Perfil epidemiológico dos pacientes com cânceres de cabeça e pescoço no Hospital das Clínicas da Faculdade de Medicina de Botucatu
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Data
2022-08-25
Autores
Cristiano, Luigi Carrara
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Universidade Estadual Paulista (Unesp)
Resumo
Introdução: Os cânceres de cabeça e pescoço são neoplasias muito frequentes e de distribuição global. Tabaco e álcool são reconhecidamente os principais fatores de risco para essas doenças, no entanto a infecção pelo HPV é fator de risco emergente. No Brasil a incidência desses cânceres é expressiva, sendo os portadores diagnosticados frequentemente em estágios tardios da doença, o que determina maior morbimortalidade e pior prognóstico a esses doentes. O Serviço de Otorrinolaringologia e Cirurgia de Cabeça e Pescoço do Hospital das Clínicas da Faculdade de Medicina de Botucatu atende pacientes com cânceres de cabeça e pescoço. A maior parte dos casos chega ao serviço em estágio avançado com baixa chance de cura. Faz-se necessário o conhecimento do perfil epidemiológico desses pacientes a fim de permitir um melhor atendimento e identificar as possíveis falhas responsáveis pelo insucesso terapêutico e diferentes taxas de sobrevida. Objetivo: Delinear o perfil epidemiológico dos pacientes portadores de câncer de cabeça e pescoço atendidos no Ambulatório de Cirurgia de Cabeça e Pescoço do Hospital das Clínicas da Faculdade de Medicina de Botucatu e identificar fatores relacionados à sobrevida desses pacientes. Material e Método: Estudo epidemiológico de coorte-transversal. Realizou-se análise de prontuários dos pacientes com cânceres de cabeça e pescoço atendidos em ambulatório de Cirurgia de Cabeça e Pescoço do Hospital das Clínicas da Faculdade de Medicina de Botucatu e que realizaram caso novo entre junho de 2012 e dezembro de 2019. Os parâmetros analisados foram: profissão, idade, cidade de origem, comorbidades, sintomas principais, histórico de tabagismo e etilismo, sítio tumoral, estadiamento tumoral ao diagnóstico, tratamento realizado e tempos de espera durante o manejo dos pacientes. O desfecho foi a sobrevida livre de doença maior ou igual a 05 anos. Os dados foram analisados de forma descritiva e comparativa visando associação com o desfecho. Resultados: Foram analisados prontuários de 398 pacientes. Homens representaram 80,65% dos pacientes, sendo a média de idade de 60,54 anos. 91,46% dos diagnósticos anatomopatológicos foram de carcinoma de células escamosas. 55,98% dos pacientes eram tabagistas e etilistas, apenas 17,05% dos pacientes não tinham história de tabagismo ou etilismo. 368 pacientes (92,46%) apresentaram sítio tumoral primário em boca, orofaringe, laringe ou hipofaringe. 73,85% dos pacientes foram diagnosticados com doença em estadio tardio. Quimioterapia associada à radioterapia foi o tratamento realizado pela maioria dos pacientes (61,99%). Apenas 19,02% dos pacientes apresentaram sobrevida maior ou igual a 05 anos. Pacientes com estadios precoces ao diagnóstico, com menores intervalos de tempo entre início do tratamento e diagnóstico anatomopatológico, bem como com menores intervalos de tempo entre início do tratamento e data do caso novo foram associados com sobrevida maior ou igual à 05 anos com significância estatística (p<0,05). Conclusão: O perfil epidemiológico dos pacientes analisados neste trabalho corresponde ao encontrado na literatura. O diagnóstico dos tumores em estadios precoces e a maior rapidez na instituição do tratamento estiveram relacionados à maior sobrevida dos pacientes.
Introduction: Head and neck cancers are very frequent neoplasias with global distribution. Tobacco and alcohol are recognized as the main risk factors for these diseases, however HPV infection is an emerging risk factor. In Brazil, the incidence of these cancers is expressive, and carriers are often diagnosed in late stages of the disease, determining high morbidity and mortality and worse prognosis for these patients.The Otorhinolaryngology and Head and Neck Surgery Service at the Clinical Hospital of Botucatu Medical School assists patients with head and neck cancer. Most of the cases that arrive at the service are in an advanced stage with a low chance of cure. It is necessary to know the epidemiological profile of these patients in order to allow better care and identify possible issues that may be responsible for therapeutic failure and different survival rates. Objective: To trace the epidemiological profile of patients with head and neck cancer treated at the Head and Neck Surgery Clinic of the Clinical Hospital of Botucatu Medical School and to identify factors related to the survival of these patients. Material and Method: Epidemiological cross-sectional cohort study. An analysis was performed considering the medical records of patients with head and neck cancer treated at the Head and Neck Surgery Clinic of Clinical Hospital of Botucatu Medical School and the ones who had a new case between June 2012 and December 2019. The parameters analyzed were: profession, age, city of origin, comorbidities, main symptoms, smoking and alcohol consumption history, tumor site, tumor staging at diagnosis, treatment performed and waiting times during patient management. The outcome was disease-free survival of 05 years or more. The data were analyzed in a descriptive and comparative way aiming at the association with the outcome. Results: The medical records of 398 patients were analyzed. Men represented 80.65% of patients, with an average age of 60.54 years. 91.46% of the anatomopathological diagnoses were squamous cell carcinoma. 55.98% of the patients were smokers and alcohol consumers, only 17.05% of the patients had no history of smoking or alcohol consumption. 368 patients (92.46%) had a primary tumor site in the mouth, oropharynx, larynx or hypopharynx. 73.85% of patients were diagnosed with late-stage disease. Chemotherapy associated with radiotherapy was the treatment performed on most patients (61.99%). Only 19.02% of patients had a survival time greater than or equal to 05 years. Patients diagnosed in earlier stages, with shorter time intervals between the start of treatment and anatomopathological diagnosis, as well as with shorter time intervals between the start of treatment and the date of the new case were associated with survival time greater than or equal to 05 years with statistical significance ( p<0.05). Conclusion: The epidemiological profile of the analyzed patients in this study corresponds to that found in the literature. The diagnosis of tumors in early stages and faster treatment initiation were related to longer patient survival.
Introduction: Head and neck cancers are very frequent neoplasias with global distribution. Tobacco and alcohol are recognized as the main risk factors for these diseases, however HPV infection is an emerging risk factor. In Brazil, the incidence of these cancers is expressive, and carriers are often diagnosed in late stages of the disease, determining high morbidity and mortality and worse prognosis for these patients.The Otorhinolaryngology and Head and Neck Surgery Service at the Clinical Hospital of Botucatu Medical School assists patients with head and neck cancer. Most of the cases that arrive at the service are in an advanced stage with a low chance of cure. It is necessary to know the epidemiological profile of these patients in order to allow better care and identify possible issues that may be responsible for therapeutic failure and different survival rates. Objective: To trace the epidemiological profile of patients with head and neck cancer treated at the Head and Neck Surgery Clinic of the Clinical Hospital of Botucatu Medical School and to identify factors related to the survival of these patients. Material and Method: Epidemiological cross-sectional cohort study. An analysis was performed considering the medical records of patients with head and neck cancer treated at the Head and Neck Surgery Clinic of Clinical Hospital of Botucatu Medical School and the ones who had a new case between June 2012 and December 2019. The parameters analyzed were: profession, age, city of origin, comorbidities, main symptoms, smoking and alcohol consumption history, tumor site, tumor staging at diagnosis, treatment performed and waiting times during patient management. The outcome was disease-free survival of 05 years or more. The data were analyzed in a descriptive and comparative way aiming at the association with the outcome. Results: The medical records of 398 patients were analyzed. Men represented 80.65% of patients, with an average age of 60.54 years. 91.46% of the anatomopathological diagnoses were squamous cell carcinoma. 55.98% of the patients were smokers and alcohol consumers, only 17.05% of the patients had no history of smoking or alcohol consumption. 368 patients (92.46%) had a primary tumor site in the mouth, oropharynx, larynx or hypopharynx. 73.85% of patients were diagnosed with late-stage disease. Chemotherapy associated with radiotherapy was the treatment performed on most patients (61.99%). Only 19.02% of patients had a survival time greater than or equal to 05 years. Patients diagnosed in earlier stages, with shorter time intervals between the start of treatment and anatomopathological diagnosis, as well as with shorter time intervals between the start of treatment and the date of the new case were associated with survival time greater than or equal to 05 years with statistical significance ( p<0.05). Conclusion: The epidemiological profile of the analyzed patients in this study corresponds to that found in the literature. The diagnosis of tumors in early stages and faster treatment initiation were related to longer patient survival.
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Palavras-chave
Câncer de cabeça e pescoço, Epidemiologia, Sobrevida, Head and neck cancer, Epidemiology, Survival