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1.
Salud ment ; 38(4): 253-258, jul.-ago. 2015. ilus
Artigo em Espanhol | LILACS-Express | LILACS | ID: lil-766938

RESUMO

ANTECEDENTES: La sintomatología ansiosa y depresiva es parte de los principales problemas de salud mental en pacientes oncológicos, lo cual afecta la calidad de vida y la adhesión al tratamiento, además de que se asocia con mayor número de síntomas y estancia hospitalaria. Mediante instrumentos de tamizaje válidos y confiables, como la Escala hospitalaria de ansiedad y depresión (HADS), ha sido posible detectar posibles casos en pacientes hospitalarios. Sin embargo, hasta ahora no se habían caracterizado las propiedades psicométricas en pacientes oncológicos en población mexicana.OBJETIVO: Determinar las propiedades psicométricas de la HADS en una muestra de pacientes oncológicos.MÉTODO: Participaron 400 pacientes del Instituto Nacional de Cancerología, de los cuales 226 eran mujeres (56.5%) y 174 eran hombres (43.6%); la edad promedio fue de 47.4 ± 14.1 años. Los participantes contestaron, además de la HADS, los siguientes inventarios: depresión de Beck, ansiedad de Beck, termómetro de distrés.RESULTADOS: Un análisis factorial ajustado a dos factores presentó un instrumento con 12 reactivos, similar a la versión original. La consistencia interna de la escala global mostró un índice satisfactorio (a=0.86). Los alfas de Cronbach de cada subescala tuvieron un valor de .79 y .80 que explicaron el 48.04% de la varianza. La validez, por medio de correlación con las medidas concurrentes, mostró resultados significativos (r de Pearson de .51 a .71, p<0.05).DISCUSIÓN Y CONCLUSIÓN: La HADS en pacientes con cáncer en población mexicana presentó adecuadas características psicométricas. La relevancia de los resultados obtenidos radica en que se trata de una población que puede llegar a requerir atención oportuna en salud mental en etapas tempranas de su tratamiento. La detección de sintomatología ansiosa y depresiva por medio de la HADS deriva en beneficios para la población oncológica y en estrategias funcionales de atención adecuada y costo-efectivas.


BACKGROUND: Symptoms of anxiety and depression are among the major mental health problems in cancer patients. These symptoms affect the quality of life and treatment adherence, and are associated with other symptoms and longer hospital stays. Valid and reliable screening instruments such as the Hospital Anxiety and Depression Scale (HADS), have made possible the detection of possible cases of depression and anxiety in medically ill patients. However, the psychometric properties of this instrument have not been documented in different types of cancer diagnoses in the Mexican population.OBJECTIVE: To determine the psychometric properties of the HADS in a sample of patients with cancer from the Mexican population.METHOD: Four hundred patients from the National Cancer Institute participated, of which 226 were women (56.5%) and 174 men (43.6%), with a mean age of 47.4 ±14.1 years. Participants completed concurrently the HADS as well as the following inventories: 1. Beck Depression, 2. Beck Anxiety and 3. Distress Thermometer.RESULTS: A factor analysis adjusted to two factors explained 48.04% of the variance, with 12 items loading on these two factors in a way similar to the original version. The internal consistency of the overall scale was satisfactory (α=0.86). Cronbach's alphas for each subscale were .79 and .80. The concurrent validity assessed by way of correlations with concurrent measures showed significant associations (Pearson r=51-71, p<0.05).DISCUSSION AND CONCLUSION: The HADS has adequate construct validity, internal consistency and concurrent validity for its use in cancer patients from the Mexican population. The relevance of these results is a cost effective tool to provide timely mental health care early in oncological treatment for those in need. Detecting anxiety and depression symptoms through the HADS may benefit cancer patients by ensuring appropriate care that may increase their quality of life and treatment adherence, and reduce their hospital stays.

2.
Psicooncología (Pozuelo de Alarcón) ; 12(1): 51-58, jun. 2015. tab
Artigo em Espanhol | IBECS | ID: ibc-138194

RESUMO

La sintomatología ansiosa es uno de los principales problemas psicológicos en pacientes oncológicos. La Escala de Ansiedad de Beck (BAI) ha demostrado ser un instrumento válido y confiable. Sin embargo, hasta ahora no se había documentado su comportamiento psicométrico en población oncológica en México. Objetivo: Determinar las propiedades psicométricas de la Escala de Ansiedad de Beck (BAI) en una muestra de pacientes con cáncer. Material y Método: participaron 250 pacientes del Instituto Nacional de Cancerología, de los cuales 138 eran mujeres (55,2%) y 112 eran hombres (44,8%); la edad promedio fue de 46,6 ± 14,3 años. Los participantes contestaron además del BAI, la Subescala de ansiedad de la Escala de Ansiedad y Depresión (HADS-A). Resultados: El análisis factorial varimax con 21 reactivos presentó una estructura con 4 factores: Subjetivo, Neurofisiológico, Autonómico y Síntomas vasomotores que explicaron el 46,38% de la varianza. La consistencia interna de la escala global mostró un índice satisfactorio (α=0,82). La validez por medio de correlación con el HADS-A mostraron resultados significativos (r de Pearson de 0,58, p <0,05) y el ECOG (r de Pearson de -0,36 p <0,05). Conclusiones: el BAI en pacientes con cáncer en población mexicana presentó adecuadas características psicométricas. La detección de sintomatología ansiosa a través del BAI deriva en beneficios para la población oncológica y en estrategias funcionales de atención adecuada y costo-efectivas


Introduction: Depressive symptomatology is a major mental health problem in cancer patients. The Beck Anxiety Scale (BAI) has proven to be a reliable and valid instrument. However, until now has not been documented it’s psychometric properties in Mexican population with cancer. Objetives: Determine the psychometric properties of the Beck Anxiety Scale BAI in a sample of cancer patients. Material and methods: Involved 250 patients from the National Cancer Institute, of which 112 were women (55.2%) were male and 138 (44.82%); the average age was 46.6 ± 14.3 years. Participants answered the BAI, and also the Anxiety Sub-scale of HADS. Results: A varimax factor analysis with 21 items show a structure of 4 factors: Subjective, Neurophysiological, Autonomic and vasomotor symptoms that explain 46.38% of the variance. The internal consistency of the overall scale was satisfactory (α=0.82). The validity through correlations with the HADS-A showed significant associations (Pearson r=0.58, p <0.05) and ECOG (Pearson -0.36, p <0.05). Conclusions: The BAI in Mexican population with cancer showed adequate psychometric characteristics. Detection of anxiety symptoms through BAI provides benefits to the cancer population and facilitates the development of adequate and cost-effective care strategies


Assuntos
Adolescente , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Psicometria/instrumentação , Ansiedade/diagnóstico , Neoplasias/psicologia , Qualidade de Vida , Perfil de Impacto da Doença
3.
Psicooncología (Pozuelo de Alarcón) ; 12(1): 87-104, jun. 2015. tab, ilus
Artigo em Espanhol | IBECS | ID: ibc-138197

RESUMO

Introducción: Los cuidadores primarios representan un papel crucial en la atención de los pacientes con cáncer, lo que comúnmente representan tareas complejas de cuidado. Los cuidadores de los pacientes pueden experimentar diversas afectaciones físicas y psicológicas, así como un funcionamiento social deficiente. Objetivo: Proporcionar a los servicios de psicooncología un algoritmo con los elementos suficientes que faciliten el diagnóstico y tratamiento psicosocial de cuidadores primarios de pacientes con cáncer. Método: Se realizó una búsqueda de la literatura en PsycInfo, LatinIndex y Medline en el período de 2005-2014. Resultados: El presente algoritmo se divide en dos momentos clave: 1). Evaluación y 2). Tratamiento del cuidador primario. Los instrumentos más empleados para ansiedad y depresión son: CES-D, BDI, IDARE, HADS y POMS. Para carga el ECCZ y CRA; las intervenciones psico-educativa, capacitación y orientación terapéutica presentan efectos benéficos para esta población. Conclusiones: El algoritmo ofrece un proceso de toma de decisiones para el diagnóstico y tratamiento psicooncológico del cuidador primario informal


Introduction: The primary caregivers play a crucial role in the care of cancer patients, which commonly represent complex care tasks. Caregivers of patients may experience various physical and psychological effects, and poor social functioning. Objective: To provide at psychooncology services of an algorithm with sufficient elements for diagnosis and psychosocial treatment of primary caregivers of patients with cancer elements. Method: A literature search in PsycInfo, Medline LatinIndex in the period of 2005 to 2014. Results: This algorithm is divided into two key points: 1) Evaluation and 2) Treatment of primary caregiver. More used instruments are CES-D, BDI, IDARE, HADS and POMS. For Burden ECCZ and CRA; the psycho-educational interventions, training and therapeutic orientation have beneficial effects for this population. Conclusions: The algorithm provides a process of decision making for the diagnosis and psychooncologic treatment of the primary caregiver


Assuntos
Humanos , Cuidadores/psicologia , Neoplasias/psicologia , Ansiedade/epidemiologia , Depressão/epidemiologia , Carga de Trabalho/estatística & dados numéricos , Estresse Psicológico/epidemiologia
5.
Psicooncología (Pozuelo de Alarcón) ; 11(2/3): 233-241, dic. 2014. tab
Artigo em Espanhol | IBECS | ID: ibc-131106

RESUMO

Introducción: Durante las últimas décadas la detección temprana y tratamientos eficaces contra el cáncer han producido un aumento en el número de supervivientes de cáncer. Lo que representa un amplio grupo de pacientes susceptibles de presentar afectaciones psicológicas, físicas y sociales posteriores al tratamiento oncológico. Objetivo: Hacer una revisión de la literatura sobre los efectos de las terapias psicológicas en el manejo de aspectos psicológicos y/o síntomas de los supervivientes de cáncer. Método: Se realizó una revisión de la literatura reportada en MEDLINE, PsycINFO, CINAHL, MedicLatina y Psychology and Behavioral Sciences Collection en el periodo de Enero de 2009 a Diciembre de 2013. Resultados: Se identificaron 24 artículos. Solo 22 cumplieron con los criterios de selección, en 2 casos no se tuvo acceso a los artículos completos, por lo que solo se incluyeron 19. Se identificaron efectos estadísticamente significativos en afectaciones del sueño, bienestar emocional, fatiga, calidad de vida, y síntomas post menopáusicos; y tamaños del efecto entre 0,00-1,40. Conclusiones: Los efectos de la mayoría de las intervenciones psicológicas fueron positivos tanto en modalidad única como en combinación con otras modalidades de tratamiento así como las intervenciones telefónicas y modalidades terapéuticas en línea


Introduction: During the past decades early detection and effective cancer treatments have produced an increase in the number of cancer survivors. This represents a large group of patients susceptible to psychological, physical and social impairments after cancer treatment. Objective: To review the literature on the effects of psychological therapies in the management of psychological and / or somatic symptoms of cancer survivors. Method: A review of the literature reported in MEDLINE, PsycINFO, CINAHL, and MedicLatina Psychology and Behavioral Sciences Collection in the period January 2009 to December 2013 was conducted. Results: 24 articles were identified. Only 22 met the selection criteria; in 2 cases no access to the full articles was obtained, so only 19 were included. Statistically significant effects were identified in sleep difficulties, emotional symptoms, fatigue, quality of life, and post menopausal symptoms. Effect sizes were mostly small to moderate ranging from 0.00 - 1.40. Conclusions: The effects of most psychological interventions were positive whether independent or in combination with other treatment modalities. Interventions via telephone and online therapeutic modalities also showed positive results (AU)


Assuntos
Humanos , Sobrevivência/psicologia , Neoplasias/psicologia , Depressão/psicologia , Ansiedade/psicologia , Estresse Psicológico/psicologia , Medo/psicologia , Avaliação de Resultado de Intervenções Terapêuticas , Qualidade de Vida , Perfil de Impacto da Doença
6.
Psicooncología (Pozuelo de Alarcón) ; 10(2/3): 407-415, dic. 2013.
Artigo em Espanhol | IBECS | ID: ibc-117883

RESUMO

Objetivo: Desarrollar y validar una Lista de Chequeo de aspectos psico- oncológicos (LC-Psico-onco) en pacientes con cáncer en tratamiento médico. Método: Se entrevistó a 200 pacientes del Instituto Nacional de Cancerología de México (INCAN). La obtención de la muestra fue por disponibilidad en el periodo comprendido de Octubre de 2012 a Enero de 2013. Resultados: El análisis factorial oblicuo presentó un modelo de tres factores y 2 indicadores con 16 reactivos. La consistencia interna de la escala global mostró un índice satisfactorio (α=0,811). Las alfas de Cronbach de cada subescala tuvieron un valor de 0,753 y 0,507 que explican el 43,81% de la varianza. La validez por correlación con medidas concurrentes mostró resultados significativos (r de Pearson de 0,51 a 0,68, p<0,05). Conclusiones: La LC-Psico-onco presentó adecuadas características psicométricas. Al ser breve y fácil de aplicar tanto en la práctica clínica como en la investigación con población oncológica ofrece una guía en la planeación de evaluaciones exhaustivas y el diseño de un plan de tratamiento psicooncológico (AU)


Objective: Develop and validate a Checklist of psycho-oncologic issues (LC-Psycho-onco) for oncologic patients in treatment. Method: We included 200 patients at the National Cancer Institute (INCAN). The sample collection was for availability during the period of October 2012 to January 2013. Results: An oblique factor analysis presented a three-factor model with 16 indicators and two reagents. The internal consistency of the global scale showed a satisfactory index (α= 0.811). The Cronbach’s alphas for each subscale were worth 0.753 and 0.507 which explain 43.81% of the variance. The validity through the correlation with concurrent measures showed significant results (Pearson’s r = .51 to .68, p<0.05). Conclusions: The LC-Psycho-onco showed adequate psychometric properties. Being a brief and easy instrument it is useful for both clinical practice and investigation. It provides a guide for planning psychological interventions (AU)


Assuntos
Humanos , Depressão/epidemiologia , Ansiedade/epidemiologia , Neoplasias/psicologia , Psicometria/instrumentação , Lista de Checagem/métodos , Qualidade de Vida , Perfil de Impacto da Doença , Programas de Rastreamento/métodos
7.
Psicooncología (Pozuelo de Alarcón) ; 10(1): 69-78, jun. 2013.
Artigo em Espanhol | IBECS | ID: ibc-113527

RESUMO

Introducción: El cáncer de testículo (CT) constituye la neoplasia más común entre los 15 y 39 años. Debido a su incidencia cada vez mayor y a su alta tasa de supervivencia, la literatura se ha centrado en el impacto que puedan tener las secuelas del tratamiento a mediano y a largo plazo. El CT y su asociación con la ansiedad y la depresión constituyen problemas psicológicos frecuentes durante el tratamiento y periodo de seguimiento, en este contexto el afrontamiento ante la enfermedad puede representar un mecanismo de mejor adaptación psicológico. Objetivo: Identificar y comparar los niveles de ansiedad y depresión en pacientes en tratamiento y periodo de seguimiento; así como su relación con los diferentes estilos de afrontamiento positivo. Método: 49 pacientes en tratamiento y 84 en periodo de seguimiento del Instituto Nacional de Cancerología. Se empleo un diseño transversal, no experimental y ex-post-facto. Se utilizaron los Inventarios de Ansiedad de Beck –BAI–, el Inventario de Depresión de Beck –BDI–, y el Instrumento de afrontamiento al estrés de Lazarus y Folkman. Resultados: Se identificaron mayores niveles de ansiedad y depresión en el grupo de pacientes en tratamiento. Se identificó una relación inversamente proporcional entre los estilos de afrontamiento positivos y menores niveles de sintomatología ansiosa y depresiva en ambos grupos. Conclusiones: Se corrobora la asociación entre los estilos de afrontamiento positivos y niveles bajos de ansiedad y depresión. Se recomienda promover en el paciente con CT afrontamiento positivo durante el tratamiento y periodo de seguimiento (AU)


Background: Testicular cancer is the most common malignancy between 15 and 39 years old. Due to the increasing incidence and high survival rate of patients with testicular cancer (CT), literature has focused on the impact that may have the aftermath of medium and long term treatment. The CT and its association with anxiety and depression are common psychological problems, in this context, active coping with this disease may represent a psychological best adaptation mechanism. Objective: To identify and compare the levels of depression and anxiety in patients in treatment and follow-up period; as well as his relationship with positive coping styles. Participants and methods: 49 patients in treatment and follow-up period 84 in the National Cancer Institute follow-up period. It is a transversal, retrospective, not experimental and ex-post-facto. The inventories of Beck Depression –BDI– (1961), the Beck anxiety inventory –BAI– (1988) and the instrument of Lazarus and Folkman (1985) for coping with the stress. Results: Higher levels of anxiety and depression in patients in treatment. If you can identify an inversely proportional relationship between positive coping styles and lower levels of anxious and depressive symptoms in both groups. Conclusions: Is confirmed the association between positive coping styles and low levels of depression and anxiety. It is recommended to promote in patients with CT positive coping during treatment and follow-up period (AU)


Assuntos
Humanos , Masculino , Neoplasias Testiculares/psicologia , Ansiedade/epidemiologia , Depressão/epidemiologia , Resiliência Psicológica , Avaliação de Resultado de Intervenções Terapêuticas
8.
Rev Invest Clin ; 65 Suppl 1: S5-84, 2013 Mar.
Artigo em Espanhol | MEDLINE | ID: mdl-24459776

RESUMO

Mexican specialists in oncology, oncologic surgery, thoracic surgery, pneumology, pathology, molecular biology, anesthesiology, algology, psychology, nutrition, and rehabilitation (all of them experts in lung cancer treatment) in order to develop the National Consensus on Lung Cancer. The consensus has been developed as an answer to the need of updated Mexican guidelines for the optimal treatment of the disease, as well as to the requirements that such guidelines be established by multidisciplinary panel, depicting the current attention given to cancer lung cases in Mexico. Thus, this paper analyses the epidemiological review, screening, diagnosis, staging, pathology, translational medicine, and the suitable therapies for early, locally advanced, and metastatic disease in the first, second, and third lines of management, as well as rehabilitation and palliative measures.


Assuntos
Carcinoma Pulmonar de Células não Pequenas/diagnóstico , Carcinoma Pulmonar de Células não Pequenas/terapia , Neoplasias Pulmonares/diagnóstico , Neoplasias Pulmonares/terapia , Algoritmos , Carcinoma Pulmonar de Células não Pequenas/complicações , Carcinoma Pulmonar de Células não Pequenas/etiologia , Carcinoma Pulmonar de Células não Pequenas/secundário , Árvores de Decisões , Humanos , Neoplasias Pulmonares/complicações , Neoplasias Pulmonares/etiologia , México , Estadiamento de Neoplasias , Fumar/efeitos adversos
9.
Invest. educ. enferm ; 30(1): 9-17, mar. 15, 2012. tab
Artigo em Espanhol | LILACS, BDENF - Enfermagem | ID: lil-638905

RESUMO

Objetivo. Describir las habilidades del cuidador primario (CP) en términos de conocimiento, valor y paciencia del de mujeres mastectomizadas. Metodología. En 2010 se llevó a cabo un estudio descriptivo de tipo transversal en una muestra de 100 cuidadores primarios del Instituto Nacional de Cancerología de la Ciudad de México. Para la medición de la habilidad se utilizó el instrumento “Inventario de habilidad de cuidado”, que tiene tres subescalas: conocimiento, valor y paciencia. Se estimaron las correlaciones entre la sumatoria de los términos, comparándolas con las variables sociodemográficas. Resultados. El 41% de los CP fueron hombres, casados en un 77%; predominantemente fueron hijos (41%) o esposos (32%) del paciente. La edad mediana del CP, fue 43 años. En las habilidades del cuidador se encontró: alta puntuación para las dimensiones de conocimiento y paciencia, y baja para la de valor. Se identificó una correlación significativa entre las dimensiones de conocimiento y paciencia, mientras que la correlación de valor y paciencia fue menor. Conclusión. Las habilidades más importantes con que debe contar el CP son el conocimiento y la paciencia; el valor no mostró tal relevancia.


Objective. To describe the abilities in care, mastectomized women primary caregivers (PC) have, in terms of knowledge, value and patience. Methodology. Cross sectional descriptive study carried out in 2010 in the National Institute of cancerology in Mexico City. A sample of 100 primary caregivers was used. For the abilities measurement the instrument “caring abilities inventory”, which has 3 subscales, Knowledge, value and patience, was used. Correlations were estimated among the sum of the terms comparing them with the sociodemographic variables. Results.41% of the PC were men, 77% were married, 41% were the patient’s children and 32% their couple, most of them had a paid job. Caregivers mean age was 43 years. Regarding caregiver abilities a high score for the dimensions knowledge and patience, and a low score for value was found. The correlation between value and patience was low. Conclusion. The most important abilities caregivers must have are knowledge and patience. Value didn’t show such relevance.


Objetivo. Descrever as habilidades no cuidado em termos de conhecimento, valor e paciência do cuidador primário (CEP) de mulheres mastectomizadas. Metodologia. Em 2010 se levou a cabo um estudo descritivo de tipo transversal numa mostra de 100 cuidadores primários do Instituto Nacional de Cancerologia da Cidade do México. Para a medição da habilidade se utilizou o instrumento “Inventário de habilidade de cuidado”, que tem três sub-escalas: conhecimento, valor e paciência. Estimaram-se as correlações entre a sumatória dos termos, comparando-as com as variáveis sócio-demográficas. Resultados. O 41% dos CEP foram homens, casados num 77%; predominantemente foram filhos (41%) ou esposos (32%) do paciente, e a maioria tinham um trabalho remunerado. A média de idade do CEP foi de 43 anos. Nas habilidades do cuidador se encontrou: alta pontuação para as dimensões de conhecimento e paciência, e baixa para a de valor. Identificou-se uma correlação significativa entre as dimensões de conhecimento e paciência, enquanto a correlação de valor e paciência foi menor. Conclusão. As habilidades mais importantes com do que deve contar o CEP são o conhecimento e a paciência; o valor não mostrou tal relevância.


Assuntos
Humanos , Cuidadores , Mastectomia , Mulheres , Neoplasias da Mama
10.
Cir Cir ; 79(5): 439-46, 2011.
Artigo em Inglês, Espanhol | MEDLINE | ID: mdl-22385764

RESUMO

BACKGROUND: Psychosocial adaptation is a measurement that represents the patient's adjustment to those changes involved in their illness. We undertook this study to search for individual characteristics and clinical aspects associated with successful psychosocial adjustment in patients with colorectal cancer (CRC) undergoing (CT) chemotherapy or chemoradiotherapy (CRT). METHODS: Seventy-five patients with CRC treated with CT or CRT in a cancer center were included. Psychosocial Adjustment to Illness Scale Self-Reporting (PAIS-SR) questionnaire was used as a measurement of psychosocial adjustment. RESULTS: Psychosocial adaptation was successful in 18 patients (24%) and unsuccessful in 57 patients (76%). Young patients, married patients and males showed lower psychosocial adaptation to disease. This is associated with the decrease in sexual relations, economic resources and psychological symptoms. Patients complained that they were unsatisfied due to the lack of disease and treatment information offered by the heath care team. CONCLUSIONS: In the process of adaptation, clinical features such as tumor location and treatment scheme are considered basic, as well as age, education, marital status. Areas such as sexuality, interpersonal and family relationships, economic status and emotional state of patients affected by the disease and treatments provide a deep complexity in the study of the psychosocial adaptation process in patients with CRC.


Assuntos
Adaptação Psicológica , Adenocarcinoma/psicologia , Neoplasias Colorretais/psicologia , Atividades Cotidianas , Adenocarcinoma/tratamento farmacológico , Adenocarcinoma/economia , Adenocarcinoma/terapia , Adulto , Idoso , Idoso de 80 Anos ou mais , Quimiorradioterapia/psicologia , Quimioterapia Adjuvante/psicologia , Neoplasias Colorretais/tratamento farmacológico , Neoplasias Colorretais/economia , Neoplasias Colorretais/terapia , Efeitos Psicossociais da Doença , Estudos Transversais , Tratamento Farmacológico/psicologia , Feminino , Humanos , Masculino , México , Pessoa de Meia-Idade , Terapia Neoadjuvante/psicologia , Cuidados Paliativos/psicologia , Educação de Pacientes como Assunto , Satisfação do Paciente , Estudos de Amostragem , Comportamento Sexual , Apoio Social , Adulto Jovem
11.
Rev Invest Clin ; 63(6): 665-702, 2011.
Artigo em Espanhol | MEDLINE | ID: mdl-23650680

RESUMO

INTRODUCTION: Ovarian cancer (OC) is the third most common gynecologic malignancy worldwide. Most of cases it is of epithelial origin. At the present time there is not a standardized screening method, which makes difficult the early diagnosis. The 5-year survival is 90% for early stages, however most cases present at advanced stages, which have a 5-year survival of only 5-20%. GICOM collaborative group, under the auspice of different institutions, have made the following consensus in order to make recommendations for the diagnosis and management regarding to this neoplasia. MATERIAL AND METHODS: The following recommendations were made by independent professionals in the field of Gynecologic Oncology, questions and statements were based on a comprehensive and systematic review of literature. It took place in the context of a meeting of two days in which a debate was held. These statements are the conclusions reached by agreement of the participant members. RESULTS: No screening method is recommended at the time for the detection of early lesions of ovarian cancer in general population. Staging is surgical, according to FIGO. In regards to the pre-surgery evaluation of the patient, it is recommended to perform chest radiography and CT scan of abdomen and pelvis with IV contrast. According to the histopathology of the tumor, in order to consider it as borderline, the minimum percentage of proliferative component must be 10% of tumor's surface. The recommended standardized treatment includes primary surgery for diagnosis, staging and cytoreduction, followed by adjuvant chemotherapy Surgery must be performed by an Oncologist Gynecologist or an Oncologist Surgeon because inadequate surgery performed by another specialist has been reported in 75% of cases. In regards to surgery it is recommended to perform total omentectomy since subclinic metastasis have been documented in 10-30% of all cases, and systematic limphadenectomy, necessary to be able to obtain an adequate surgical staging. Fertility-sparing surgery will be performed in certain cases, the procedure should include a detailed inspection of the contralateral ovary and also negative for malignancy omentum and ovary biopsy. Until now, laparoscopy for diagnostic-staging surgery is not well known as a recommended method. The recommended chemotherapy is based on platin and taxanes for 6 cycles, except in Stage IA, IB and grade 1, which have a good prognosis. In advanced stages, primary cytoreduction is recommended as initial treatment. Minimal invasion surgery is not a recommended procedure for the treatment of advanced ovarian cancer. Radiotherapy can be used to palliate symptoms. Follow up of the patients every 2-4 months for 2 years, every 3-6 months for 3 years and anually after the 5th year is recommended. Evaluation of quality of life of the patient must be done periodically. CONCLUSIONS: In the present, there is not a standardized screening method. Diagnosis in early stages means a better survival. Standardized treatment includes primary surgery with the objective to perform an optimal cytoreduction followed by chemotherapy Treatment must be individualized according to each patient. Radiotherapy can be indicated to palliate symptoms.


Assuntos
Neoplasias Ovarianas , Assistência ao Convalescente , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Quimioterapia Adjuvante , Terapia Combinada , Resistencia a Medicamentos Antineoplásicos , Diagnóstico Precoce , Feminino , Genes Neoplásicos , Humanos , Laparoscopia , Excisão de Linfonodo , Terapia Neoadjuvante , Estadiamento de Neoplasias/normas , Síndromes Neoplásicas Hereditárias/genética , Omento/cirurgia , Compostos Organoplatínicos/administração & dosagem , Neoplasias Ovarianas/diagnóstico , Neoplasias Ovarianas/epidemiologia , Neoplasias Ovarianas/genética , Neoplasias Ovarianas/patologia , Neoplasias Ovarianas/terapia , Ovariectomia/métodos , Cuidados Paliativos , Qualidade de Vida , Radioterapia Adjuvante , Terapia de Salvação , Taxoides/administração & dosagem
12.
Ann Surg Oncol ; 16(1): 88-95, 2009 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-18979141

RESUMO

Health-related quality of life (HRQL) is a fundamental outcome in surgical oncology and culturally valid tools are essential for this purpose. Our aim was to validate the Mexican-Spanish versions of the European Organization for Research and Treatment of Cancer (EORTC) Quality-of-Life Questionnaire QLQ-C30 and the QLQ-STO22 disease-specific questionnaire module in Mexican patients with gastric cancer (GC). The translation procedure followed EORTC guidelines. Both instruments were completed by patients with GC and analyses were performed within three clinically distinct groups: (1) patients undergoing palliative treatment, (2) patients undergoing treatment with curative intent, and (3) GC survivors. Tests for reliability and validity were performed. One hundred and fifty patients (mean age 54.2 years) completed both questionnaires. Sixty-seven, 55, and 28 patients were allocated to groups 1, 2, and 3, respectively. Compliance rates were high, and questionnaires were well-accepted. Survivors of treatment for GC reported better functional HRQL scores and lower symptom scores than patients in group 2 who were currently undergoing treatment. Patients selected for potentially curative treatment had better HRQL than group 1 (palliative treatments). Scales in the QLQ-C30 and QLQ-STO22 distinguished between other clinically distinct groups of patients. Cronbach's alpha coefficients of 14 scales of both questionnaires were >0.7. Multitrait scaling analysis demonstrated good convergent and discriminant validity. Test-retest scores were consistent. We conclude that the Mexican-Spanish versions of EORTC QLQ-C30 and QLQ-C22 questionnaires are reliable and valid for HRQL measurement in patients with GC and are therefore recommended for use in clinical trials of Mexican community.


Assuntos
Adenocarcinoma/psicologia , Idioma , Qualidade de Vida , Perfil de Impacto da Doença , Neoplasias Gástricas/psicologia , Inquéritos e Questionários/normas , Adenocarcinoma/terapia , Feminino , Nível de Saúde , Humanos , Masculino , México , Pessoa de Meia-Idade , Psicometria , Neoplasias Gástricas/terapia , Sobreviventes , Traduções
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