Carta al Director
Respuesta de los autores
Response by the Authors
J.. José Abal Arca
Servicio de Neumología, Complexo Hospitalario Ourense, Ourense, España
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Soriano" "autores" => array:1 [ 0 => array:2 [ "nombre" => "Joan B." "apellidos" => "Soriano" ] ] ] ] ] "idiomaDefecto" => "es" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289609004608?idApp=UINPBA00003Z" "url" => "/03002896/0000004600000005/v1_201305150319/S0300289609004608/v1_201305150319/es/main.assets" ] "es" => array:12 [ "idiomaDefecto" => true "cabecera" => "<span class="elsevierStyleTextfn">Carta al Director</span>" "titulo" => "Respuesta de los autores" "tieneTextoCompleto" => true "saludo" => "Sr. Director:" "paginas" => array:1 [ 0 => array:1 [ "paginaInicial" => "282" ] ] "autores" => array:1 [ 0 => array:3 [ "autoresLista" => "José Abal Arca" "autores" => array:1 [ 0 => array:4 [ "Iniciales" => "J." "nombre" => "José" "apellidos" => "Abal Arca" "email" => array:1 [ 0 => "jose.abal.arca@sergas.es" ] ] ] "afiliaciones" => array:1 [ 0 => array:1 [ "entidad" => "Servicio de Neumología, Complexo Hospitalario Ourense, Ourense, España" ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Response by the Authors" ] ] "textoCompleto" => "<span class="elsevierStyleSections"><p class="elsevierStylePara elsevierViewall">Agradecemos a Joan B. Soriano el interés que ha mostrado por nuestro artículo recientemente publicado<a class="elsevierStyleCrossRef" href="#bib1"><span class="elsevierStyleSup">1</span></a>. Consideramos sus comentarios pertinentes y acertados, y sus sugerencias mejoran, sin duda, lo aportado por el original.</p><p class="elsevierStylePara elsevierViewall">Siguiendo sus consejos hemos reanalizado los datos eliminando los 16 pacientes con EPOC sin espirometría. Las curvas de supervivencia Kaplan-Meier siguen siendo significativamente distintas entre los pacientes con y sin EPOC, siendo mayor en aquellos con EPOC (p=0,006).</p><p class="elsevierStylePara elsevierViewall">Efectivamente, tal como apunta el autor de la carta y está reflejado en el apartado de resultados, se realizó un modelo de regresión de Cox ajustado para las variables significativas en el análisis bivariado, aunque en el modelo final solo permanecieron el estadio y el tratamiento. La EPOC, por el contrario, no resultó estadísticamente significativa. En la discusión se comentó la posibilidad del sesgo diagnóstico como causa de las diferencias en la supervivencia debido a que quizás los pacientes EPOC se diagnostican en estadios más precoces, aunque quizás debería haberse hecho más hincapié en discutir los resultados del análisis multivariante. Por todo ello, tenemos que reconsiderar nuestra conclusión y decir que no se observan diferencias significativas en la supervivencia entre los pacientes con EPOC y sin EPOC.</p><p class="elsevierStylePara elsevierViewall">Por otra parte, nos parece muy interesante la idea de analizar el tiempo transcurrido entre el diagnóstico de EPOC y el de cáncer de pulmón, e incluso el tratamiento con corticoides inhalados y su influencia en la supervivencia, tal como han estudiado otros autores<a class="elsevierStyleCrossRefs" href="#bib2"><span class="elsevierStyleSup">2,3</span></a>. Aunque el recabar algunos de esos datos se nos antoja difícil, al tratarse de un estudio retrospectivo y partir de una base de datos de cáncer de pulmón y no de EPOC.</p></span>" "pdfFichero" => "main.pdf" "tienePdf" => true "bibliografia" => array:2 [ "titulo" => "Bibliografía" "seccion" => array:1 [ 0 => array:1 [ "bibliografiaReferencia" => array:3 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Cáncer de pulmón y EPOC: una asociación frecuente" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:6 [ 0 => "J. Abal Arca" 1 => "I. Parente Lamelas" 2 => "R. Almazán Ortega" 3 => "J. Blanco Pérez" 4 => "M.E. Toubes Navarro" 5 => "P. Marcos Velázquez" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.arbres.2009.07.005" "Revista" => array:6 [ "tituloSerie" => "Arch Bronconeumol" "fecha" => "2009" "volumen" => "45" "paginaInicial" => "502" "paginaFinal" => "507" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/19748721" "web" => "Medline" ] ] ] ] ] ] ] ] 1 => array:3 [ "identificador" => "bib2" "etiqueta" => "2" "referencia" => array:1 [ 0 => array:1 [ "referenciaCompleta" => "Kiri VA, Soriano JB, Visick G, Fabbri L. Recent trends in lung cancer and its association with COPD: an analysis using the UK GP Research Database. Prim Care Respir J. 2009. pii:pcrj-2009-02-0021. <a class="elsevierStyleInterRef" href="http://dx.doi.org/10.4104/pcrj.2009.00048">doi:10.4104/pcrj.2009.00048</a>." ] ] ] 2 => array:3 [ "identificador" => "bib3" "etiqueta" => "3" "referencia" => array:1 [ 0 => array:2 [ "contribucion" => array:1 [ 0 => array:2 [ "titulo" => "Inhaled corticosteroids and risk of lung cancer among COPD patients who quit smoking" "autores" => array:1 [ 0 => array:2 [ "etal" => false "autores" => array:4 [ 0 => "V.A. Kiri" 1 => "L.M. Fabbri" 2 => "K.J. Davis" 3 => "J.B. Soriano" ] ] ] ] ] "host" => array:1 [ 0 => array:2 [ "doi" => "10.1016/j.rmed.2008.07.024" "Revista" => array:6 [ "tituloSerie" => "Respir Med" "fecha" => "2009" "volumen" => "103" "paginaInicial" => "85" "paginaFinal" => "90" "link" => array:1 [ 0 => array:2 [ "url" => "https://www.ncbi.nlm.nih.gov/pubmed/18793832" "web" => "Medline" ] ] ] ] ] ] ] ] ] ] ] ] ] "idiomaDefecto" => "es" "url" => "/03002896/0000004600000005/v1_201305150319/S0300289609004700/v1_201305150319/es/main.assets" "Apartado" => array:4 [ "identificador" => "9222" "tipo" => "SECCION" "es" => array:2 [ "titulo" => "Letters to the Director / Cartas al Director" "idiomaDefecto" => true ] "idiomaDefecto" => "es" ] "PDF" => "https://static.elsevier.es/multimedia/03002896/0000004600000005/v1_201305150319/S0300289609004700/v1_201305150319/es/main.pdf?idApp=UINPBA00003Z&text.app=https://archbronconeumol.org/" "EPUB" => "https://multimedia.elsevier.es/PublicationsMultimediaV1/item/epub/S0300289609004700?idApp=UINPBA00003Z" ]
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