RESUMO
Breast cancer is the most prevalent malignant neoplasm and the leading cause cancer of death among women globally. In Brazil, survival rates vary according to the region and few studies have been conducted on breast cancer survival in less developed areas, such as the Amazon region. The aim of this study was to analyze the five-year survival rate and prognostic factors in women treated for breast cancer in the city of Belém in northern Brazil. A retrospective hospital-based cohort study was conducted (2007-2013). Sociodemographic, clinical/tumor, and treatment variables were obtained from the records at the Ophir Loyola Hospital. Survival analysis involved the Kaplan-Meier statistical method and Cox regression analysis was performed. The significance level was 5% (p <0.05). A total of 1,430 cases were analyzed. Mean survival time was 51.71 (± 17.22) months, with an estimated overall survival of 79.4%. In the multivariate analysis, referral from the public health care system, advanced clinical stage, lymph node involvement and metastasis were associated with worse prognosis and lower survival rate. Radiotherapy and hormone therapy were associated with increased survival. These findings can contribute to the development of regional strategies for early detection of breast cancer, reducing the incidence and mortality rates and increasing survival time.
Assuntos
Neoplasias da Mama , Feminino , Humanos , Taxa de Sobrevida , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Neoplasias da Mama/patologia , Brasil/epidemiologia , Prognóstico , Estudos de Coortes , Estudos Retrospectivos , HospitaisRESUMO
RESUMO O objetivo deste artigo é avaliar o índice de função sexual de mulheres submetidas à histerectomia total com ooforectomia bilateral (HT-OB), a prevalência de incontinência urinária por esforço (IUE) e sua associação com a realização desse procedimento cirúrgico em um hospital de referência em Belém (PA). Foram incluídas 162 mulheres, com vida sexual ativa, alocadas em dois grupos: aquelas que realizaram HT-OB em período superior a 12 meses (n=68), e aquelas que não realizaram (n=94). Utilizou-se o questionário female sexual function index (FSFI) para avaliação da função sexual, e um questionário desenvolvido pelos pesquisadores para coletar dados sociais, econômicos e clínicos, incluindo informações quanto à presença de IUE. O valor de significância foi definido como p<0,05. Houve diferença significativa no índice de função sexual entre o grupo HT-OB e o grupo-controle, com escore geral do FSFI de 23,56 e 28,68, respectivamente (p=0,0001). Os domínios desejo, excitação, lubrificação (p<0,0001), orgasmo (p=0,04), satisfação (p=0,0006) e dor (p=0,015) apresentaram escores inferiores em mulheres histerectomizadas. A prevalência de sintomas de IUE no grupo HT-OB foi de 35,3%, sendo observada associação significativa entre a presença desses sintomas e a realização da histerectomia (p=0,02). Mulheres que realizam HT-OB têm maior risco de disfunção sexual, e este procedimento cirúrgico é associado ao desenvolvimento de IUE.
RESUMEN El presente artículo tuvo el objetivo de evaluar el índice de función sexual de mujeres sometidas a histerectomía total con ooforectomía bilateral (HT-OB), la prevalencia de incontinencia urinaria de esfuerzo (IUE) y su asociación con la realización de este procedimiento quirúrgico en un hospital de referencia en Belém (Brasil). Se incluyeron a 162 mujeres con vida sexual activa, que fueron divididas en dos grupos: las que se sometieron a HT-OB durante el período superior a 12 meses (n=68) y las que no lo había hecho (n=94). Se les aplicaron el cuestionario female sexual function index (FSFI), para evaluar la función sexual, y un cuestionario desarrollado por investigadores para recopilar datos sociales, económicos y clínicos, con informaciones en cuanto a la presencia de IUE. El valor de significación fue de p<0,05. Hubo una diferencia significativa en el índice de función sexual entre el grupo HT-OB y el grupo control, con un puntaje general de FSFI de 23,56 y 28,68, respectivamente (p=0,0001). Los dominios deseo, excitación, lubricación (p<0,0001), orgasmo (p=0,04), satisfacción (p=0,0006) y dolor (p=0,015) tuvieron puntajes más bajos en mujeres histerectomizadas. La prevalencia de síntomas de IUE fue del 35,3% en el grupo HT-OB, además se observó una asociación significativa entre la presencia de estos síntomas y la realización de la histerectomía (p=0,02). Las mujeres que se someten a HT-OB tienen un mayor riesgo de disfunción sexual, y este procedimiento quirúrgico está asociado al desarrollo de IUE.
ABSTRACT The objective of this article was to evaluate the sexual function index of women submitted to total hysterectomy with bilateral oophorectomy (THBO), the prevalence of urinary incontinence (SUI) and its association with the performance of this surgical procedure in a reference hospital in Belém, Pará. One hundred sixty-two women with active sexual life were included in two groups: those who have undergone THBO for more than 12 months (n=68), and those who have not (n=94). The Female Sexual Function Index (FSFI) questionnaire was used to evaluate sexual function along with a questionnaire developed by the researchers to collect social, economic and clinical data, including information on the presence of SUI. The significance level was defined as p<0.05. There was a significant difference in the sexual function index between THBO group and the control group, with an FSFI overall score of 23.56 and 28.68, respectively (p=0.0001). Desire, arousal, lubrication (p<0.0001), orgasm (p=0.04), satisfaction (p=0.0006) and pain (p=0.015) domains had lower scores in hysterectomized women. The prevalence of SUI symptoms in THBO group was 35.3%, and a significant association was observed between the presence of SUI and hysterectomy (p=0.02). Women who undergo THBO have a higher risk of sexual dysfunction, and this surgical procedure is associated with the development of SUI.
