ABSTRACT
OBJECTIVE: We aimed to estimate the overall survival (OS) and conditional survival (CS) in patients diagnosed with oral and oropharyngeal squamous cell carcinoma (SCC) and to determine their survival trends. METHODS: The study included all consecutive patients treated at the A.C. Camargo Cancer Center for oral or oropharyngeal SCC between 2001 and 2012. Data were obtained from the Hospital Cancer Registry. OS and CS were analyzed using the Kaplan-Meier method to evaluate the probability of survival with Cox predictor models. RESULTS: Data of 505 oral and 380 oropharyngeal SCC patients obtained in 2001-2006 and 2007-2012 were analyzed. Most of the oral SCC (59%) and oropharyngeal SCC (90%) patients had stages III-IV SCC. The 5-year OS for patients with oral SCC was 51.7%, with no significant difference between the first and second periods. The CS rates in 2007-2012 were 65% after the first year and 86% up to the fifth year. For oropharyngeal SCC, the 5-year OS rate was 45.0% in the first period. The survival rate increased to 49.1% from 2007 to 2012, with a reduction in the risk of death (HR=0.69;0.52-09.2). The CS estimates from 2007 to 2012 were 59% after the first year and 75% up to the fifth year. CONCLUSION: Survival across the two time periods remained stable for oral SCC but showed a significant increase for oropharyngeal SCC, possibly because of improvements in the patients' response to radiotherapy, such as intensity-modulated radiation therapy, and the use of more accurate diagnostic imaging approaches.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Mouth Neoplasms/mortality , Carcinoma, Squamous Cell/mortality , Oropharyngeal Neoplasms/mortality , Prognosis , Brazil/epidemiology , Mouth Neoplasms/pathology , Carcinoma, Squamous Cell/pathology , Oropharyngeal Neoplasms/pathology , Proportional Hazards Models , Survival Analysis , Retrospective Studies , Kaplan-Meier Estimate , Neoplasm StagingABSTRACT
Estudou-se o impacto das neoplasias malignas de esôfago sobre o estado nutricional e imunológico dos pacientes e correlacionaram-se os resultados obtidos com o tratamento recebido e a evoluçäo desses pacientes. Foram estudados 38 pacientes portadores de carcinoma espinocelular de esôfago, no Depto. de Cirurgia Torácica do Hospital A. C. Camargo, no período de l983-1984. Medidas antropométricas, laboratoriais e imunológicas foram realizadas. Verificou-se que há uma interaçäo entre a desnutriçäo e a imunoincompetência provocada ou agravada por ela e que se justifica a necessidade de suporte nutricional e imunológico como parte do tratamento multidisciplinar destes tumores
Subject(s)
Humans , Male , Adult , Middle Aged , Nutritional Status , Immunity, Cellular , Esophageal Neoplasms/immunology , Antibody FormationABSTRACT
Publicaçöes recentes enfatizam a freqüência com que o hiperparatiroidismo primário se apresenta simulando patologias ósseas, renais, gastrintestinais e neuromusculares, assim como a dificuldade em se fazer o diagnóstico quando näo se suspeita de alteraçöes endócrinas. Estudam-se 6 casos de hiperparatiroidismo primário cuja etiologia foi adenoma de paratiróide. Pretende-se a importância das manifestaçöes ósseas na suspeita da moléstia e descartar as outras condiçöes que envolvam procedimentos mais agressivos que uma cervicotomia. Ilustram-se a fisiopatologia e os diagnósticos diferenciais das diferentes entidades ósseas implicadas; revisam-se os meios diagnósticos e discutem-se as terapêuticas, dando ênfase às condutas cirúrgicas nos casos de adenoma e hiperplasia da paratiróide