Prevention of upper aerodigestive tract cancer through active search strategies and use of equipped propaedeutics / Prevenção ao câncer do trato aerodigestivo superior através das estratégias de buscaativa e uso da propedêutica armada

Abstract Introduction Upper aerodigestive tract cancer is among the most frequent malignancies and has epidemiological importance worldwide. Most cases are already advanced at the diagnosis, with a strong negative impact on survival and high cost to the government. Campaigns directed against these cancers have often failed in Brazil. Objective To evaluate the effectiveness of screening for upper aerodigestive tract cancers, using active search strategies and the use of equipped propaedeutics. Methods A cross-sectional, prospective, descriptive, analytical and exploratory study, since its objectives are based on the visualization of cancerous lesions in a sample consisting of individuals with risk factors, aiming to expand the necessary knowledge for cancer detection, aiming at secondary prevention of the oral cavity, oropharynx, larynx and hypopharynx cancer. Results A total of 16.7% of precancerous lesions and 0.5% of cancer lesions located in the upper aerodigestive tract were clinically visualized. Conclusion The method was effective in the identification of precancerous lesions for the purpose of secondary prevention, but equally important against upper aerodigestive tract cancer, since in the present study the chance of finding the latter was increased by 22.7, showing it is an alternative for future campaigns against the disease.

Resumo Introdução O câncer do trato aerodigestivo superior configura-se entre os mais frequentes e apresenta-se com importância epidemiológica no mundo. A maior parte apresenta-se avançada ao diagnóstico, com forte impacto negativo na sobrevida e elevado custo ao erário. As campanhas feitas contra esses cânceres têm frequentemente falhado no Brasil. Objetivo Avaliar a efetividade do rastreamento para lesões cancerizáveis do trato aerodigestivo superior com estratégias de busca ativa e uso da propedêutica armada. Método Estudo transversal, prospectivo, descritivo, analítico e exploratório, uma vez que os seus objetivos se alicerçam na visualização das lesões cancerizáveis numa amostra composta por indivíduos com fatores de risco, de forma a aprofundar o conhecimento necessário para a sua detecção, visando à prevenção secundária do câncer da cavidade oral, orofaringe, laringe e hipofaringe. Resultado Foram visualizadas clinicamente 16,7% lesões cancerizáveis e 0,5% cânceres de localização no trato aerodigestivo superior. Conclusão O método mostrou-se efetivo na identificação de lesões cancerizáveis com intuito de prevenção secundária, mas igualmente importante contra o câncer do trato aerodigestivo superior, uma vez que neste presente estudo multiplicou-se a chance do encontro desse por 22,7; apresenta-se como opção para futuras campanhas contra a doença.

Prevention of upper aerodigestive tract cancer through active search strategies and use of equipped propaedeutics.

INTRODUCTION: Upper aerodigestive tract cancer is among the most frequent malignancies and has epidemiological importance worldwide. Most cases are already advanced at the diagnosis, with a strong negative impact on survival and high cost to the government. Campaigns directed against these cancers have often failed in Brazil. OBJECTIVE: To evaluate the effectiveness of screening for upper aerodigestive tract cancers, using active search strategies and the use of equipped propaedeutics. METHODS: A cross-sectional, prospective, descriptive, analytical and exploratory study, since its objectives are based on the visualization of cancerous lesions in a sample consisting of individuals with risk factors, aiming to expand the necessary knowledge for cancer detection, aiming at secondary prevention of the oral cavity, oropharynx, larynx and hypopharynx cancer. RESULTS: A total of 16.7% of precancerous lesions and 0.5% of cancer lesions located in the upper aerodigestive tract were clinically visualized. CONCLUSION: The method was effective in the identification of precancerous lesions for the purpose of secondary prevention, but equally important against upper aerodigestive tract cancer, since in the present study the chance of finding the latter was increased by 22.7, showing it is an alternative for future campaigns against the disease.

Correlacao entre sintomas e tempo de evolucao do cancer do trato aerodigestivo superior com o estadio inicial e avancado / Correlation between symptoms and course duration of upper aerodigestive tract cancer at early and advanced stages

Muitos dos aspectos clínicos e biológicos da história natural do câncer do trato aerodigestivo superior estão por elucidar, o que no Brasil tem como consequência direta a falha sistemática das campanhas de prevenção e de diagnóstico precoce. OBJETIVO: Analisar os sinais e sintomas apresentados por portadores da doença em estadiamentos iniciais e avançados. Outras variáveis como o tempo de evolução da doença, o estado geral e nutricional foram consideradas. MÉTODO: Estudo de coorte histórica com corte transversal em 895 indivíduos portadores do câncer do trato aerodigestivo superior. RESULTADOS: Os sinais e sintomas encontrados não se correlacionaram de forma estatisticamente significativa com o tempo de evolução da doença nem com a doença em fases iniciais, mas evidenciaram um desenvolvimento rápido da doença. CONCLUSÃO: Os resultados sugerem uma doença de início insidioso nas fases iniciais e de rápida evolução. O tempo longo de evolução - maior que três meses, associou-se às pioras nos estados geral e nutricional dos pacientes. .

There still are many clinical and biological aspects of the natural history of cancer of the upper aerodigestive tract to be unveiled; which in Brazil is a direct consequence of the failure of systematic prevention and early diagnosis campaigns. OBJECTIVE: To analyze the signs and symptoms presented by patients with the disease at initial and advanced stages. Other variables such as disease duration, general and nutritional status were considered. METHOD: A historical cohort study with a cross-section involving 895 subjects with cancer of the upper aerodigestive tract. RESULTS: Clinical findings were not statistically correlated with disease progression, nor with the disease in early stages, but it showed rapid disease development. CONCLUSION: The results suggest a disease of insidious onset in the early stages and fast course afterwards. The long disease duration - greater than three months, was associated with worsening in general and nutritional states of patients. .

Quality of life of patients with head and neck cancer.

UNLABELLED: Patients with head and neck cancer have to deal with the impact of treatment on its functional and aesthetic aspects, and its self-report enables improvements in clinical and social support. OBJECTIVE: To evaluate the quality of life of patients dealing with squamous cell carcinoma of the head and neck. METHOD: A prospective analytical study. Twenty nine patients with mean age of 57 years answered at three stages: onset, middle and end of treatment, the questionnaires: Quality of Life Core Questionnaire - Cancer 30 and the Quality of Life Questionnaire - Head and Neck, the European Organization for Research and Treatment of Cancer. We used the Friedman test at: 0.05. RESULTS: There were high mean values concerning physical, cognitive, social functions; improvements in general health and social function decline during treatment; and a significant difference in taste and smell (p = 0.020), swallowing (p = 0.040), cough (p = 0.013) and weight loss (p = 0.011). CONCLUSION: There was a significant reduction in the quality of life for some common symptoms resulting from cancer treatment, which was not seen in the evaluation of the aspects related to physical, cognitive and social functions, and general health.

Qualidade de vida de pacientes com carcinoma em cabeça e pescoço / Quality of life of patients with head and neck cancer

Pacientes com câncer em cabeça e pescoço têm de lidar com o impacto de seu tratamento sobre aspectos funcionais e estéticos e seu autorrelato permite aprimorar medidas de suporte clínico e social. OBJETIVO: Avaliar a qualidade de vida de pacientes em tratamento de carcinoma de células escamosas em cabeça e pescoço. MÉTODO: Estudo analítico prospectivo. Vinte e nove pacientes com idade média de 57 anos responderam em três momentos: início, metade e final do tratamento, aos questionários: Quality of Life Core Questionnaire - Cancer 30 e ao Quality of Life Questionnaire - Head and Neck, European Organization for the Research and Treatment of Cancer. Foi realizado teste de Friedman, significância: 0,05. RESULTADO: Houve altas médias para as funções física, cognitiva, social; melhora no estado de saúde geral e declínio da função social ao longo do tratamento e diferença significativa para gosto e cheiro (p = 0,020), deglutição (p = 0,040), tosse (p = 0,013), e perda de peso (p = 0,011). CONCLUSÃO: Houve redução significativa da qualidade de vida em relação a alguns sintomas comuns decorrentes do tratamento do câncer, que não ocorreu na avaliação das dimensões relacionadas às funções física, cognitiva, social e ao estado geral de saúde.

Patients with head and neck cancer have to deal with the impact of treatment on its functional and aesthetic aspects, and its self-report enables improvements in clinical and social support. OBJECTIVE: To evaluate the quality of life of patients dealing with squamous cell carcinoma of the head and neck. METHOD: A prospective analytical study. Twenty nine patients with mean age of 57 years answered at three stages: onset, middle and end of treatment, the questionnaires: Quality of Life Core Questionnaire - Cancer 30 and the Quality of Life Questionnaire - Head and Neck, the European Organization for Research and Treatment of Cancer. We used the Friedman test at: 0.05. RESULTS: There were high mean values concerning physical, cognitive, social functions; improvements in general health and social function decline during treatment; and a significant difference in taste and smell (p = 0.020), swallowing (p = 0.040), cough (p = 0.013) and weight loss (p = 0.011). CONCLUSION: There was a significant reduction in the quality of life for some common symptoms resulting from cancer treatment, which was not seen in the evaluation of the aspects related to physical, cognitive and social functions, and general health.

Correlation between symptoms and course duration of upper aerodigestive tract cancer at early and advanced stages.

UNLABELLED: There still are many clinical and biological aspects of the natural history of cancer of the upper aerodigestive tract to be unveiled; which in Brazil is a direct consequence of the failure of systematic prevention and early diagnosis campaigns. OBJECTIVE: To analyze the signs and symptoms presented by patients with the disease at initial and advanced stages. Other variables such as disease duration, general and nutritional status were considered. METHOD: A historical cohort study with a cross-section involving 895 subjects with cancer of the upper aerodigestive tract. RESULTS: Clinical findings were not statistically correlated with disease progression, nor with the disease in early stages, but it showed rapid disease development. CONCLUSION: The results suggest a disease of insidious onset in the early stages and fast course afterwards. The long disease duration - greater than three months, was associated with worsening in general and nutritional states of patients.

Analysis of ECOG performance status in head and neck squamous cell carcinoma patients: association with sociodemographical and clinical factors, and overall survival.

PURPOSE: In the present study, we analyzed sociodemographical and clinical factors, and the Eastern Cooperative Oncology Group performance status (ECOG-PS) scale in head and neck squamous cell carcinoma (HNSCC) patients. We evaluated the impact of a range of variables on overall survival. METHODS: We investigated a sample of HNSCC patients (n = 671), using sociodemographical and clinical information, and survival data collected from a review of epidemiological, clinical, and treatment reports. Statistical associations were analyzed by bivariate and multivariate statistical tests. Statistical significance was set at p < 0.05. RESULTS: Of patients 85.4% recorded good ECOG-PS scores. Poor ECOG-PS scores were associated with the covariates indicative of dysphagia [odd ratios (OR) = 2.660, CI 95% = 1.661­4.260, p = 0.000] and large-size malignant disease (T3­T4; OR = 5.337, CI 95% = 2.251­12.652, p = 0.000). Overall survival analysis revealed that ECOG-PS scores (OR = 1.879, CI 95% = 1.162­3.038, p = 0.010), tumor size (OR = 1.665, CI 95% = 1.035­2.680, p = 0.036), and the presence of cervical metastasis (OR = 3.145, CI 95% = 2.008­4.926, p = 0.000) were independent predictors. CONCLUSION: Evaluation of physical consumption in head and neck cancer patients at diagnosis may indicate a more aggressive type of malignant disease. Thus, the ECOG-PS scale may help to identify HNSCC patients in need of rapid referral, who may benefit from specific therapeutic and rehabilitative interventions.

A high HIF-1α expression genotype is associated with poor prognosis of upper aerodigestive tract carcinoma patients.

The aim of the present study was to evaluate the role of HIF-1α genetic polymorphisms and protein expression in the development of metastasis in upper aerodigestive tract cancer (UADTC) patients. The expression of pro-angiogenic markers was also evaluated. Protein expression was analysed using immunohistochemistry, and RFLP analysis was used to investigate HIF-1α C1779T and G1790A polymorphisms in 52 patients with UADTC. Primary lesions were divided into 2 groups according to the absence or presence of metastasis. Lymph node samples were divided into 3 groups: metastatic lymph nodes, non-metastatic lymph nodes (both derived from patients with metastatic disease), and control lymph nodes, which were obtained from patients without any metastasis. The allele T was more frequently found in patients with metastatic disease. HIF-1α protein expression in the lymph nodes was increased in the presence of the T allele. Metastatic lymph nodes showed lower levels of HIF-1α, VEGFR1, and MMP-9 proteins compared to lymph nodes without metastasis, while VEGFR2 protein levels were increased. In agreement, HIF-1α expression was correlated with MMP-9. Cox regression analysis demonstrated that higher HIF-1α and MMP-9 protein expression levels and GA and GG genotypes were associated with poor survival. Our findings show that the C1772T and G1790A polymorphisms of the HIF-1α gene are associated with increased expression of the HIF-1α protein in UADTC. The present data indicate that non-metastatic tissues express higher levels of HIF-1α, VEGFR1, and MMP-9, while in metastatic lymph nodes, VEGFR2 protein expression is elevated. The present study also shows that the HIF-1α G1790A polymorphism and its protein expression have an impact on the prognosis of UADTC patients.

Sindrome de Eagle simulando neuralgia occipital: relato de caso e revisão de literatura / Eagle Syndrome simulating occipital neuralgia: case report and literature review

Síndrome de Eagle caracteriza-se por sinais e sintomas faríngeos e cervicais associados ao alongamento do processo estilóide do osso temporal ou calcificação do ligamento estilo-hióideo. Apesar de ser rara, ela está bem documentada na literatura da otorrinolaringologia e da odontologia. Todavia, na literatura neurológica há poucos relatos. O objetivo desse trabalho é relatar um caso e fazer uma revisão de literatura sobre a Síndrome de Eagle. Pretende-se, dessa forma, familiarizar os neurologistas e neurocirurgiões com os sintomas, diagnóstico e o tratamento dessa afecção.

Lip squamous cell carcinoma in a Brazilian population: Epidemiologicalstudy and clinicopathological associations

Objectives: It was evaluated epidemiological aspects of primary lip squamous cell carcinoma (LSCC) and its associationswith clinicopathological factors. Study design: This retrospective, cross-sectional study analysed a sociodemographic,clinical, and morphological data of HNSCC in a Brazilian population (n=30). Data analysis includeddescriptive statistics and bivariate analyses using the chi-square and Fisher’s exact tests to compare the variables.Results: The LSCC represented 10.8% of all oral cavity squamous cell carcinoma. Lip malignant disease was moreprevalent in elderly men, with male-to-female ratio of 5:1. Lower lip was more affected. It was observed high ratesof chronic solar exposure, and tobacco and alcohol drinking habits. Clinically, early TNM staging, small tumourlesions, and non-metastatic disease were predominant findings. It was identified a high frequency of well differentiatedtumor samples. Worse Karnofsky performance status was associated with cervical metastasis. Conclusions:Our findings showed that LSCC patients exhibited similar epidemiological and clinical profiles as noted in otherstudies. Still, the occurrence of metastatic disease was associated with a worse physical performance status of theLSCC patients during diagnosis (AU)

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