Evolution of Health-Related Quality of Life in Breast Cancer Patients during the First Year of Follow-Up
Identifieur interne : 002341 ( Pmc/Checkpoint ); précédent : 002340; suivant : 002342Evolution of Health-Related Quality of Life in Breast Cancer Patients during the First Year of Follow-Up
Auteurs : David Moro-Valdezate [Espagne] ; Salvador Peir [Espagne] ; Elvira Buch-Villa [Espagne] ; Antonio Caballero-Gárate [Espagne] ; M. Dolores Morales-Monsalve [Espagne] ; Ángel Martínez-Agull [Espagne] ; Félix Checa-Ayet [Espagne] ; Joaquín Ortega-Serrano [Espagne]Source :
- Journal of Breast Cancer [ 1738-6756 ] ; 2013.
Abstract
The objective of this study was to describe the evolution of health-related quality of life (HRQOL) in a cohort of breast cancer patients over 1 year after surgery and to analyse the predictive ability of HRQOL measurement instruments.
Observational, multicenter and prospective study of a cohort of breast cancer patients, assessing HRQOL at 1, 6, and 12 months after surgery using three questionnaires: EuroQol-5D-3L, EORTC QLQ-C30, and EORTC QLQ-BR23.
A total of 364 women participated in the study. Visual Analogue Scale (VAS) scores from the EuroQol improved (1 month vs. 1 year: 70 vs. 80;
HRQOL improved during the follow-up period. Likewise, HRQOL measurement instruments can predict early HRQOL.
Url:
DOI: 10.4048/jbc.2013.16.1.104
PubMed: 23593090
PubMed Central: 3625756
Affiliations:
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Evolution of Health-Related Quality of Life in Breast Cancer Patients during the First Year of Follow-Up</title><author><name sortKey="Moro Valdezate, David" sort="Moro Valdezate, David" uniqKey="Moro Valdezate D" first="David" last="Moro-Valdezate">David Moro-Valdezate</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Peir, Salvador" sort="Peir, Salvador" uniqKey="Peir S" first="Salvador" last="Peir">Salvador Peir</name><affiliation wicri:level="1"><nlm:aff id="A2">Health Services Research Unit, Centro Superior de Investigación en Salud Pública (CSISP), Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Health Services Research Unit, Centro Superior de Investigación en Salud Pública (CSISP), Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Buch Villa, Elvira" sort="Buch Villa, Elvira" uniqKey="Buch Villa E" first="Elvira" last="Buch-Villa">Elvira Buch-Villa</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Surgery, Hospital de Sagunto, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital de Sagunto, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Caballero Garate, Antonio" sort="Caballero Garate, Antonio" uniqKey="Caballero Garate A" first="Antonio" last="Caballero-Gárate">Antonio Caballero-Gárate</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Morales Monsalve, M Dolores" sort="Morales Monsalve, M Dolores" uniqKey="Morales Monsalve M" first="M. Dolores" last="Morales-Monsalve">M. Dolores Morales-Monsalve</name><affiliation wicri:level="1"><nlm:aff id="A4">Department of Surgery, Hospital Universitario Doctor Peset de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Universitario Doctor Peset de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Martinez Agull, Angel" sort="Martinez Agull, Angel" uniqKey="Martinez Agull A" first="Ángel" last="Martínez-Agull">Ángel Martínez-Agull</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Checa Ayet, Felix" sort="Checa Ayet, Felix" uniqKey="Checa Ayet F" first="Félix" last="Checa-Ayet">Félix Checa-Ayet</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Surgery, Hospital de Sagunto, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital de Sagunto, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Ortega Serrano, Joaquin" sort="Ortega Serrano, Joaquin" uniqKey="Ortega Serrano J" first="Joaquín" last="Ortega-Serrano">Joaquín Ortega-Serrano</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">23593090</idno><idno type="pmc">3625756</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3625756</idno><idno type="RBID">PMC:3625756</idno><idno type="doi">10.4048/jbc.2013.16.1.104</idno><date when="2013">2013</date><idno type="wicri:Area/Pmc/Corpus">004030</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Corpus" wicri:corpus="PMC">004030</idno><idno type="wicri:Area/Pmc/Curation">004029</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Curation">004029</idno><idno type="wicri:Area/Pmc/Checkpoint">002341</idno><idno type="wicri:explorRef" wicri:stream="Pmc" wicri:step="Checkpoint">002341</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Evolution of Health-Related Quality of Life in Breast Cancer Patients during the First Year of Follow-Up</title><author><name sortKey="Moro Valdezate, David" sort="Moro Valdezate, David" uniqKey="Moro Valdezate D" first="David" last="Moro-Valdezate">David Moro-Valdezate</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Peir, Salvador" sort="Peir, Salvador" uniqKey="Peir S" first="Salvador" last="Peir">Salvador Peir</name><affiliation wicri:level="1"><nlm:aff id="A2">Health Services Research Unit, Centro Superior de Investigación en Salud Pública (CSISP), Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Health Services Research Unit, Centro Superior de Investigación en Salud Pública (CSISP), Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Buch Villa, Elvira" sort="Buch Villa, Elvira" uniqKey="Buch Villa E" first="Elvira" last="Buch-Villa">Elvira Buch-Villa</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Surgery, Hospital de Sagunto, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital de Sagunto, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Caballero Garate, Antonio" sort="Caballero Garate, Antonio" uniqKey="Caballero Garate A" first="Antonio" last="Caballero-Gárate">Antonio Caballero-Gárate</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Morales Monsalve, M Dolores" sort="Morales Monsalve, M Dolores" uniqKey="Morales Monsalve M" first="M. Dolores" last="Morales-Monsalve">M. Dolores Morales-Monsalve</name><affiliation wicri:level="1"><nlm:aff id="A4">Department of Surgery, Hospital Universitario Doctor Peset de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Universitario Doctor Peset de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Martinez Agull, Angel" sort="Martinez Agull, Angel" uniqKey="Martinez Agull A" first="Ángel" last="Martínez-Agull">Ángel Martínez-Agull</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Checa Ayet, Felix" sort="Checa Ayet, Felix" uniqKey="Checa Ayet F" first="Félix" last="Checa-Ayet">Félix Checa-Ayet</name><affiliation wicri:level="1"><nlm:aff id="A3">Department of Surgery, Hospital de Sagunto, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital de Sagunto, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author><author><name sortKey="Ortega Serrano, Joaquin" sort="Ortega Serrano, Joaquin" uniqKey="Ortega Serrano J" first="Joaquín" last="Ortega-Serrano">Joaquín Ortega-Serrano</name><affiliation wicri:level="1"><nlm:aff id="A1">Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.</nlm:aff><country xml:lang="fr" wicri:curation="lc">Espagne</country><wicri:regionArea>Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia</wicri:regionArea><wicri:noRegion>Valencia</wicri:noRegion></affiliation></author></analytic><series><title level="j">Journal of Breast Cancer</title><idno type="ISSN">1738-6756</idno><idno type="eISSN">2092-9900</idno><imprint><date when="2013">2013</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Purpose</title><p>The objective of this study was to describe the evolution of health-related quality of life (HRQOL) in a cohort of breast cancer patients over 1 year after surgery and to analyse the predictive ability of HRQOL measurement instruments.</p></sec><sec><title>Methods</title><p>Observational, multicenter and prospective study of a cohort of breast cancer patients, assessing HRQOL at 1, 6, and 12 months after surgery using three questionnaires: EuroQol-5D-3L, EORTC QLQ-C30, and EORTC QLQ-BR23.</p></sec><sec><title>Results</title><p>A total of 364 women participated in the study. Visual Analogue Scale (VAS) scores from the EuroQol improved (1 month vs. 1 year: 70 vs. 80; <italic>p</italic><0.0001); however, the EuroQol score showed no significant change (0.81 vs. 0.83; <italic>p</italic>=0.1323). In contrast, Global Health Status on the EORTC QLQ-C30 improved (66.67 vs. 100.00; <italic>p</italic><0.0001), as did all of this instrument's scales and most of its independent items. The EORTC QLQ-BR23 dimensions showed improvement, except for sexual functioning (100.00 vs. 86.67; <italic>p</italic>=0.0030) and future perspective (33.33 vs. 66.67; <italic>p</italic><0.0001). Patients with good HRQOL outcomes at 1 month showed improved levels of HRQOL at 1 year; HRQOL measured at 1 month was predictive of HRQOL at 1 year.</p></sec><sec><title>Conclusion</title><p>HRQOL improved during the follow-up period. 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<front><journal-meta><journal-id journal-id-type="nlm-ta">J Breast Cancer</journal-id><journal-id journal-id-type="iso-abbrev">J Breast Cancer</journal-id><journal-id journal-id-type="publisher-id">JBC</journal-id><journal-title-group><journal-title>Journal of Breast Cancer</journal-title></journal-title-group><issn pub-type="ppub">1738-6756</issn><issn pub-type="epub">2092-9900</issn><publisher><publisher-name>Korean Breast Cancer Society</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="pmid">23593090</article-id><article-id pub-id-type="pmc">3625756</article-id><article-id pub-id-type="doi">10.4048/jbc.2013.16.1.104</article-id><article-categories><subj-group subj-group-type="heading"><subject>Original Article</subject></subj-group></article-categories><title-group><article-title>Evolution of Health-Related Quality of Life in Breast Cancer Patients during the First Year of Follow-Up</article-title></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name><surname>Moro-Valdezate</surname><given-names>David</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Peiró</surname><given-names>Salvador</given-names></name><xref ref-type="aff" rid="A2">1</xref></contrib><contrib contrib-type="author"><name><surname>Buch-Villa</surname><given-names>Elvira</given-names></name><xref ref-type="aff" rid="A3">2</xref></contrib><contrib contrib-type="author"><name><surname>Caballero-Gárate</surname><given-names>Antonio</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Morales-Monsalve</surname><given-names>M. Dolores</given-names></name><xref ref-type="aff" rid="A4">3</xref></contrib><contrib contrib-type="author"><name><surname>Martínez-Agulló</surname><given-names>Ángel</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib><contrib contrib-type="author"><name><surname>Checa-Ayet</surname><given-names>Félix</given-names></name><xref ref-type="aff" rid="A3">2</xref></contrib><contrib contrib-type="author"><name><surname>Ortega-Serrano</surname><given-names>Joaquín</given-names></name><xref ref-type="aff" rid="A1"></xref></contrib></contrib-group><aff id="A1">Department of Surgery, Hospital Clínico Universitario de Valencia, Valencia, Spain.</aff><aff id="A2"><label>1</label>Health Services Research Unit, Centro Superior de Investigación en Salud Pública (CSISP), Valencia, Spain.</aff><aff id="A3"><label>2</label>Department of Surgery, Hospital de Sagunto, Valencia, Spain.</aff><aff id="A4"><label>3</label>Department of Surgery, Hospital Universitario Doctor Peset de Valencia, Valencia, Spain.</aff><author-notes><corresp>Correspondence to: David Moro-Valdezate. Department of Surgery, Hospital Clínico Universitario de Valencia, C/General San Martín, 24-4, Valencia 46004, Spain. Tel: +34-605985405, Fax: +34-963862644, <email>davidmoro78@gmail.com</email></corresp></author-notes><pub-date pub-type="ppub"><month>3</month><year>2013</year></pub-date><pub-date pub-type="epub"><day>31</day><month>3</month><year>2013</year></pub-date><volume>16</volume><issue>1</issue><fpage>104</fpage><lpage>111</lpage><history><date date-type="received"><day>28</day><month>11</month><year>2012</year></date><date date-type="accepted"><day>18</day><month>2</month><year>2013</year></date></history><permissions><copyright-statement>© 2013 Korean Breast Cancer Society. All rights reserved.</copyright-statement><copyright-year>2013</copyright-year><license license-type="open-access" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/"><license-p>This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (<ext-link ext-link-type="uri" xlink:href="http://creativecommons.org/licenses/by-nc/3.0/">http://creativecommons.org/licenses/by-nc/3.0/</ext-link>) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.</license-p></license></permissions><abstract><sec><title>Purpose</title><p>The objective of this study was to describe the evolution of health-related quality of life (HRQOL) in a cohort of breast cancer patients over 1 year after surgery and to analyse the predictive ability of HRQOL measurement instruments.</p></sec><sec><title>Methods</title><p>Observational, multicenter and prospective study of a cohort of breast cancer patients, assessing HRQOL at 1, 6, and 12 months after surgery using three questionnaires: EuroQol-5D-3L, EORTC QLQ-C30, and EORTC QLQ-BR23.</p></sec><sec><title>Results</title><p>A total of 364 women participated in the study. Visual Analogue Scale (VAS) scores from the EuroQol improved (1 month vs. 1 year: 70 vs. 80; <italic>p</italic><0.0001); however, the EuroQol score showed no significant change (0.81 vs. 0.83; <italic>p</italic>=0.1323). In contrast, Global Health Status on the EORTC QLQ-C30 improved (66.67 vs. 100.00; <italic>p</italic><0.0001), as did all of this instrument's scales and most of its independent items. The EORTC QLQ-BR23 dimensions showed improvement, except for sexual functioning (100.00 vs. 86.67; <italic>p</italic>=0.0030) and future perspective (33.33 vs. 66.67; <italic>p</italic><0.0001). Patients with good HRQOL outcomes at 1 month showed improved levels of HRQOL at 1 year; HRQOL measured at 1 month was predictive of HRQOL at 1 year.</p></sec><sec><title>Conclusion</title><p>HRQOL improved during the follow-up period. Likewise, HRQOL measurement instruments can predict early HRQOL.</p></sec></abstract><kwd-group><kwd>Breast neoplasms</kwd><kwd>Quality of life</kwd><kwd>Questionnaires</kwd></kwd-group></article-meta></front><floats-group><fig id="F1" position="float"><label>Figure 1</label><caption><p>Evolution of health-related quality of life (HRQOL) from 1 month to 1 year after surgery.</p><p>VAS=Visual Analogue Scale; EuroQol-5D-3L=European Group of Quality of Life Questionnaire; EORTC QLQ-C30=European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 items.</p></caption><graphic xlink:href="jbc-16-104-g001"></graphic></fig><table-wrap id="T1" position="float"><label>Table 1</label><caption><p>Clinical characteristics of breast cancer patients comparing nonrespondents and respondents (n=551)</p></caption><graphic xlink:href="jbc-16-104-i001"></graphic><table-wrap-foot><fn><p>Values are presented as number.</p><p>SLNB=sentinel lymph node biopsy; BCS=breast-conserving surgery.</p><p><sup>*</sup><italic>p</italic><0.005 is considered to indicate statistical significance from Fisher's exact test.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T2" position="float"><label>Table 2</label><caption><p>Changes in HRQOL from 1 month to 1 year after surgery</p></caption><graphic xlink:href="jbc-16-104-i002"></graphic><table-wrap-foot><fn><p>HRQOL=health-related quality of life; EuroQol-5D-3L=European Group of Quality of Life Questionnaire; VAS=Visual Analogue Scale; EORTC QLQ-C30=European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 items; EORTC QLQ-BR23=Quality of life Questionnaire Breast 23 items.</p><p><sup>*</sup>n=364 (n corresponds to the comparison between 1 month vs. 1 year; values lower than 364 are due to no answer for some items); <sup>†</sup><italic>p</italic><0.005 is considered to indicate statistical significance from Wilcoxon matched pairs test.</p></fn></table-wrap-foot></table-wrap><table-wrap id="T3" position="float"><label>Table 3</label><caption><p>Association between HRQOL at 1 month and EuroQol-5D-3L (score and VAS) and Global Health Status of EORTC QLQ-C30 at 1 year after surgery</p></caption><graphic xlink:href="jbc-16-104-i003"></graphic><table-wrap-foot><fn><p>HRQOL=health-related quality of life; EuroQol-5D-3L=European Group of Quality of Life Questionnaire; VAS=Visual Analogue Scale; EORTC QLQ-C30=European Organization for Research and Treatment of Cancer Quality of Life Questionnaire 30 items; T=tertiles of scores at 1 month after surgery in the corresponding scale.</p><p>Values between brackets are initial and final scores of the tertile; EORTC QLQ-BR23=Quality of life Questionnaire Breast 23 items.</p><p><sup>*</sup>n=364; <sup>†</sup><italic>p</italic><0.005 is considered to indicate statistical significance from Kruskal-Wallis test.</p></fn></table-wrap-foot></table-wrap></floats-group></pmc><affiliations><list><country><li>Espagne</li></country></list><tree><country name="Espagne"><noRegion><name sortKey="Moro Valdezate, David" sort="Moro Valdezate, David" uniqKey="Moro Valdezate D" first="David" last="Moro-Valdezate">David Moro-Valdezate</name></noRegion><name sortKey="Buch Villa, Elvira" sort="Buch Villa, Elvira" uniqKey="Buch Villa E" first="Elvira" last="Buch-Villa">Elvira Buch-Villa</name><name sortKey="Caballero Garate, Antonio" sort="Caballero Garate, Antonio" uniqKey="Caballero Garate A" first="Antonio" last="Caballero-Gárate">Antonio Caballero-Gárate</name><name sortKey="Checa Ayet, Felix" sort="Checa Ayet, Felix" uniqKey="Checa Ayet F" first="Félix" last="Checa-Ayet">Félix Checa-Ayet</name><name sortKey="Martinez Agull, Angel" sort="Martinez Agull, Angel" uniqKey="Martinez Agull A" first="Ángel" last="Martínez-Agull">Ángel Martínez-Agull</name><name sortKey="Morales Monsalve, M Dolores" sort="Morales Monsalve, M Dolores" uniqKey="Morales Monsalve M" first="M. Dolores" last="Morales-Monsalve">M. Dolores Morales-Monsalve</name><name sortKey="Ortega Serrano, Joaquin" sort="Ortega Serrano, Joaquin" uniqKey="Ortega Serrano J" first="Joaquín" last="Ortega-Serrano">Joaquín Ortega-Serrano</name><name sortKey="Peir, Salvador" sort="Peir, Salvador" uniqKey="Peir S" first="Salvador" last="Peir">Salvador Peir</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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