Estudo epidemiológico das neoplasias pulmonares submetidas a tratamento cirúrgico e das inoperáveis ao diagnóstico
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Data
2019-08-01
Autores
Ximenes, Agláia Moreira Garcia
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Universidade Estadual Paulista (Unesp)
Resumo
Objetivo: Comparar características epidemiológicas dos pacientes com diagnóstico de carcinoma broncogênico submetidos a tratamento cirúrgico com aqueles inoperáveis ao diagnóstico, identificar os fatores que levaram ao diagnóstico tardio e propor um novo protocolo de diagnóstico rastreamento. Métodos: estudo observacional retrospectivo, através de coleta de dados de prontuários de pacientes com diagnóstico de carcinoma broncogênico atendidos entre 2005 e 2018. Foram coletados dados clínicos, de exames laboratoriais, exames de imagem e terapêutica instituída. A amostra foi submetida análise descritiva de frequências. Em seguida foi dividida em dois grupos: operado e não operado, que foram comparados utilizando teste do qui quadrado e teste t, considerando significativo p < 0,05. As variáveis foram comparadas com a sobrevida utilizando os testes citados e o método de Kaplan-Meier para obtenção das curvas de sobrevida. Resultados: foram avaliados 230 pacientes com diagnóstico tomográfico ou anátomo-patológico de carcinoma broncogênico, tendo mais de 50% da amostra estadio avançado. Apenas 42 pacientes apresentavam doença operável ao diagnóstico. Nos dois grupos a massa pulmonar ao diagnóstico foi o achado de imagem mais frequente, visível na radiografia simples. No grupo inoperável, houve maior prevalência de sintomas e alterações laboratoriais associadas. A sobrevida foi impactada de forma negativa por alterações laboratoriais, tamanho do tumor e pior pontuação nos scores de performance. Conclusão: é possível utilizar a combinação de características clínicas, laboratoriais e de radiografia simples de tórax para estabelecer um protocolo adequado de rastreamento do câncer de pulmão.
Objective: to compare patients diagnosed with bronchogenic carcinoma who underwent surgical resection and those with inoperable disease at diagnosis, to identify factors leading to late diagnosis and to suggest a new diagnosis and screening protocol. Method: retrospective observational study, through data available in medical records from patients diagnosed with bronchogenic carcinoma between 2005 and 2018. We collected data regarding clinical features, laboratory exams, imaging exams and treatment. Data was analyzed using descriptive statistics and frequency distributions. Patients were also divided into two groups: operable and inoperable, and comparisons between these groups were made using Chi-square test and Student’s t test. We considered the differences significant when p < 0,05. All variables were compared to survival using the same tests and through the Kaplan-Meier Method. Results: we evaluated 230 patients who had tomographic or pathological diagnosis of bronchogenic carcinoma. More than 50% of the patients were in advanced stages of the disease, and only 42 patients had operable disease when diagnosed. In both groups, pulmonary mass was the most frequent alteration at diagnosis, and all were visible in chest radiograph. Among the patients in the inoperable group, symptoms and altered laboratory exams were more frequent. Presence of laboratory alterations, dyspnea, tumor size and worse punctuation in performance scores resulted in lower survival rates. Conclusion: it is possible to utilize the combination of clinical findings, laboratorial analysis and chest radiograph to establish an adequate screening protocol for patients with bronchogenic carcinoma.
Objective: to compare patients diagnosed with bronchogenic carcinoma who underwent surgical resection and those with inoperable disease at diagnosis, to identify factors leading to late diagnosis and to suggest a new diagnosis and screening protocol. Method: retrospective observational study, through data available in medical records from patients diagnosed with bronchogenic carcinoma between 2005 and 2018. We collected data regarding clinical features, laboratory exams, imaging exams and treatment. Data was analyzed using descriptive statistics and frequency distributions. Patients were also divided into two groups: operable and inoperable, and comparisons between these groups were made using Chi-square test and Student’s t test. We considered the differences significant when p < 0,05. All variables were compared to survival using the same tests and through the Kaplan-Meier Method. Results: we evaluated 230 patients who had tomographic or pathological diagnosis of bronchogenic carcinoma. More than 50% of the patients were in advanced stages of the disease, and only 42 patients had operable disease when diagnosed. In both groups, pulmonary mass was the most frequent alteration at diagnosis, and all were visible in chest radiograph. Among the patients in the inoperable group, symptoms and altered laboratory exams were more frequent. Presence of laboratory alterations, dyspnea, tumor size and worse punctuation in performance scores resulted in lower survival rates. Conclusion: it is possible to utilize the combination of clinical findings, laboratorial analysis and chest radiograph to establish an adequate screening protocol for patients with bronchogenic carcinoma.
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Palavras-chave
Pulmões Câncer, Pulmões Radiografia, carcinoma broncogênico, Cancer no pulmão, Programas de rastreamento, Lungs Radiography, Lungs Cancer