; para los linfomas y neoplasias reticuloendoteliales&#59; y del 68&#37; &#40;53-84&#37;&#41; para los neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">Comparando ambos sexos no se encontraron diferencias estad&#237;sticamente significativas en la supervivencia por grupos diagn&#243;sticos&#44; aunque existe una tendencia a una mejor supervivencia para las ni&#241;as en los linfomas y las neoplasias reticuloendoteliales y para los ni&#241;os en los tumores del SNC y en las leucemias&#44; SMD y SMP &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall">Al comparar la supervivencia del global de tumores a los 5 a&#241;os del diagn&#243;stico por cohortes de tiempo &#40;1999-2004 vs&#46; 2005-2010&#41; esta mejor&#243; en el segundo grupo &#40;76&#37; vs&#46; 81&#37; respectivamente&#41;&#44; aunque sin alcanzar significaci&#243;n estad&#237;stica &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Comparando estas mismas cohortes de tiempo por grupos diagn&#243;sticos la supervivencia mejor&#243; en la segunda cohorte en pr&#225;cticamente todas las categor&#237;as diagn&#243;sticas&#44; aunque solo se alcanz&#243; la significaci&#243;n estad&#237;stica en el grupo de tumores del SNC y otros tumores intracraneales e intraespinales &#40;67&#37; vs&#46; 80&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">El <span class="elsevierStyleItalic">hazard ratio</span> &#40;regresi&#243;n de Cox&#41; para evaluar las diferencias en riesgo de muerte de los pacientes con tumores del SNC en las dos cohortes de periodos fue de &#8722;0&#44;51 &#40;IC 95&#37;&#41;&#44; lo que indica que los pacientes con tumores del SNC pertenecientes a la cohorte 1999-2004 presentaron 2 veces m&#225;s riesgo de fallecer por su tumor que los diagnosticados en la cohorte m&#225;s reciente &#40;2005-2010&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n y conclusiones</span><p id="par0180" class="elsevierStylePara elsevierViewall">El Registro de Tumores Hospitalario es un sistema de informaci&#243;n cl&#237;nica de los pacientes con c&#225;ncer que son atendidos en los servicios sanitarios dependientes del hospital&#46; Tiene como objetivos&#44; entre otros&#44; el llevar a cabo estudios sobre la incidencia observada&#44; la mortalidad y la supervivencia de los pacientes en funci&#243;n de cada tipo de tumor&#44; edad&#44; extensi&#243;n de la enfermedad en el momento del diagn&#243;stico&#44; etc&#46; Adem&#225;s de ser una herramienta fundamental para evaluar la calidad asistencial en los enfermos oncol&#243;gicos&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">En nuestro hospital los tumores en edad infantil suponen el 1&#44;3&#37; del total de tumores entre los a&#241;os 1999 y 2016 y en m&#225;s de la mitad de los casos el tumor se diagnostica en estadio localizado en el &#243;rgano de origen&#46; La frecuencia es mayor en ni&#241;os que en ni&#241;as&#44; globalmente y para la mayor&#237;a de tumores&#46; Estos datos son similares a los registrados en el conjunto de Espa&#241;a y de Europa<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a>&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">En Espa&#241;a funciona desde 1980 un Registro Nacional de Tumores Infantiles &#40;RETI-SEHOP&#41; cuyos datos provienen de la declaraci&#243;n voluntaria de los servicios de oncolog&#237;a pedi&#225;trica de los hospitales p&#250;blicos espa&#241;oles&#46; Tambi&#233;n recoge los datos de tumores en edad infantil de los Registros Poblacionales Espa&#241;oles&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">La categor&#237;a diagn&#243;stica m&#225;s frecuente en nuestro hospital son los tumores del SNC&#44; a diferencia de los datos recogidos por el RETI-SEHOP&#44; donde el primer puesto corresponde a las leucemias<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#8211;9</span></a>&#46; Probablemente la causa sea que nuestro hospital es un centro de referencia nacional en neurocirug&#237;a pedi&#225;trica&#46; El resto de categor&#237;as muestran una distribuci&#243;n similar a la descrita en Espa&#241;a y Europa&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">En nuestra serie la supervivencia a los 5 a&#241;os para el total de tumores en la infancia en el periodo 2005-2007 fue del 78&#37; &#40;74-82&#37;&#41;&#44; similar a la que se registr&#243; en Espa&#241;a para esa misma fecha &#40;76&#37;&#44; IC 95&#37;&#58; 74-78&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>&#46; No existieron diferencias significativas en la supervivencia seg&#250;n el sexo&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Comparando las cohortes de periodos para las distintas categor&#237;as diagn&#243;sticas la supervivencia mejor&#243; en la segunda cohorte &#40;2005-2010&#41; en pr&#225;cticamente todas las categor&#237;as&#44; aunque solo existieron diferencias significativas en los tumores del SNC &#40;13 puntos en la cohorte m&#225;s reciente&#41;&#46; Los pacientes diagnosticados con tumores del SNC en la primera cohorte de a&#241;os &#40;1999-2004&#41; presentaron 2 veces m&#225;s riesgo de morir por su tumor que los diagnosticados en la cohorte m&#225;s reciente&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">La mejor&#237;a en la supervivencia global de los pacientes pedi&#225;tricos con c&#225;ncer es fruto de la mejora en el diagn&#243;stico precoz&#44; la investigaci&#243;n b&#225;sica y traslacional&#44; los ensayos cl&#237;nicos&#44; nuevos f&#225;rmacos&#44; la mejor&#237;a de las fuentes de la radioterapia&#44; las t&#233;cnicas quir&#250;rgicas y en el tratamiento en el contexto de equipos multidisciplinares&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Los Registros de Tumores tienen un papel importante en el reclutamiento de pacientes para estos estudios&#46; La investigaci&#243;n cl&#237;nica se basa en estudios cooperativos&#44; generalmente de car&#225;cter internacional<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">9&#44;10</span></a>&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">En nuestra serie los resultados de supervivencia de los pacientes menores de 15 a&#241;os son equiparables a los de series m&#225;s extensas&#46; No obstante&#44; hay que considerar una serie de puntos&#46; Se trata de un registro de tumores hospitalario&#44; no de un registro poblacional&#46; En segundo lugar&#44; somos un hospital de tercer nivel&#44; de referencia regional y nacional en el que adem&#225;s se realizan muchos ensayos cl&#237;nicos&#46; Todo esto puede constituir un sesgo&#44; al considerar la supervivencia de los pacientes oncol&#243;gicos pedi&#225;tricos&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Nuestros resultados son similares a los del Registro Espa&#241;ol de Tumores Infantiles&#46; La informaci&#243;n aportada por los Registros de Tumores es necesaria para un mayor conocimiento del c&#225;ncer y para garantizar la calidad asistencial de los enfermos oncol&#243;gicos&#46; Nuestros resultados permiten la comparaci&#243;n por cohortes hist&#243;ricas&#44; con otros centros y la planificaci&#243;n de la asistencia&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Ser&#237;a interesante seguir profundizando en el an&#225;lisis de casos de los pr&#243;ximos a&#241;os para poder hacer an&#225;lisis de tendencias&#46; El fin &#250;ltimo ser&#237;a aportar datos a las Direcciones de Planificaci&#243;n para una mejora de la gesti&#243;n y planificaci&#243;n de recursos&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicto de intereses</span><p id="par0235" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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              "titulo" => "Resultados"
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              "titulo" => "Introduction"
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          "titulo" => "Conflicto de intereses"
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          "titulo" => "Bibliograf&#237;a"
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    "pdfFichero" => "main.pdf"
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    "fechaRecibido" => "2020-06-03"
    "fechaAceptado" => "2020-09-17"
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          "clase" => "keyword"
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          "palabras" => array:3 [
            0 => "Tumores infantiles"
            1 => "Supervivencia"
            2 => "Registro de tumores hospitalario"
          ]
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        0 => array:4 [
          "clase" => "keyword"
          "titulo" => "Keywords"
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          "palabras" => array:3 [
            0 => "Childhood tumours"
            1 => "Survival"
            2 => "Hospital tumour registration"
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    "resumen" => array:2 [
      "es" => array:3 [
        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El c&#225;ncer es la primera causa de muerte por enfermedad en ni&#241;os&#46; Se detallan algunos aspectos epidemiol&#243;gicos del c&#225;ncer infantil obtenidos del Registro de Tumores de un hospital de tercer nivel de Madrid&#44; con el fin de aportar informaci&#243;n &#250;til para el manejo del c&#225;ncer en este grupo de pacientes&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis descriptivo y retrospectivo de los datos del Registro de Tumores de un hospital de tercer nivel &#40;periodo 1999-2016&#41;&#44; con el objetivo de analizar la incidencia &#40;global y por categor&#237;as diagn&#243;sticas&#41; y la supervivencia &#40;global&#44; por grupos diagn&#243;sticos y por cohortes de a&#241;os de diagn&#243;stico&#41; del c&#225;ncer infantil&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Entre 1999 y 2016 se registraron 769 tumores infantiles&#44; 431 en ni&#241;os y 338 en ni&#241;as&#46; Las neoplasias m&#225;s frecuentes fueron los tumores del sistema nervioso central &#40;32&#44;5&#37;&#41;&#44; las leucemias&#44; los s&#237;ndromes mielodispl&#225;sicos y s&#237;ndromes mieloproliferativos &#40;19&#37;&#41;&#44; los linfomas &#40;15&#37;&#41; y los neuroblastomas &#40;7&#44;5&#37;&#41;&#46; La supervivencia global a los 5 a&#241;os fue del 78&#37;&#46; La supervivencia a los 5 a&#241;os para estas categor&#237;as diagn&#243;sticas fue del 74&#37; &#40;67-81&#37;&#41; para los tumores del sistema nervioso central&#59; del 80&#37; &#40;72-88&#37;&#41; para las leucemias&#44; s&#237;ndromes mielodispl&#225;sicos y s&#237;ndromes mieloproliferativos&#59; del 87&#37; &#40;80-95&#37;&#41; para los linfomas y neoplasias reticuloendoteliales&#59; y del 68&#37; &#40;53-84&#37;&#41; para los neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La comparativa entre dos cohortes de a&#241;os de diagn&#243;stico &#40;1999-2004 vs&#46; 2005-2010&#41; revela un incremento de la supervivencia en la cohorte m&#225;s reciente&#44; que solo es estad&#237;sticamente significativo en los tumores del sistema nervioso central&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Nuestros resultados son similares a los del Registro Espa&#241;ol de Tumores Infantiles&#46; La informaci&#243;n aportada por los Registros de Tumores es necesaria para un mayor conocimiento del c&#225;ncer y para garantizar la calidad asistencial de los enfermos oncol&#243;gicos&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
          ]
          1 => array:2 [
            "identificador" => "abst0010"
            "titulo" => "Material y m&#233;todos"
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          2 => array:2 [
            "identificador" => "abst0015"
            "titulo" => "Resultados"
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            "identificador" => "abst0020"
            "titulo" => "Conclusiones"
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        "titulo" => "Abstract"
        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cancer is the leading cause of death from disease in children&#46; Some epidemiological aspects of childhood cancer obtained from the Tumour Registry of a tertiary care hospital in Madrid are detailed&#44; in order to provide useful information for the management of cancer in this group of patients&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Descriptive and retrospective analysis of the data from the Hospital&#39;s Tumour Registry &#40;period 1999-2016&#41;&#44; with the aim of analysing the incidence &#40;overall&#44; and by diagnostic categories&#41; and survival &#40;overall&#44; by diagnostic groups and cohorts of years of diagnosis&#41; of childhood cancer&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A total of 769 childhood tumours were registered between 1999 and 2016&#44; 431 in boys and 338 in girls&#46; The most common neoplasms were central nervous system tumours &#40;32&#46;5&#37;&#41;&#44; leukaemias&#44; myelodysplastic syndromes and myeloproliferative syndromes &#40;19&#37;&#41;&#59; lymphomas &#40;15&#37;&#41;&#44; and neuroblastomas &#40;7&#46;5&#37;&#41;&#46; Overall 5-year survival was 78&#37;&#46; Five-year survival of these diagnostic categories was 74&#37; &#40;67-81&#37;&#41; for central nervous system tumours&#59; 80&#37; &#40;72-88&#37;&#41; for leukaemias&#44; myelodysplastic syndromes and myeloproliferative syndromes&#59; 87&#37; &#40;80-95&#37;&#41; for lymphomas and reticuloendothelial neoplasms&#59; and 68&#37; &#40;53-84&#37;&#41; for neuroblastomas and other peripheral nerve cells tumours&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The comparison between two diagnostic cohorts &#40;1999-2004 vs 2005-2010&#41; showed an increase in survival in the most recent cohort&#44; which was only statistically significant in central nervous system tumours&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">These results are similar to those of the Spanish Register of Childhood Tumours&#46; The information provided by the Tumour Registries is necessary for greater knowledge of cancer and to ensure the quality of care for cancer patients&#46;</p></span>"
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            "titulo" => "Results"
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          "es" => "<p id="spar0060" class="elsevierStyleSimplePara elsevierViewall">Categor&#237;as diagn&#243;sticas seg&#250;n grupos de edad&#46; A&#241;os 1999 a 2016&#46;</p>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Columnas &#171;Grupos de edad&#187;&#58; Los porcentajes que se muestran son respecto del total de su fila&#44; no del total global y no suman con el porcentaje de la columna &#171;Total&#187;&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Los &#37; que acompa&#241;an al N Total&#44; al N Ni&#241;os y al N Ni&#241;as de casos en cada grupo de edad indican el porcentaje que representa ese N del grupo de edad respecto del total de casos correspondiente de ese grupo diagn&#243;stico&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Columna &#171;Total&#187;&#58; En cada grupo diagn&#243;stico&#44; los &#37; que acompa&#241;an al N por sexo indican el porcentaje que representa cada sexo respecto del total de casos en ese grupo diagn&#243;stico&#46; El &#37; que acompa&#241;a al N &#171;Total&#187; indica el porcentaje que representa el N de ese grupo diagn&#243;stico respecto del N Total de la fila &#171;Todos los tumores&#187; &#40;769 casos&#41;&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Categor&#237;as diagn&#243;sticas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">0 a 4 a&#241;os</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">5 a 9 a&#241;os</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">10 a 14 a&#241;os</th><th class="td" title="\n
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                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Total</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td" title="\n
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                  \t\t\t\t  " colspan="9" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">I&#46; Leucemias&#44; SMD y SMP</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ni&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">41&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="left" valign="\n
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                  \t\t\t\t">50&#44;6&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&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="left" valign="\n
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                  \t\t\t\t">30&#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="left" valign="\n
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                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">18&#44;5&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="left" valign="\n
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                  \t\t\t\t">81&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="left" valign="\n
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                  \t\t\t\t">55&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ni&#241;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">33&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="left" valign="\n
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                  \t\t\t\t">50&#44;8&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="left" valign="\n
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                  \t\t\t\t">15&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="left" valign="\n
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                  \t\t\t\t">23&#44;1&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="left" valign="\n
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                  \t\t\t\t">17&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#44;2&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">IV&#46; Neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">VI&#46; Tumores renales</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">XI&#46; Melanomas malignos y otras neoplasias epiteliales malignas</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">Todos los tumores</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ni&#241;os&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">126&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">112&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">417&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ni&#241;as&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">149&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;3&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;3&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;4&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">352&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">328&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;7&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">215&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;0&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">226&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;4&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">769&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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        "descripcion" => array:1 [
          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n de casos por categor&#237;as diagn&#243;sticas&#44; sexo y grupos de edad&#46; A&#241;os 1999 a 2016</p>"
        ]
      ]
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            0 => array:2 [
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LRD&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Localizado&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">413&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">53&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diseminado&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">72&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad sist&#233;mica&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">219&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">769&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
                  """
              ]
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                0 => "xTab2449147.png"
              ]
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          ]
        ]
        "descripcion" => array:1 [
          "es" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n seg&#250;n la extensi&#243;n &#40;localizado&#44; regional o diseminado&#41; de los tumores al diagn&#243;stico &#40;LRD&#41; entre 1999 y 2016</p>"
        ]
      ]
      6 => array:8 [
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        "etiqueta" => "Tabla 3"
        "tipo" => "MULTIMEDIATABLA"
        "mostrarFloat" => true
        "mostrarDisplay" => false
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          0 => array:3 [
            "identificador" => "at3"
            "detalle" => "Tabla "
            "rol" => "short"
          ]
        ]
        "tabla" => array:1 [
          "tablatextoimagen" => array:1 [
            0 => array:2 [
              "tabla" => array:1 [
                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Categor&#237;as diagn&#243;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1 a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">5 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I&#46; Leucemias&#44; SMD y SMP &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>95&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;84-96&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81 &#40;73-89&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80 &#40;72-88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">II&#46; Linfomas y neoplasias reticuloendoteliales &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>83&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91 &#40;85-97&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;80-95&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;80-95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">III&#46; SNC y otros tumores intracraneales e intraespinales &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>158&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;83-93&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79 &#40;72-85&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;67-81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IV&#46; Neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>37&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83 &#40;71-96&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;53-84&#41;&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="left" valign="\n
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                  \t\t\t\t">68 &#40;53-84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VI&#46; Tumores renales &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&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="left" valign="\n
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                  \t\t\t\t">100&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="left" valign="\n
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                  \t\t\t\t">96 &#40;88-100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">VIII&#46; Tumores &#243;seos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41;&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="left" valign="\n
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                  \t\t\t\t">84 &#40;72-97&#41;&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="left" valign="\n
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                  \t\t\t\t">81 &#40;67-95&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#40;52-86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t</td><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">88 &#40;74-100&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#40;52-79&#41;&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="left" valign="\n
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                  \t\t\t\t">61 &#40;41-81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&#46; Tumores de c&#233;lulas germinales &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&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="left" valign="\n
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                  \t\t\t\t">100&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="left" valign="\n
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                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">XI&#46; Melanomas malignos y otras neoplasias epiteliales malignas &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">90 &#40;77-100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">74 &#40;55-94&#41;&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="left" valign="\n
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                  \t\t\t\t">74 &#40;55-94&#41;&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Supervivencia a 1&#44; 3 y 5 a&#241;os para las distintas categor&#237;as diagn&#243;sticas con n&#250;mero de casos mayor de 20&#46; IC 95&#37;&#46; 0-14 a&#241;os&#46; 1999 a 2010</p>"
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                  \t\t\t\t" scope="col">Categor&#237;as diagn&#243;sticas<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Supervivencia 5 a&#241;os IC 95&#37;</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ni&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ni&#241;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">I&#46; Leucemias&#44; SMD y SMP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">II&#46; Linfomas y neoplasias reticuloendoteliales&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">84 &#40;75-94&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">90 &#40;79-101&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">67 &#40;56-79&#41;&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Supervivencia a 5 a&#241;os para las primeras categor&#237;as diagn&#243;sticas seg&#250;n sexo&#46; IC 95&#37;&#46; 0-14 a&#241;os&#46; 1999 a 2010</p>"
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              "identificador" => "bib0055"
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                0 => array:1 [
                  "referenciaCompleta" => "Organizaci&#243;n Mundial de la Salud &#40;OMS&#41;&#46; El c&#225;ncer infantil&#46; 2018 &#91;consultado 10 Abr 2020&#93;&#46; Disponible en&#58; <a target="_blank" href="https://www.who.int/es/news-room/fact-sheets/detail/cancer-in-children">https&#58;&#47;&#47;www&#46;who&#46;int&#47;es&#47;news-room&#47;fact-sheets&#47;detail&#47;cancer-in-children</a>"
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                  "referenciaCompleta" => "International Agency for Research on C&#225;ncer &#40;IARC&#41; de la Organizaci&#243;n Mundial de la Salud &#40;OMS&#41; &#91;consultado 24 May 2019&#93;&#46; Disponibles en&#58; <a target="_blank" href="http://gco.iarc.fr/">http&#58;&#47;&#47;gco&#46;iarc&#46;fr&#47;</a>"
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            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La situaci&#243;n del c&#225;ncer en Espa&#241;a 1975-2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Cabanes Domenech"
                            1 => "B&#46; P&#233;rez-G&#243;mez"
                            2 => "N&#46; Aragon&#233;s"
                            3 => "M&#46; Poll&#225;n"
                            4 => "G&#46; L&#243;pez-Abente"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2009"
                        "editorial" => "Instituto de Salud Carlos III"
                        "editorialLocalizacion" => "Madrid"
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            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
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                0 => array:1 [
                  "referenciaCompleta" => "&#205;ndice Nacional de Defunciones &#40;IND&#41;&#46;&#160;Ministerio de Sanidad Consumo y Bienestar Social&#46;"
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              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimaciones de la incidencia y la supervivencia del c&#225;ncer en Espa&#241;a y su situaci&#243;n en Europa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Galceran"
                            1 => "A&#46; Ameijide"
                            2 => "M&#46; Carulla"
                            3 => "A&#46; Mateos"
                            4 => "J&#46;R&#46; Quir&#243;s"
                            5 => "A&#46; Alem&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "2014"
                        "editorial" => "Red Espa&#241;ola de Registros de C&#225;ncer &#40;REDECAN&#41;"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "C&#225;ncer Infantil en Espa&#241;a &#40;estad&#237;sticas 1980-2016&#41;&#46; Registro Espa&#241;ol de Tumores Infantiles &#40;RETI-SEHOP&#41; &#91;consultado 10 Abr 2020&#93;&#46; Disponible en&#58; <a target="_blank" href="https://www.uv.es/rnti/pdfs/Informe_RETI-SEHOP_1980-2016.pdf">https&#58;&#47;&#47;www&#46;uv&#46;es&#47;rnti&#47;pdfs&#47;Informe&#95;RETI-SEHOP&#95;1980-2016&#46;pdf</a>"
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                0 => array:2 [
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                      "titulo" => "C&#225;ncer infantil en Espa&#241;a Estad&#237;sticas 1980-2008&#46; Registro Nacional de Tumores infantiles &#40;RNTI-SEHOP&#41;"
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                        0 => array:2 [
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                          "autores" => array:6 [
                            0 => "R&#46; Peris Bonet"
                            1 => "S&#46; Felipe Garc&#237;a"
                            2 => "G&#46; Fuentes Garc&#237;a"
                            3 => "V&#46; Gonz&#225;lez Ros"
                            4 => "R&#46; Navarro Jord&#225;n"
                            5 => "E&#46; Pardo Romaguerra"
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                        ]
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                    ]
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                  "host" => array:1 [
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                      "Libro" => array:3 [
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                        "editorial" => "Universidad de Valencia"
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            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidencia y supervivencia del c&#225;ncer en la infancia"
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                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Peris Bonet"
                            1 => "B&#46; Giner Ripoll"
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                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Esp Pediatr&#46;"
                        "fecha" => "2008"
                        "volumen" => "64"
                        "paginaInicial" => "342"
                        "paginaFinal" => "356"
                      ]
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            8 => array:3 [
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              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood cancer survival in Europe"
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                        0 => array:3 [
                          "colaboracion" => "EUROCARE Working Group"
                          "etal" => false
                          "autores" => array:6 [
                            0 => "G&#46; Gatta"
                            1 => "I&#46; Corazziari"
                            2 => "C&#46; Magnani"
                            3 => "R&#46; Peris-Bonet"
                            4 => "P&#46; Roazzi"
                            5 => "C&#46; Stiller"
                          ]
                        ]
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                    ]
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                  "host" => array:1 [
                    0 => array:2 [
                      "doi" => "10.1093/annonc/mdg755"
                      "Revista" => array:7 [
                        "tituloSerie" => "Ann Oncol&#46;"
                        "fecha" => "2003"
                        "volumen" => "14"
                        "numero" => "Suppl&#46; 5"
                        "paginaInicial" => "v119"
                        "paginaFinal" => "v127"
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Original
Cáncer en el Hospital 12 de Octubre de Madrid. Evolución en la supervivencia. Años 1999-2016
Childhood cancer in a tertiary care hospital in Madrid. Evolution of survival. Years 1999-2016
Montserrat Pilasa,b,
Autor para correspondencia
montserrat.pilas@salud.madrid.org

Autor para correspondencia.
, Óscar Toldosb,c, Ana María Muñozb, Javier Salamancab,c
a Departamento de Enfermería, Hospital Universitario 12 de Octubre, Madrid, España
b Registro de Tumores, Hospital Universitario 12 de Octubre, Madrid, España
c Servicio de Anatomía Patológica, Hospital Universitario 12 de Octubre, Madrid, España
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          "es" => "<p id="spar0055" class="elsevierStyleSimplePara elsevierViewall">Pir&#225;mide de edad&#46; A&#241;os 1999 a 2016&#46;</p>"
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    "textoCompleto" => "<span class="elsevierStyleSections"><span id="sec0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0065">Introducci&#243;n y objetivos</span><p id="par0005" class="elsevierStylePara elsevierViewall">El c&#225;ncer infantil comprende los tumores diagnosticados en ni&#241;os y adolescentes menores de 15 a&#241;os de edad&#44; si bien algunas clasificaciones incluyen los tumores que aparecen hasta los 19 a&#241;os<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46; Aunque en este periodo de la vida la frecuencia de c&#225;ncer es muy baja&#44; la disminuci&#243;n de la morbimortalidad por enfermedades infecciosas ha hecho que los tumores infantiles est&#233;n cobrando cada d&#237;a mayor relevancia dentro de la patolog&#237;a pedi&#225;trica&#46; El c&#225;ncer infantil tiene una incidencia de 300&#46;000 casos nuevos al a&#241;o en todo el mundo<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46; En Espa&#241;a&#44; la incidencia es de 155&#44;5 casos nuevos anuales por mill&#243;n de ni&#241;os&#47;as en edades comprendidas entre los 0 y 14 a&#241;os de vida&#46; La probabilidad de desarrollar un c&#225;ncer en este grupo de edad es de 0&#44;29 en ni&#241;os y 0&#44;23 en ni&#241;as<a class="elsevierStyleCrossRef" href="#bib0055"><span class="elsevierStyleSup">1</span></a>&#46;</p><p id="par0010" class="elsevierStylePara elsevierViewall">Seg&#250;n los datos basados en las &#225;reas de cobertura poblacional del Registro Espa&#241;ol de Tumores Infantiles &#40;RETI-SEHOP&#41; &#40;Arag&#243;n&#44; Catalu&#241;a&#44; Madrid&#44; Navarra y Pa&#237;s Vasco&#41;&#44; que cubre un 39&#37; de la poblaci&#243;n en la edad infantil espa&#241;ola&#44; la tasa bruta de incidencia del c&#225;ncer infantil &#40;0-14 a&#241;os de edad&#41; para el periodo 2000-2012 se situ&#243; en 153 casos por mill&#243;n de ni&#241;os&#47;as y la tasa ajustada a la poblaci&#243;n est&#225;ndar mundial en 155 casos &#40;IC 95&#37;&#58; 151-159&#41;&#46; Los tumores infantiles difieren en muchos aspectos de los tumores de los adultos &#40;epidemiol&#243;gicos&#44; cl&#237;nicos&#44; topofiguras&#44; histol&#243;gicos&#44; terap&#233;uticos y pron&#243;sticos&#41;&#46; A veces es dif&#237;cil ubicarlos dentro del rango de edad infantil debido a que tumores considerados pedi&#225;tricos&#44; como el sarcoma de Ewing&#44; se inician en edades que se alejan del periodo de la infancia y la adolescencia&#44; como los 19 e incluso los 21 a&#241;os&#46;</p><p id="par0015" class="elsevierStylePara elsevierViewall">A pesar de los enormes avances que se han producido en los &#250;ltimos a&#241;os&#44; los tumores infantiles constituyen la segunda causa de muerte en este sector de poblaci&#243;n por detr&#225;s de los accidentes y la primera causa de muerte por enfermedad en la infancia y adolescencia a partir del primer a&#241;o de vida<a class="elsevierStyleCrossRef" href="#bib0060"><span class="elsevierStyleSup">2</span></a>&#46; Las estad&#237;sticas de la OMS indican que&#44; en los pa&#237;ses desarrollados&#44; el 80&#37; de los ni&#241;os con c&#225;ncer se curan&#44; mientras que en los pa&#237;ses de medio y bajo desarrollo solo sobrevive el 20&#37;&#44; debido a la dificultad de acceso a los tratamientos&#46;</p><p id="par0020" class="elsevierStylePara elsevierViewall">Nuestro hospital atiende un volumen importante de tumores en poblaci&#243;n pedi&#225;trica&#46; Los objetivos de este estudio son&#58;<ul class="elsevierStyleList" id="lis0005"><li class="elsevierStyleListItem" id="lsti0005"><span class="elsevierStyleLabel">1&#46;</span><p id="par0025" class="elsevierStylePara elsevierViewall">Cuantificar la incidencia observada de tumores infantiles en el periodo 1999-2016&#46;</p></li><li class="elsevierStyleListItem" id="lsti0010"><span class="elsevierStyleLabel">2&#46;</span><p id="par0030" class="elsevierStylePara elsevierViewall">Presentar la distribuci&#243;n tumoral agrupada por categor&#237;as diagn&#243;sticas y determinar su incidencia&#46;</p></li><li class="elsevierStyleListItem" id="lsti0015"><span class="elsevierStyleLabel">3&#46;</span><p id="par0035" class="elsevierStylePara elsevierViewall">Analizar la supervivencia de los pacientes al quinto a&#241;o del diagn&#243;stico &#40;cohorte 1999-2010&#41;&#44; global y por categor&#237;as diagn&#243;sticas&#46;</p></li><li class="elsevierStyleListItem" id="lsti0020"><span class="elsevierStyleLabel">4&#46;</span><p id="par0040" class="elsevierStylePara elsevierViewall">Comparar la evoluci&#243;n de la supervivencia seg&#250;n cohortes de a&#241;os de diagn&#243;stico &#40;1999-2004 y 2005-2010&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0025"><span class="elsevierStyleLabel">5&#46;</span><p id="par0045" class="elsevierStylePara elsevierViewall">Comparar los &#250;ltimos datos publicados por el Registro Espa&#241;ol de Tumores Infantiles &#40;RETI-SEHOP&#41; con los resultados de la supervivencia de nuestros pacientes en la misma cohorte&#46;</p></li></ul></p></span><span id="sec0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0070">Material y m&#233;todos</span><p id="par0050" class="elsevierStylePara elsevierViewall">Se dise&#241;&#243; un estudio observacional&#44; longitudinal&#44; de cohorte&#44; con datos retrospectivos y anal&#237;tico&#46;</p><p id="par0055" class="elsevierStylePara elsevierViewall">La fuente de informaci&#243;n utilizada fue el Registro de Tumores del Hospital &#40;RTH&#41;&#46; Se analizaron los tumores malignos y todos los tumores &#40;malignos&#44; benignos e inciertos&#41; del sistema nervioso central &#40;SNC&#41; e intracraneales&#44; diagnosticados y&#47;o tratados entre el 1 de enero de 1999 y el 31 de diciembre de 2016&#44; en la edad infantil&#46;</p><p id="par0060" class="elsevierStylePara elsevierViewall">Se registra todo tumor distinto que pueda presentar un paciente&#46; Cada caso es registrado por separado y constituye la unidad de an&#225;lisis contable de las estad&#237;sticas que se calculan&#46;</p><p id="par0065" class="elsevierStylePara elsevierViewall">Los datos del RTH se definieron siguiendo las recomendaciones de la <span class="elsevierStyleItalic">International Agency for Research on Cancer</span> &#40;IARC&#41;<a class="elsevierStyleCrossRef" href="#bib0065"><span class="elsevierStyleSup">3</span></a> y la <span class="elsevierStyleItalic">International Association of Cancer Registries</span> &#40;IACR&#41;<a class="elsevierStyleCrossRef" href="#bib0070"><span class="elsevierStyleSup">4</span></a>&#46;</p><p id="par0070" class="elsevierStylePara elsevierViewall">Para clasificar los tumores se utiliz&#243; el primer nivel de la Clasificaci&#243;n Internacional para C&#225;ncer Infantil basada en la CIE-O-3&#44; que agrupa los tumores infantiles en 12 categor&#237;as diagn&#243;sticas<a class="elsevierStyleCrossRef" href="#bib0075"><span class="elsevierStyleSup">5</span></a>&#46;</p><p id="par0075" class="elsevierStylePara elsevierViewall">Se describi&#243; la informaci&#243;n a trav&#233;s de la frecuencia absoluta y relativa&#44; o media y desviaci&#243;n est&#225;ndar seg&#250;n la naturaleza de dicha informaci&#243;n&#46; La comparaci&#243;n entre grupos de la muestra se estim&#243; mediante el test chi-cuadrado o test exacto de Fisher y la t de Student&#44; dependiendo de la naturaleza de las variables&#46;</p><p id="par0080" class="elsevierStylePara elsevierViewall">El tiempo de seguimiento de los pacientes se defini&#243; como el tiempo transcurrido desde la fecha de diagn&#243;stico hasta la fecha de fallecimiento &#40;recogida del &#205;ndice Nacional de Defunciones&#41; o la fecha del &#250;ltimo contacto obtenida de la &#250;ltima frecuentaci&#243;n hospitalaria del paciente &#40;consultas&#44; ingresos&#44; urgencias&#44; otros&#41;&#46; Se analiz&#243; la mediana de seguimiento empleando a todos los sujetos&#46; La supervivencia se estim&#243; a 1&#44; 3 y 5 a&#241;os del diagn&#243;stico mediante el m&#233;todo de Kaplan-Meier&#44; con un intervalo de confianza del 95&#37;&#46; Para el an&#225;lisis de la supervivencia se consideraron solo los pacientes diagnosticados entre los a&#241;os 1999 y 2010 para poder disponer de 5 a&#241;os completos de seguimiento&#46; Se realizaron an&#225;lisis por subgrupos en funci&#243;n de la edad&#44; el sexo&#44; la extensi&#243;n del tumor y por cohortes de a&#241;os de diagn&#243;stico &#40;1999-2004 y 2005-2010&#41;&#46; La supervivencia observada se compar&#243; entre los subgrupos utilizando una prueba de log-rank&#46; Para cuantificar ese cambio se emple&#243; el <span class="elsevierStyleItalic">hazard ratio</span> con el IC 95&#37; correspondiente entre los subgrupos mediante un modelo de regresi&#243;n de Cox a los 5 a&#241;os del diagn&#243;stico&#46;</p><p id="par0085" class="elsevierStylePara elsevierViewall">No se calcularon las curvas de supervivencia cuando el n&#250;mero de casos presente en las cohortes fue inferior a 20&#44; n&#250;mero m&#237;nimo para que los resultados sean interpretables<a class="elsevierStyleCrossRef" href="#bib0080"><span class="elsevierStyleSup">6</span></a>&#46;</p><p id="par0090" class="elsevierStylePara elsevierViewall">El an&#225;lisis de los datos se realiz&#243; mediante el paquete estad&#237;stico SPSS&#44; versi&#243;n 22&#46;</p></span><span id="sec0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0075">Resultados</span><p id="par0095" class="elsevierStylePara elsevierViewall">En el periodo 1999-2016 se registraron 59&#46;023 tumores&#44; de los cuales 769 &#40;1&#44;3&#37;&#41; correspondieron a pacientes menores de 15 a&#241;os&#46; Estos tumores fueron m&#225;s frecuentes en ni&#241;os &#40;431&#59; 56&#37;&#41; que en ni&#241;as &#40;338&#59; 44&#37;&#41;&#44; con una raz&#243;n de 1&#44;3 y una media de edad al diagn&#243;stico de 6&#44;5<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;6 a&#241;os para los ni&#241;os y 7&#44;2<span class="elsevierStyleHsp" style=""></span>&#177;<span class="elsevierStyleHsp" style=""></span>4&#44;8 a&#241;os para las ni&#241;as&#44; sin significaci&#243;n estad&#237;stica&#46;</p><p id="par0100" class="elsevierStylePara elsevierViewall">La base de diagn&#243;stico fue citohistol&#243;gica en el 94&#44;6&#37; de los casos&#46;</p><p id="par0105" class="elsevierStylePara elsevierViewall">La edad de aparici&#243;n m&#225;s frecuente en el global de tumores fue dentro de los 5 primeros a&#241;os de vida para ambos sexos &#40;42&#44;7&#37; del total&#41;&#46; Hasta los 10 a&#241;os los tumores fueron m&#225;s frecuentes en ni&#241;os y a partir de esa edad se igualaron &#40;<a class="elsevierStyleCrossRef" href="#fig0005">fig&#46; 1</a>&#41;&#59; sin embargo&#44; no existieron diferencias significativas por grupos de edad y sexo&#46;</p><elsevierMultimedia ident="fig0005"></elsevierMultimedia><p id="par0110" class="elsevierStylePara elsevierViewall">La distribuci&#243;n de casos por categor&#237;as diagn&#243;sticas&#44; sexo y grupos de edad se muestra en la <a class="elsevierStyleCrossRef" href="#tbl0005">tabla 1</a>&#46; La mayor&#237;a de los tumores se diagnosticaron localizados en el &#243;rgano de origen &#40;<a class="elsevierStyleCrossRef" href="#tbl0010">tabla 2</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0005"></elsevierMultimedia><elsevierMultimedia ident="tbl0010"></elsevierMultimedia><p id="par0115" class="elsevierStylePara elsevierViewall">Los grupos de tumores m&#225;s frecuentes en edad infantil fueron&#58;<ul class="elsevierStyleList" id="lis0010"><li class="elsevierStyleListItem" id="lsti0030"><span class="elsevierStyleLabel">1&#41;</span><p id="par0120" class="elsevierStylePara elsevierViewall">Tumores del SNC y otras neoplasias intracraneales e intraespinales &#40;32&#44;5&#37;&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0035"><span class="elsevierStyleLabel">2&#41;</span><p id="par0125" class="elsevierStylePara elsevierViewall">Leucemias&#44; s&#237;ndromes mielodispl&#225;sicos &#40;SMD&#41; y s&#237;ndromes mieloproliferativos &#40;SMP&#41; &#40;19&#37;&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0040"><span class="elsevierStyleLabel">3&#41;</span><p id="par0130" class="elsevierStylePara elsevierViewall">Linfomas y neoplasias reticuloendoteliales &#40;15&#37;&#41;&#46;</p></li><li class="elsevierStyleListItem" id="lsti0045"><span class="elsevierStyleLabel">4&#41;</span><p id="par0135" class="elsevierStylePara elsevierViewall">Neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas &#40;7&#44;5&#37;&#41;&#46;</p></li></ul></p><p id="par0140" class="elsevierStylePara elsevierViewall">En cuanto a la distribuci&#243;n seg&#250;n el sexo&#44; observamos que el orden de frecuencia fue el mismo&#44; con mayor volumen en ni&#241;os que en ni&#241;as excepto en retinoblastomas y en la categor&#237;a melanomas-otras neoplasias epiteliales&#46;</p><p id="par0145" class="elsevierStylePara elsevierViewall">Por segmentos de edad&#44; la mayor&#237;a de los tumores &#40;excepto los linfomas y neoplasias reticuloendoteliales&#44; los tumores &#243;seos y los melanomas malignos-otras neoplasias epiteliales malignas&#41; fueron m&#225;s frecuentes en los pacientes menores de 5 a&#241;os &#40;<a class="elsevierStyleCrossRef" href="#fig0010">fig&#46; 2</a>&#41;&#46;</p><elsevierMultimedia ident="fig0010"></elsevierMultimedia><p id="par0150" class="elsevierStylePara elsevierViewall">En el grupo de pacientes diagnosticados entre los a&#241;os 1999 y 2010&#44; la supervivencia a los 5 a&#241;os del diagn&#243;stico para el global de tumores &#40;IC 95&#37;&#41; fue del 78&#37; &#40;74-82&#37;&#41;&#44; con una mediana de seguimiento de 85 meses&#46; No existieron diferencias significativas en la supervivencia seg&#250;n el sexo &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46;</p><elsevierMultimedia ident="fig0015"></elsevierMultimedia><p id="par0155" class="elsevierStylePara elsevierViewall">La supervivencia a los 5 a&#241;os de las categor&#237;as diagn&#243;sticas m&#225;s frecuentes fue del 74&#37; &#40;67-81&#37;&#41; para los tumores del SNC&#59; del 80&#37; &#40;72-88&#37;&#41; para las leucemias&#44; SMD y SMP&#59; del 87&#37; &#40;80-95&#37;&#41; para los linfomas y neoplasias reticuloendoteliales&#59; y del 68&#37; &#40;53-84&#37;&#41; para los neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas &#40;<a class="elsevierStyleCrossRef" href="#tbl0015">tabla 3</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0015"></elsevierMultimedia><p id="par0160" class="elsevierStylePara elsevierViewall">Comparando ambos sexos no se encontraron diferencias estad&#237;sticamente significativas en la supervivencia por grupos diagn&#243;sticos&#44; aunque existe una tendencia a una mejor supervivencia para las ni&#241;as en los linfomas y las neoplasias reticuloendoteliales y para los ni&#241;os en los tumores del SNC y en las leucemias&#44; SMD y SMP &#40;<a class="elsevierStyleCrossRef" href="#tbl0020">tabla 4</a>&#41;&#46;</p><elsevierMultimedia ident="tbl0020"></elsevierMultimedia><p id="par0165" class="elsevierStylePara elsevierViewall">Al comparar la supervivencia del global de tumores a los 5 a&#241;os del diagn&#243;stico por cohortes de tiempo &#40;1999-2004 vs&#46; 2005-2010&#41; esta mejor&#243; en el segundo grupo &#40;76&#37; vs&#46; 81&#37; respectivamente&#41;&#44; aunque sin alcanzar significaci&#243;n estad&#237;stica &#40;<a class="elsevierStyleCrossRef" href="#fig0015">fig&#46; 3</a>&#41;&#46;</p><p id="par0170" class="elsevierStylePara elsevierViewall">Comparando estas mismas cohortes de tiempo por grupos diagn&#243;sticos la supervivencia mejor&#243; en la segunda cohorte en pr&#225;cticamente todas las categor&#237;as diagn&#243;sticas&#44; aunque solo se alcanz&#243; la significaci&#243;n estad&#237;stica en el grupo de tumores del SNC y otros tumores intracraneales e intraespinales &#40;67&#37; vs&#46; 80&#37;&#59; p<span class="elsevierStyleHsp" style=""></span>&#60;<span class="elsevierStyleHsp" style=""></span>0&#44;05&#41; &#40;<a class="elsevierStyleCrossRef" href="#fig0020">fig&#46; 4</a>&#41;&#46;</p><elsevierMultimedia ident="fig0020"></elsevierMultimedia><p id="par0175" class="elsevierStylePara elsevierViewall">El <span class="elsevierStyleItalic">hazard ratio</span> &#40;regresi&#243;n de Cox&#41; para evaluar las diferencias en riesgo de muerte de los pacientes con tumores del SNC en las dos cohortes de periodos fue de &#8722;0&#44;51 &#40;IC 95&#37;&#41;&#44; lo que indica que los pacientes con tumores del SNC pertenecientes a la cohorte 1999-2004 presentaron 2 veces m&#225;s riesgo de fallecer por su tumor que los diagnosticados en la cohorte m&#225;s reciente &#40;2005-2010&#41;&#46;</p></span><span id="sec0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0080">Discusi&#243;n y conclusiones</span><p id="par0180" class="elsevierStylePara elsevierViewall">El Registro de Tumores Hospitalario es un sistema de informaci&#243;n cl&#237;nica de los pacientes con c&#225;ncer que son atendidos en los servicios sanitarios dependientes del hospital&#46; Tiene como objetivos&#44; entre otros&#44; el llevar a cabo estudios sobre la incidencia observada&#44; la mortalidad y la supervivencia de los pacientes en funci&#243;n de cada tipo de tumor&#44; edad&#44; extensi&#243;n de la enfermedad en el momento del diagn&#243;stico&#44; etc&#46; Adem&#225;s de ser una herramienta fundamental para evaluar la calidad asistencial en los enfermos oncol&#243;gicos&#46;</p><p id="par0185" class="elsevierStylePara elsevierViewall">En nuestro hospital los tumores en edad infantil suponen el 1&#44;3&#37; del total de tumores entre los a&#241;os 1999 y 2016 y en m&#225;s de la mitad de los casos el tumor se diagnostica en estadio localizado en el &#243;rgano de origen&#46; La frecuencia es mayor en ni&#241;os que en ni&#241;as&#44; globalmente y para la mayor&#237;a de tumores&#46; Estos datos son similares a los registrados en el conjunto de Espa&#241;a y de Europa<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#44;7</span></a>&#46;</p><p id="par0190" class="elsevierStylePara elsevierViewall">En Espa&#241;a funciona desde 1980 un Registro Nacional de Tumores Infantiles &#40;RETI-SEHOP&#41; cuyos datos provienen de la declaraci&#243;n voluntaria de los servicios de oncolog&#237;a pedi&#225;trica de los hospitales p&#250;blicos espa&#241;oles&#46; Tambi&#233;n recoge los datos de tumores en edad infantil de los Registros Poblacionales Espa&#241;oles&#46;</p><p id="par0195" class="elsevierStylePara elsevierViewall">La categor&#237;a diagn&#243;stica m&#225;s frecuente en nuestro hospital son los tumores del SNC&#44; a diferencia de los datos recogidos por el RETI-SEHOP&#44; donde el primer puesto corresponde a las leucemias<a class="elsevierStyleCrossRefs" href="#bib0080"><span class="elsevierStyleSup">6&#8211;9</span></a>&#46; Probablemente la causa sea que nuestro hospital es un centro de referencia nacional en neurocirug&#237;a pedi&#225;trica&#46; El resto de categor&#237;as muestran una distribuci&#243;n similar a la descrita en Espa&#241;a y Europa&#46;</p><p id="par0200" class="elsevierStylePara elsevierViewall">En nuestra serie la supervivencia a los 5 a&#241;os para el total de tumores en la infancia en el periodo 2005-2007 fue del 78&#37; &#40;74-82&#37;&#41;&#44; similar a la que se registr&#243; en Espa&#241;a para esa misma fecha &#40;76&#37;&#44; IC 95&#37;&#58; 74-78&#37;&#41;<a class="elsevierStyleCrossRef" href="#bib0095"><span class="elsevierStyleSup">9</span></a>&#46; No existieron diferencias significativas en la supervivencia seg&#250;n el sexo&#46;</p><p id="par0205" class="elsevierStylePara elsevierViewall">Comparando las cohortes de periodos para las distintas categor&#237;as diagn&#243;sticas la supervivencia mejor&#243; en la segunda cohorte &#40;2005-2010&#41; en pr&#225;cticamente todas las categor&#237;as&#44; aunque solo existieron diferencias significativas en los tumores del SNC &#40;13 puntos en la cohorte m&#225;s reciente&#41;&#46; Los pacientes diagnosticados con tumores del SNC en la primera cohorte de a&#241;os &#40;1999-2004&#41; presentaron 2 veces m&#225;s riesgo de morir por su tumor que los diagnosticados en la cohorte m&#225;s reciente&#46;</p><p id="par0210" class="elsevierStylePara elsevierViewall">La mejor&#237;a en la supervivencia global de los pacientes pedi&#225;tricos con c&#225;ncer es fruto de la mejora en el diagn&#243;stico precoz&#44; la investigaci&#243;n b&#225;sica y traslacional&#44; los ensayos cl&#237;nicos&#44; nuevos f&#225;rmacos&#44; la mejor&#237;a de las fuentes de la radioterapia&#44; las t&#233;cnicas quir&#250;rgicas y en el tratamiento en el contexto de equipos multidisciplinares&#46;</p><p id="par0215" class="elsevierStylePara elsevierViewall">Los Registros de Tumores tienen un papel importante en el reclutamiento de pacientes para estos estudios&#46; La investigaci&#243;n cl&#237;nica se basa en estudios cooperativos&#44; generalmente de car&#225;cter internacional<a class="elsevierStyleCrossRefs" href="#bib0095"><span class="elsevierStyleSup">9&#44;10</span></a>&#46;</p><p id="par0220" class="elsevierStylePara elsevierViewall">En nuestra serie los resultados de supervivencia de los pacientes menores de 15 a&#241;os son equiparables a los de series m&#225;s extensas&#46; No obstante&#44; hay que considerar una serie de puntos&#46; Se trata de un registro de tumores hospitalario&#44; no de un registro poblacional&#46; En segundo lugar&#44; somos un hospital de tercer nivel&#44; de referencia regional y nacional en el que adem&#225;s se realizan muchos ensayos cl&#237;nicos&#46; Todo esto puede constituir un sesgo&#44; al considerar la supervivencia de los pacientes oncol&#243;gicos pedi&#225;tricos&#46;</p><p id="par0225" class="elsevierStylePara elsevierViewall">Nuestros resultados son similares a los del Registro Espa&#241;ol de Tumores Infantiles&#46; La informaci&#243;n aportada por los Registros de Tumores es necesaria para un mayor conocimiento del c&#225;ncer y para garantizar la calidad asistencial de los enfermos oncol&#243;gicos&#46; Nuestros resultados permiten la comparaci&#243;n por cohortes hist&#243;ricas&#44; con otros centros y la planificaci&#243;n de la asistencia&#46;</p><p id="par0230" class="elsevierStylePara elsevierViewall">Ser&#237;a interesante seguir profundizando en el an&#225;lisis de casos de los pr&#243;ximos a&#241;os para poder hacer an&#225;lisis de tendencias&#46; El fin &#250;ltimo ser&#237;a aportar datos a las Direcciones de Planificaci&#243;n para una mejora de la gesti&#243;n y planificaci&#243;n de recursos&#46;</p></span><span id="sec0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0085">Conflicto de intereses</span><p id="par0235" class="elsevierStylePara elsevierViewall">Los autores declaran no tener ning&#250;n conflicto de intereses&#46;</p></span></span>"
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    "fechaRecibido" => "2020-06-03"
    "fechaAceptado" => "2020-09-17"
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            1 => "Supervivencia"
            2 => "Registro de tumores hospitalario"
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            0 => "Childhood tumours"
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    "resumen" => array:2 [
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        "titulo" => "Resumen"
        "resumen" => "<span id="abst0005" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0010">Introducci&#243;n</span><p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">El c&#225;ncer es la primera causa de muerte por enfermedad en ni&#241;os&#46; Se detallan algunos aspectos epidemiol&#243;gicos del c&#225;ncer infantil obtenidos del Registro de Tumores de un hospital de tercer nivel de Madrid&#44; con el fin de aportar informaci&#243;n &#250;til para el manejo del c&#225;ncer en este grupo de pacientes&#46;</p></span> <span id="abst0010" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0015">Material y m&#233;todos</span><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">An&#225;lisis descriptivo y retrospectivo de los datos del Registro de Tumores de un hospital de tercer nivel &#40;periodo 1999-2016&#41;&#44; con el objetivo de analizar la incidencia &#40;global y por categor&#237;as diagn&#243;sticas&#41; y la supervivencia &#40;global&#44; por grupos diagn&#243;sticos y por cohortes de a&#241;os de diagn&#243;stico&#41; del c&#225;ncer infantil&#46;</p></span> <span id="abst0015" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0020">Resultados</span><p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">Entre 1999 y 2016 se registraron 769 tumores infantiles&#44; 431 en ni&#241;os y 338 en ni&#241;as&#46; Las neoplasias m&#225;s frecuentes fueron los tumores del sistema nervioso central &#40;32&#44;5&#37;&#41;&#44; las leucemias&#44; los s&#237;ndromes mielodispl&#225;sicos y s&#237;ndromes mieloproliferativos &#40;19&#37;&#41;&#44; los linfomas &#40;15&#37;&#41; y los neuroblastomas &#40;7&#44;5&#37;&#41;&#46; La supervivencia global a los 5 a&#241;os fue del 78&#37;&#46; La supervivencia a los 5 a&#241;os para estas categor&#237;as diagn&#243;sticas fue del 74&#37; &#40;67-81&#37;&#41; para los tumores del sistema nervioso central&#59; del 80&#37; &#40;72-88&#37;&#41; para las leucemias&#44; s&#237;ndromes mielodispl&#225;sicos y s&#237;ndromes mieloproliferativos&#59; del 87&#37; &#40;80-95&#37;&#41; para los linfomas y neoplasias reticuloendoteliales&#59; y del 68&#37; &#40;53-84&#37;&#41; para los neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas&#46;</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">La comparativa entre dos cohortes de a&#241;os de diagn&#243;stico &#40;1999-2004 vs&#46; 2005-2010&#41; revela un incremento de la supervivencia en la cohorte m&#225;s reciente&#44; que solo es estad&#237;sticamente significativo en los tumores del sistema nervioso central&#46;</p></span> <span id="abst0020" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0025">Conclusiones</span><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Nuestros resultados son similares a los del Registro Espa&#241;ol de Tumores Infantiles&#46; La informaci&#243;n aportada por los Registros de Tumores es necesaria para un mayor conocimiento del c&#225;ncer y para garantizar la calidad asistencial de los enfermos oncol&#243;gicos&#46;</p></span>"
        "secciones" => array:4 [
          0 => array:2 [
            "identificador" => "abst0005"
            "titulo" => "Introducci&#243;n"
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            "identificador" => "abst0010"
            "titulo" => "Material y m&#233;todos"
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        "resumen" => "<span id="abst0025" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0035">Introduction</span><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">Cancer is the leading cause of death from disease in children&#46; Some epidemiological aspects of childhood cancer obtained from the Tumour Registry of a tertiary care hospital in Madrid are detailed&#44; in order to provide useful information for the management of cancer in this group of patients&#46;</p></span> <span id="abst0030" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0040">Material and methods</span><p id="spar0035" class="elsevierStyleSimplePara elsevierViewall">Descriptive and retrospective analysis of the data from the Hospital&#39;s Tumour Registry &#40;period 1999-2016&#41;&#44; with the aim of analysing the incidence &#40;overall&#44; and by diagnostic categories&#41; and survival &#40;overall&#44; by diagnostic groups and cohorts of years of diagnosis&#41; of childhood cancer&#46;</p></span> <span id="abst0035" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0045">Results</span><p id="spar0040" class="elsevierStyleSimplePara elsevierViewall">A total of 769 childhood tumours were registered between 1999 and 2016&#44; 431 in boys and 338 in girls&#46; The most common neoplasms were central nervous system tumours &#40;32&#46;5&#37;&#41;&#44; leukaemias&#44; myelodysplastic syndromes and myeloproliferative syndromes &#40;19&#37;&#41;&#59; lymphomas &#40;15&#37;&#41;&#44; and neuroblastomas &#40;7&#46;5&#37;&#41;&#46; Overall 5-year survival was 78&#37;&#46; Five-year survival of these diagnostic categories was 74&#37; &#40;67-81&#37;&#41; for central nervous system tumours&#59; 80&#37; &#40;72-88&#37;&#41; for leukaemias&#44; myelodysplastic syndromes and myeloproliferative syndromes&#59; 87&#37; &#40;80-95&#37;&#41; for lymphomas and reticuloendothelial neoplasms&#59; and 68&#37; &#40;53-84&#37;&#41; for neuroblastomas and other peripheral nerve cells tumours&#46;</p><p id="spar0045" class="elsevierStyleSimplePara elsevierViewall">The comparison between two diagnostic cohorts &#40;1999-2004 vs 2005-2010&#41; showed an increase in survival in the most recent cohort&#44; which was only statistically significant in central nervous system tumours&#46;</p></span> <span id="abst0040" class="elsevierStyleSection elsevierViewall"><span class="elsevierStyleSectionTitle" id="sect0050">Conclusions</span><p id="spar0050" class="elsevierStyleSimplePara elsevierViewall">These results are similar to those of the Spanish Register of Childhood Tumours&#46; The information provided by the Tumour Registries is necessary for greater knowledge of cancer and to ensure the quality of care for cancer patients&#46;</p></span>"
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          "leyenda" => "<p id="spar0080" class="elsevierStyleSimplePara elsevierViewall">Columnas &#171;Grupos de edad&#187;&#58; Los porcentajes que se muestran son respecto del total de su fila&#44; no del total global y no suman con el porcentaje de la columna &#171;Total&#187;&#46;</p><p id="spar0085" class="elsevierStyleSimplePara elsevierViewall">Los &#37; que acompa&#241;an al N Total&#44; al N Ni&#241;os y al N Ni&#241;as de casos en cada grupo de edad indican el porcentaje que representa ese N del grupo de edad respecto del total de casos correspondiente de ese grupo diagn&#243;stico&#46;</p><p id="spar0090" class="elsevierStyleSimplePara elsevierViewall">Columna &#171;Total&#187;&#58; En cada grupo diagn&#243;stico&#44; los &#37; que acompa&#241;an al N por sexo indican el porcentaje que representa cada sexo respecto del total de casos en ese grupo diagn&#243;stico&#46; El &#37; que acompa&#241;a al N &#171;Total&#187; indica el porcentaje que representa el N de ese grupo diagn&#243;stico respecto del N Total de la fila &#171;Todos los tumores&#187; &#40;769 casos&#41;&#46;</p>"
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                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td-with-role" title="\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col">Categor&#237;as diagn&#243;sticas&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">0 a 4 a&#241;os</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">10 a 14 a&#241;os</th><th class="td" title="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">N&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="9" align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">I&#46; Leucemias&#44; SMD y SMP</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ni&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">41&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="left" valign="\n
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                  \t\t\t\t">50&#44;6&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="left" valign="\n
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                  \t\t\t\t">25&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">30&#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="left" valign="\n
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                  \t\t\t\t">15&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t">18&#44;5&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="left" valign="\n
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                  \t\t\t\t">81&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="left" valign="\n
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                  \t\t\t\t">55&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ni&#241;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">33&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td><td class="td" title="\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">50&#44;8&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">15&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">23&#44;1&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">IV&#46; Neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">IX&#46; Sarcomas de tejidos blandos y otros extra&#243;seos</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t"><span class="elsevierStyleItalic">XI&#46; Melanomas malignos y otras neoplasias epiteliales malignas</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">4&#44;8&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="9" align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleItalic">Todos los tumores</span></td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ni&#241;os&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">179&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">126&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">30&#44;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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">112&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">26&#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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">417&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">54&#44;2&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Ni&#241;as&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">149&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;3&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">89&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">25&#44;3&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">114&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">32&#44;4&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">352&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">45&#44;8&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t"><span class="elsevierStyleHsp" style=""></span>Total&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">328&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">42&#44;7&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
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                  \t\t\t\t\ttop\n
                  \t\t\t\t">215&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;0&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">226&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">29&#44;4&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">769&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0075" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n de casos por categor&#237;as diagn&#243;sticas&#44; sexo y grupos de edad&#46; A&#241;os 1999 a 2016</p>"
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                  <table border="0" frame="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">LRD&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&#37;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
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                  \t\t\t\t">Localizado&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t</td><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">53&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Regional&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">65&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">8&#44;5&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Diseminado&nbsp;\t\t\t\t\t\t\n
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                  \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">72&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">9&#44;4&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Enfermedad sist&#233;mica&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">219&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">28&#44;6&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">Total&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">769&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&#44;0&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr></tbody></table>
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          "es" => "<p id="spar0095" class="elsevierStyleSimplePara elsevierViewall">Distribuci&#243;n seg&#250;n la extensi&#243;n &#40;localizado&#44; regional o diseminado&#41; de los tumores al diagn&#243;stico &#40;LRD&#41; entre 1999 y 2016</p>"
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                0 => """
                  <table border="0" frame="\n
                  \t\t\t\t\tvoid\n
                  \t\t\t\t" class=""><thead title="thead"><tr title="table-row"><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Categor&#237;as diagn&#243;sticas&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">1 a&#241;o&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">3 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th><th class="td" title="\n
                  \t\t\t\t\ttable-head\n
                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">5 a&#241;os&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t\t\t</th></tr></thead><tbody title="tbody"><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">I&#46; Leucemias&#44; SMD y SMP &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>95&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">90 &#40;84-96&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81 &#40;73-89&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">80 &#40;72-88&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">II&#46; Linfomas y neoplasias reticuloendoteliales &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>83&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">91 &#40;85-97&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;80-95&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">87 &#40;80-95&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">III&#46; SNC y otros tumores intracraneales e intraespinales &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>158&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;83-93&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">79 &#40;72-85&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;67-81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IV&#46; Neuroblastomas y otros tumores de c&#233;lulas nerviosas perif&#233;ricas &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>37&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">83 &#40;71-96&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">68 &#40;53-84&#41;&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="left" valign="\n
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                  \t\t\t\t">68 &#40;53-84&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VI&#46; Tumores renales &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>27&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&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="left" valign="\n
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                  \t\t\t\t">100&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">96 &#40;88-100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">VIII&#46; Tumores &#243;seos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>33&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">84 &#40;72-97&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">81 &#40;67-95&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">69 &#40;52-86&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">IX&#46; Sarcomas de tejidos blandos y otros extra&#243;seos &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>24&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">88 &#40;74-100&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">70 &#40;52-79&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">61 &#40;41-81&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">X&#46; Tumores de c&#233;lulas germinales &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>23&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">100&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="left" valign="\n
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                  \t\t\t\t">95 &#40;85-100&#41;&nbsp;\t\t\t\t\t\t\n
                  \t\t\t\t</td></tr><tr title="table-row"><td class="td-with-role" title="\n
                  \t\t\t\t\ttable-entry\n
                  \t\t\t\t ; entry_with_role_rowhead " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">XI&#46; Melanomas malignos y otras neoplasias epiteliales malignas &#40;n<span class="elsevierStyleHsp" style=""></span>&#61;<span class="elsevierStyleHsp" style=""></span>20&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">90 &#40;77-100&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;55-94&#41;&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="left" valign="\n
                  \t\t\t\t\ttop\n
                  \t\t\t\t">74 &#40;55-94&#41;&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0100" class="elsevierStyleSimplePara elsevierViewall">Supervivencia a 1&#44; 3 y 5 a&#241;os para las distintas categor&#237;as diagn&#243;sticas con n&#250;mero de casos mayor de 20&#46; IC 95&#37;&#46; 0-14 a&#241;os&#46; 1999 a 2010</p>"
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                  \t\t\t\t\tvoid\n
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                  \t\t\t\t" scope="col">Categor&#237;as diagn&#243;sticas<a class="elsevierStyleCrossRef" href="#tblfn0005"><span class="elsevierStyleSup">a</span></a>&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " colspan="2" align="center" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Supervivencia 5 a&#241;os IC 95&#37;</th></tr><tr title="table-row"><th class="td" title="\n
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                  \t\t\t\t  " align="" valign="\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ni&#241;os&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t" scope="col" style="border-bottom: 2px solid black">Ni&#241;as&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">I&#46; Leucemias&#44; SMD y SMP&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">80 &#40;68-91&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">78 &#40;65-91&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">II&#46; Linfomas y neoplasias reticuloendoteliales&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">84 &#40;75-94&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t  " align="left" valign="\n
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                  \t\t\t\t">90 &#40;79-101&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t\ttable-entry\n
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                  \t\t\t\t">III&#46; SNC y otros tumores intracraneales e intraespinales&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">74 &#40;64-83&#41;&nbsp;\t\t\t\t\t\t\n
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                  \t\t\t\t">67 &#40;56-79&#41;&nbsp;\t\t\t\t\t\t\n
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          "es" => "<p id="spar0105" class="elsevierStyleSimplePara elsevierViewall">Supervivencia a 5 a&#241;os para las primeras categor&#237;as diagn&#243;sticas seg&#250;n sexo&#46; IC 95&#37;&#46; 0-14 a&#241;os&#46; 1999 a 2010</p>"
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              "identificador" => "bib0055"
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                0 => array:1 [
                  "referenciaCompleta" => "Organizaci&#243;n Mundial de la Salud &#40;OMS&#41;&#46; El c&#225;ncer infantil&#46; 2018 &#91;consultado 10 Abr 2020&#93;&#46; Disponible en&#58; <a target="_blank" href="https://www.who.int/es/news-room/fact-sheets/detail/cancer-in-children">https&#58;&#47;&#47;www&#46;who&#46;int&#47;es&#47;news-room&#47;fact-sheets&#47;detail&#47;cancer-in-children</a>"
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              "identificador" => "bib0060"
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                0 => array:1 [
                  "referenciaCompleta" => "International Agency for Research on C&#225;ncer &#40;IARC&#41; de la Organizaci&#243;n Mundial de la Salud &#40;OMS&#41; &#91;consultado 24 May 2019&#93;&#46; Disponibles en&#58; <a target="_blank" href="http://gco.iarc.fr/">http&#58;&#47;&#47;gco&#46;iarc&#46;fr&#47;</a>"
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              ]
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            2 => array:3 [
              "identificador" => "bib0065"
              "etiqueta" => "3"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "La situaci&#243;n del c&#225;ncer en Espa&#241;a 1975-2006"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:5 [
                            0 => "A&#46; Cabanes Domenech"
                            1 => "B&#46; P&#233;rez-G&#243;mez"
                            2 => "N&#46; Aragon&#233;s"
                            3 => "M&#46; Poll&#225;n"
                            4 => "G&#46; L&#243;pez-Abente"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2009"
                        "editorial" => "Instituto de Salud Carlos III"
                        "editorialLocalizacion" => "Madrid"
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                    ]
                  ]
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              ]
            ]
            3 => array:3 [
              "identificador" => "bib0070"
              "etiqueta" => "4"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "&#205;ndice Nacional de Defunciones &#40;IND&#41;&#46;&#160;Ministerio de Sanidad Consumo y Bienestar Social&#46;"
                ]
              ]
            ]
            4 => array:3 [
              "identificador" => "bib0075"
              "etiqueta" => "5"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Estimaciones de la incidencia y la supervivencia del c&#225;ncer en Espa&#241;a y su situaci&#243;n en Europa"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "J&#46; Galceran"
                            1 => "A&#46; Ameijide"
                            2 => "M&#46; Carulla"
                            3 => "A&#46; Mateos"
                            4 => "J&#46;R&#46; Quir&#243;s"
                            5 => "A&#46; Alem&#225;n"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:2 [
                        "fecha" => "2014"
                        "editorial" => "Red Espa&#241;ola de Registros de C&#225;ncer &#40;REDECAN&#41;"
                      ]
                    ]
                  ]
                ]
              ]
            ]
            5 => array:3 [
              "identificador" => "bib0080"
              "etiqueta" => "6"
              "referencia" => array:1 [
                0 => array:1 [
                  "referenciaCompleta" => "C&#225;ncer Infantil en Espa&#241;a &#40;estad&#237;sticas 1980-2016&#41;&#46; Registro Espa&#241;ol de Tumores Infantiles &#40;RETI-SEHOP&#41; &#91;consultado 10 Abr 2020&#93;&#46; Disponible en&#58; <a target="_blank" href="https://www.uv.es/rnti/pdfs/Informe_RETI-SEHOP_1980-2016.pdf">https&#58;&#47;&#47;www&#46;uv&#46;es&#47;rnti&#47;pdfs&#47;Informe&#95;RETI-SEHOP&#95;1980-2016&#46;pdf</a>"
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              ]
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            6 => array:3 [
              "identificador" => "bib0085"
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              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "C&#225;ncer infantil en Espa&#241;a Estad&#237;sticas 1980-2008&#46; Registro Nacional de Tumores infantiles &#40;RNTI-SEHOP&#41;"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => true
                          "autores" => array:6 [
                            0 => "R&#46; Peris Bonet"
                            1 => "S&#46; Felipe Garc&#237;a"
                            2 => "G&#46; Fuentes Garc&#237;a"
                            3 => "V&#46; Gonz&#225;lez Ros"
                            4 => "R&#46; Navarro Jord&#225;n"
                            5 => "E&#46; Pardo Romaguerra"
                          ]
                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Libro" => array:3 [
                        "fecha" => "2009"
                        "editorial" => "Universidad de Valencia"
                        "editorialLocalizacion" => "Valencia"
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            7 => array:3 [
              "identificador" => "bib0090"
              "etiqueta" => "8"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Incidencia y supervivencia del c&#225;ncer en la infancia"
                      "autores" => array:1 [
                        0 => array:2 [
                          "etal" => false
                          "autores" => array:2 [
                            0 => "R&#46; Peris Bonet"
                            1 => "B&#46; Giner Ripoll"
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                        ]
                      ]
                    ]
                  ]
                  "host" => array:1 [
                    0 => array:1 [
                      "Revista" => array:5 [
                        "tituloSerie" => "Rev Esp Pediatr&#46;"
                        "fecha" => "2008"
                        "volumen" => "64"
                        "paginaInicial" => "342"
                        "paginaFinal" => "356"
                      ]
                    ]
                  ]
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            8 => array:3 [
              "identificador" => "bib0095"
              "etiqueta" => "9"
              "referencia" => array:1 [
                0 => array:2 [
                  "contribucion" => array:1 [
                    0 => array:2 [
                      "titulo" => "Childhood cancer survival in Europe"
                      "autores" => array:1 [
                        0 => array:3 [
                          "colaboracion" => "EUROCARE Working Group"
                          "etal" => false
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Información del artículo
ISSN: 16954033
Idioma original: Español
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