ABSTRACT
Abstract Introduction: Bilirubin levels have been associated with risk of several malignancies. The association between pretreatment serum bilirubin levels and overall survival of patients with parotid gland carcinoma is unclear. Objectives: In this study, we assessed the effect of serum bilirubin levels to overall survival in malignant parotid tumors. Methods: This study included a total of 35 patients, 15 female and 20 male. The mean age of these patients was 60.7 ± 14.5 years. All patients who were diagnosed with parotid gland carcinoma and underwent total parotidectomy between 2008 and 2018, were retrospectively assessed. The relationship between the overall survival of patients and total bilirubin, direct bilirubin, and indirect bilirubin levels was estimated. The receiver operating characteristic (ROC) curve analysis was performed to determine the optimal cut-off points. Results: Patients with low direct bilirubin, total bilirubin and indirect bilirubin had significantly longer overall survival than those with high levels. Cut-off values for total bilirubin, direct bilirubin and indirect bilirubin were detected as 0.545 mg/dL, 0.175 mg/dL and 0.435 mg/dL, respectively. Conclusion: In our study, we observed that increased preoperative bilirubin levels are associated with reduced survival time in the postoperative period of patients with parotid gland carcinoma.
Resumo Introdução: Os níveis de bilirrubina têm sido associados ao risco de várias lesões malignas. A associação entre os níveis séricos de bilirrubina pré-tratamento e a sobrevida global dos pacientes com carcinoma da glândula parótida ainda não é clara. Objetivos: Neste estudo, avaliamos o efeito dos níveis séricos de bilirrubina na sobrevida global em tumores malignos de parótida. Método: Este estudo avaliou 35 pacientes, 15 do sexo feminino e 20 do masculino. A média de idade foi de 60,7 ± 14,5 anos. Pacientes diagnosticados com carcinoma da glândula parótida e submetidos a parotidectomia total entre 2008 e 2018 foram avaliados retrospectivamente. A relação entre a sobrevida global dos pacientes e os níveis de bilirrubina total, bilirrubina direta e bilirrubina indireta foi estimada. A análise da curva Receiver Operating Characteristic foi realizada para determinar os pontos de corte ideais. Resultados: Pacientes com níveis mais baixos de bilirrubina direta, bilirrubina indireta e bilirrubina total tiveram sobrevida global significantemente maior do que aqueles com valores mais altos. Valores de corte para bilirrubina total, bilirrubina direta e bilirrubina indireta foram estabelecidos como 0,545 mg/dL, 0,175 mg/dL e 0,435 mg/dL, respectivamente. Conclusão: Em nosso estudo, verificamos que níveis de bilirrubina aumentados no pré-operatório estão associados à redução do tempo de sobrevida no período pós-operatório em pacientes com carcinoma da glândula parótida.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Bilirubin/blood , Parotid Neoplasms/mortality , Parotid Neoplasms/blood , Biomarkers, Tumor/blood , Survival Analysis , Retrospective Studies , Risk Factors , ROC Curve , Sensitivity and SpecificityABSTRACT
Abstract Introduction: Parotid carcinomas have varying histological types and diverse biologic behaviors. Establishing an adequate treatment plan and predicting recurrence is important. Objective: To analyze the risk factors associated with recurrence in our 5 year experience with 30 cases of primary parotid carcinoma undergoing surgery at a single institute. Methods: From January 2009 to December 2013, 30 patients with surgical treatment of parotid carcinoma were identified based on their medical records. Results: The 30 patients were comprised of 17 males and 13 females. Among 11 patients with T4 tumors, seven patients had recurrence. Among seven patients with cervical nodal metastasis, all patient except one had recurrence. Clinically late stages (stage III and IV) showed more common recurrence than early stage (stage I and II) lesions. Lymphovascular invasion was seen in 5 patients, and all patients had recurrence. Among 11 patients with extracapsular spread, 7 patients had recurrence. In 17 patients with high grade carcinomas, ten patients had recurrence. In 13 patients with low grade carcinomas, no patients experienced recurrence. Conclusion: T- and N-stage, clinical stage, lymphovascular invasion, extracapsular spread, and histopathologic grade correlate significantly with recurrence in parotid carcinoma.
Resumo: Introdução: Os carcinomas da parótida têm diferentes tipos histológicos e comportamentos biológicos diversos. O estabelecimento de um plano de tratamento adequado e a previsão de recorrência são muito importantes. Objetivo: Analisar os fatores de risco associados à recorrência em nossa experiência de cinco anos com 30 casos de carcinoma parotídeo primário submetidos a cirurgia em uma única instituição. Método: De janeiro de 2009 a dezembro de 2013, 30 pacientes com tratamento cirúrgico de carcinoma parotídeo foram identificados com base nos prontuários. Resultados: Entre os 30 pacientes, 17 eram homens e 13, mulheres. Dos 11 pacientes com tumores T4, sete apresentaram recorrência. Entre sete pacientes com metástase em linfonodo cervical, todos, exceto um, apresentaram recorrência. Lesões em estágios clínicos tardios (III e IV) apresentaram recorrência mais comumente do que as dos estágios iniciais (I e II). A invasão linfovascular foi observada em cinco pacientes e todos os cinco apresentaram recorrência. Entre 11 pacientes com disseminação extracapsular, sete apresentaram recorrência. Dos 17 pacientes com carcinomas de alto grau, dez apresentaram recorrência. Em 13 pacientes com carcinomas de baixo grau, nenhum apresentou recorrência. Conclusão: Estágios T e N, estágio clínico, invasão linfovascular, disseminação extracapsular e grau histopatológico correlacionam-se de maneira significante com recorrência do carcinoma de parótida.
Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Parotid Neoplasms/mortality , Parotid Neoplasms/pathology , Neoplasm Recurrence, Local/mortality , Neoplasm Recurrence, Local/pathology , Postoperative Complications , Recurrence , Parotid Neoplasms/surgery , Survival Rate , Retrospective Studies , Risk Factors , Follow-Up Studies , Facial Paralysis/complications , Neoplasm Grading , Margins of Excision , Neoplasm Invasiveness/physiopathology , Neoplasm Recurrence, Local/surgery , Neoplasm StagingABSTRACT
Introducción: el linfoma no Hodgkin (LNH) es la segunda neoplasia más frecuente en pacientes con SIDA. Una de las principales características de los LNH asociados con el SIDA es la alta frecuencia de compromiso extranodal, incluyendo el tracto astrointestinal, como manifestación inicial de la neoplasia. Métodos: se analizaron de manera retrospectiva las características epidemiológicas, clínicas, virológicas, inmunológicas e histopatológicas de 8 pacientes con diagnóstico de linfomas del tracto gastrointestinal y glándulas anexas (hígado y parótida) asistidos en la División de VIH- /SIDA del Hospital de Enfermedades Infecciosas F J Muñiz de Buenos Aires, Argentina, entre enero de 1997 y diciembre de 2004. Todos los pacientes fueron evaluados por tomografía computarizada y examen de la médula ósea, además de los exámenes endoscópicosde diagnóstico. Resultados: todos los pacientes fueron varones; 4 eran heterosexuales, 2 homosexuales, uno hemofílico y uno adicto a drogas endovenosas. Tres pacientes presentaron coinfección por el virus de la hepatitis C. La mediana de edad fue de 42 años y la mediana de linfocitos T CD4 + fue de 87 células/uL al momento del diagnóstico de la neoplasia. Ningún paciente recibía TARGA al momento del diagnóstico del linfoma. La incidencia global de linfomas (primarios del sistema nervioso central, no Hodgkin sistémicos y de Hodgkin) durante el período de estudio fue de 2,9% (54 casos); 17 pacientes (32%) tuvieron diagnóstico de LNH sistémicos; 10 (58,8%) de ellos tuvieron presentación extranodal al momento del inicio de las mani manifestaciones clínicas y 8 (80%) comprometieron el tubo digestivo y las glándulas anexas (parótida, cavum, esófago, estómago, duodeno, colon derecho en 2 casos e hígado en el restante), como LNH primarios, de alto grado y de fenotipo "B". Todos los pacientes presentaronsíntomas "B" al momento del diagnóstico. De acuerdo con los criterios de estadificación de Lugano, 4 se encontraban en el estadio...
Background: Non-Hodgkin's lymphoma (NHL) is the second most common neoplasm among patients with AIDS. One of the major clinical characteristics of AIDS-associated NHL is the high frequency of extranodal involvement, including the gastrointestinaltract, at initial presentation. Methods: From January 1997 to December 2004, 8 cases of NHL of the digestive tract and anexal glands (liver and parotid gland) were observed at the HIV/AIDS division of the Infectious Diseases F J Muñiz Hospital from Buenos Aires,Argentina. All patients were staged by computed tomography scanning and bone marrow examination, in addition to the endoscopic evaluation. Results: All patients were males; 4 were heterosexual, 2 homosexual, and 1 were a hemophilic and an intravenous drug abuser. The median age was 42 years and the median CD4 T cell count was 87 cells/uL at the time of the diagnosis of neoplasm. No patient was receiving highly active antiretroviral therapy (HAART) at lymphoma diagnosis. The global incidence of AIDS-associated lymphomas (central nervous system lymphomas, non-Hodgkin lymphomas and Hodgkin lymphoma) during the time of study was 2,9% (54 cases); 17 patients(32%) had diagnosis of systemic NHL; 10 (58,8%) of them were extranodal at the onset of clinical symptoms and 8 (80%) involvement the digestive tract and anexal glands (parotid gland, cavum, esophagus, stomach, duodenum, the right colon in 2 patients and the liver), as primary NHL of high grade and "B" phenotype. All patients presented "B" symptoms at the time of diagnosis. Primary duodenal lymphoma was the only Burkittlymphoma of this serie and we detected the Epstein-Barr virus genome in the biopsy smears of this tumor and in the hepatic lymphoma. Four patients were treated with systemic chemotherapy with granulocytic growth factor support plus highly active antiretroviral therapy (HAART); 2 of them (cavum and one of the colon) had a prolonged survival with immune reconstitution during 5 and 6...
Subject(s)
Humans , Male , Female , Adult , Gastrointestinal Neoplasms/diagnosis , Liver Neoplasms/diagnosis , Lymphoma, AIDS-Related/diagnosis , Lymphoma, Non-Hodgkin/diagnosis , Parotid Neoplasms/diagnosis , Gastrointestinal Neoplasms/drug therapy , Gastrointestinal Neoplasms/mortality , Liver Neoplasms/drug therapy , Liver Neoplasms/mortality , Lymphoma, AIDS-Related/drug therapy , Lymphoma, AIDS-Related/mortality , Lymphoma, Non-Hodgkin/drug therapy , Lymphoma, Non-Hodgkin/mortality , Neoplasm Staging , Parotid Neoplasms/drug therapy , Parotid Neoplasms/mortality , Prognosis , Retrospective Studies , Survival AnalysisABSTRACT
El carcinoma ductal salival de los conductos excretores, es un tumor raro, biológicamente agresivo y que ocurre principalmente en hombre. La mayoría localizado a la parótida (88 por ciento), alrededor del 30 por ciento de los pacientes cursan con reccurencias. el 60 por ciento con metástasis ganglionares linfáticas al momento del diagnóstico, cerca al 46 por ciento desarrollan metástasis sistémics en el curso de la enfermedad y el 65 por ciento mueren a consecuencia del carcinoma, dentro de los cuatro años de establecido el diagnóstico
Subject(s)
Aged , Humans , Male , Carcinoma, Ductal, Breast/pathology , Immunohistochemistry , Neoplasm Metastasis/pathology , Parotid Neoplasms/mortality , Parotid Neoplasms/pathologyABSTRACT
Se presentan 30 casos de cánceres de la parótida, representando el 80 por ciento de todos los carcinomas de las glándulas salivales. Estos 30 casos han sido vistos y tratados en el Servicio de Cirugía de Cabeza y Cuello del Hospital Nacional Guillermo Almenara Irigoyen, correspondiente a un periodo de 25 años (1960-1985). Todos los casos fueron debidamente tipificados por la variedad histológica y clasificados de acuerdo a T-N-M. La mayoría fueron tumores T2 y T3, y la variedad más frecuente fue el carcinoma muco-epidermoide. La totalidad fue tratada mediante la cirugía la Parotidectomía total con o sin disección radical del cuello y la gran mayoría recibió tratamiento complementario con cobaltoterapia. Se realizó en la tercera parte de los casos la cirugía reconstructiva facial por la consecuente parálisis facial irrecuperable. La sobrevida fue del 56.6 por ciento entre 5, 10 y más años.