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Medicine (Baltimore) ; 97(47): e13228, 2018 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-30461623

RESUMO

Lymphomas are common malignancies with highly variable clinical presentations and prognosis. Prognostic value of clinical presentation at onset is still questioned. The objective of this study was to compare the disease presentation and the outcome of lymphomas diagnosed in an Internal Medicine Department of a University Hospital to disease presentation and outcome of patients who were referred to the Hematology Department of the same institution by other departments or healthcare facilities.This retrospective monocentric observational study included 37 patients. They were matched to 73 patients, who were referred to the Hematology Department, according to age, histology, and Ann Arbor stage. The demographics, clinical and biological presentations, overall survival, and progression-free survival were compared.Patients diagnosed with lymphoma in the Internal Medicine Department were more likely to be febrile (67.5% vs 21.9%; P < .001) and have higher inflammatory markers (mean C-reactive protein 86.6 vs 56.3 mg/L; P = .02). The median overall survival of these patients was poorer (P < .001), even in the subset of patients treated with standard treatment, and remained shorter in multivariable analysis (P = .002). The specific treatment started earlier (20.2 vs 37.5 days; P = .006), but was more frequently palliative (37.8% vs 19.2%; P = .04). There was no significant difference in median progression-free survival.Lymphomas diagnosed in an Internal Medicine Department had aggressive clinical presentations and a poorer outcome, despite an early start of conventional treatment.


Assuntos
Glucocorticoides/uso terapêutico , Hematologia/métodos , Departamentos Hospitalares , Medicina Interna/métodos , Linfoma , Feminino , França/epidemiologia , Testes Hematológicos/métodos , Departamentos Hospitalares/métodos , Departamentos Hospitalares/estatística & dados numéricos , Hospitalização/estatística & dados numéricos , Humanos , Linfoma/classificação , Linfoma/diagnóstico , Linfoma/epidemiologia , Linfoma/terapia , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Avaliação de Processos e Resultados em Cuidados de Saúde , Exame Físico/métodos , Exame Físico/estatística & dados numéricos , Prognóstico , Intervalo Livre de Progressão , Avaliação de Sintomas/métodos , Avaliação de Sintomas/estatística & dados numéricos , Tempo para o Tratamento/estatística & dados numéricos
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