<?xml version="1.0" encoding="ISO-8859-1"?><article xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance">
<front>
<journal-meta>
<journal-id>2444-054X</journal-id>
<journal-title><![CDATA[Cirugía y cirujanos]]></journal-title>
<abbrev-journal-title><![CDATA[Cir. cir.]]></abbrev-journal-title>
<issn>2444-054X</issn>
<publisher>
<publisher-name><![CDATA[Academia Mexicana de Cirugía A.C.]]></publisher-name>
</publisher>
</journal-meta>
<article-meta>
<article-id>S2444-054X2019000200141</article-id>
<article-id pub-id-type="doi">10.24875/ciru.18000412</article-id>
<title-group>
<article-title xml:lang="es"><![CDATA[Metástasis cervicales de carcinoma epidermoide de cabeza y cuello. Alternativas terapéuticas]]></article-title>
<article-title xml:lang="en"><![CDATA[Cervical metastasis of squamous cell carcinoma of the head and neck. Therapeutic options]]></article-title>
</title-group>
<contrib-group>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Gallegos-Hernández]]></surname>
<given-names><![CDATA[José F.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Abrego-Vázquez]]></surname>
<given-names><![CDATA[José A.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Olvera-Casas]]></surname>
<given-names><![CDATA[Aldo]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Minauro-Muñoz]]></surname>
<given-names><![CDATA[Gerardo G.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
<contrib contrib-type="author">
<name>
<surname><![CDATA[Ortiz-Maldonado]]></surname>
<given-names><![CDATA[Alma L.]]></given-names>
</name>
<xref ref-type="aff" rid="Aff"/>
</contrib>
</contrib-group>
<aff id="Af1">
<institution><![CDATA[,Instituto Mexicano del Seguro Social Centro Médico Nacional Siglo XXI Hospital de Oncología]]></institution>
<addr-line><![CDATA[Ciudad de México ]]></addr-line>
<country>México</country>
</aff>
<pub-date pub-type="pub">
<day>00</day>
<month>04</month>
<year>2019</year>
</pub-date>
<pub-date pub-type="epub">
<day>00</day>
<month>04</month>
<year>2019</year>
</pub-date>
<volume>87</volume>
<numero>2</numero>
<fpage>141</fpage>
<lpage>145</lpage>
<copyright-statement/>
<copyright-year/>
<self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_arttext&amp;pid=S2444-054X2019000200141&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_abstract&amp;pid=S2444-054X2019000200141&amp;lng=en&amp;nrm=iso"></self-uri><self-uri xlink:href="http://www.scielo.org.mx/scielo.php?script=sci_pdf&amp;pid=S2444-054X2019000200141&amp;lng=en&amp;nrm=iso"></self-uri><abstract abstract-type="short" xml:lang="es"><p><![CDATA[Resumen  Introducción: Los pacientes con metástasis voluminosas de carcinoma epidermoide de cabeza y cuello representan un reto para la decisión terapéutica; se debe lograr un equilibrio entre el control oncológico y las complicaciones. La secuencia terapéutica no tiene impacto en la supervivencia, pero sí en las secuelas.  Objetivo: Conocer los resultados oncológicos de pacientes con metástasis en el cuello tratados con cirugía inicial y con quimioterapia de inducción.  Método: Análisis retrospectivo de pacientes sometidos a tratamiento por metástasis ganglionares cervicales de carcinoma epidermoide. La secuencia terapéutica se decidió basándose en el volumen, la resecabilidad, el sitio y el tamaño del tumor primario, y el estado general del paciente. Se calculó la supervivencia global y según el estado de portador o no del virus del papiloma humano (VPH).  Resultados: Se incluyeron 30 pacientes, 22 hombres y 8 mujeres, con una media de edad de 57 años. En cuanto al estadio, 10 eran N3 y 20 eran N2. En 13 el VPH fue positivo, en 5 fue negativo y en 12 no se efectuó la determinación. Siete pacientes fueron tratados con quimioterapia inicial y 23 fueron sometidos a disección de cuello. La supervivencia a 5 años fue del 25% y el pronóstico fue mejor en los VPH positivos.  Conclusión: El tratamiento de las metástasis cervicales depende de su resecabilidad. Hay que favorecer la cirugía inicial. El VPH es un factor de buen pronóstico.]]></p></abstract>
<abstract abstract-type="short" xml:lang="en"><p><![CDATA[Abstract  Introduction: Patients with bulky metastases of squamous cell carcinoma of the head and neck represent a challenge for the therapeutic decision; balance between oncological control and complications should be achieved. The therapeutic sequence has no impact on survival but sequelae.  Objective: We analyze the oncological results in patients with bulky metastases on the neck treated with induction chemotherapy and with up-front neck dissection.  Method: Retrospective analysis of patients undergoing treatment for cervical lymph node metastasis of squamous cell carcinoma; The therapeutic sequence was decided based on volume, resectability, site, and size of the primary and general condition of the patient. Overall survival was calculated based on human papilloma virus (HPV) status.  Results: There were 30 patients, 22 men and eight women with a mean age of 57 years, 10 N3 and 20 N2. In 13 the HPV was positive, in 5 negative and in 12 the determination was not made. Seven patients were treated with initial chemotherapy, and 23 underwent neck dissection; the 5-year survival was 25%, and the prognosis was better in the positive HPV.  Conclusion: The treatment of cervical metastasis depends on the possibility of resection. We should favor the initial surgery. The HPV is a factor of good prognosis.]]></p></abstract>
<kwd-group>
<kwd lng="es"><![CDATA[Carcinoma epidermoide]]></kwd>
<kwd lng="es"><![CDATA[Cabeza]]></kwd>
<kwd lng="es"><![CDATA[Cuello]]></kwd>
<kwd lng="es"><![CDATA[Disección inicial]]></kwd>
<kwd lng="es"><![CDATA[Ganglios]]></kwd>
<kwd lng="en"><![CDATA[Squamous cell carcinoma]]></kwd>
<kwd lng="en"><![CDATA[Head]]></kwd>
<kwd lng="en"><![CDATA[Neck]]></kwd>
<kwd lng="en"><![CDATA[Up-front neck dissection]]></kwd>
<kwd lng="en"><![CDATA[Nodes]]></kwd>
</kwd-group>
</article-meta>
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