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1.
Mastology (Impr.) ; 28(2): 80-86, abr.-jun.2018.
Artigo em Inglês | LILACS-Express | ID: biblio-965397

RESUMO

Objective: To analyze the incidence of early postoperative complications in women with breast cancer according to the axillary surgery. Methods: An observational study of a cohort of women diagnosed with T1-T2N0M0 clinical stage breast cancer attended at the Brazilian National Cancer Institute from January 2007 to December 2009. The outcome was defined as postsurgical complications in the affected upper limb, such as: axillary web syndrome, winged scapula, paraesthesia and surgical wound, seroma and wound infection. The incidence of simple complications was estimated. The crude and adjusted Odds Ratios, with their respective 95% confidence intervals, were estimated by Multiple Logistic Regression analysis. Results: The incidence of postoperative complications was significantly lower in sentinel lymph node biopsy (axillary web syndrome: 6.0%; paraesthesia: 45.2%; winged scapula: 9.1%; seroma: 28.5%; wound infection: 3.8%) than in axillary lymphadenectomy (axillary web syndrome: 22.5%; paraesthesia: 89.8%; winged scapula: 50.0%; seroma: 69.4%; wound infection: 12.9%). Compared to those who underwent axillary lymphadenectomy, the risk of postoperative complications in those in whom sentinel lymph node biopsy was performed was significantly lower. Conclusion: The sentinel lymph node biopsy technique was an independent protective factor for acute postoperative complications when compared to axillary lymphadenectomy


Objetivo: Analisar a incidência de complicações pós-operatórias precoces em mulheres com câncer de mama de acordo com a cirurgia axilar. Métodos: Estudo observacional de uma coorte de mulheres diagnosticadas com câncer de mama em estágio clínico T1-T2N0M0 atendidas no Instituto Nacional de Câncer do Brasil de janeiro de 2007 a dezembro de 2009. O desfecho foi definido como complicações pós-cirúrgicas no membro superior afetado, tais como: síndrome da rede axilar, escápula alada, parestesia e ferida cirúrgica, seroma e infecção da ferida. A incidência de complicações simples foi estimada. Os Odds Ratios bruto e ajustado, com seus respectivos intervalos de confiança de 95%, foram estimados por análise de Regressão Logística Múltipla. Resultados: A incidência de complicações pós-operatórias foi significativamente menor na biópsia de linfonodo sentinela (síndrome da rede axilar: 6,0%; parestesia: 45,2%; escápula alada: 9,1%; seroma: 28,5%; infecção da ferida: 3,8%) do que na linfadenectomia axilar (síndrome da rede axilar: 22,5%; parestesia: 89,8%; escápula alada: 50,0%; seroma: 69,4%; infecção da ferida: 12,9%). Em comparação com aqueles que foram submetidos a linfadenectomia axilar, o risco de complicações pós-operatórias naqueles nos quais a biópsia de linfonodo sentinela foi realizada foi significativamente menor. Conclusão: A técnica de biópsia de linfonodo sentinela foi um fator de proteção independente para complicações pós-operatórias quando comparadas à linfadenectomia axilar

2.
Int J Gynecol Cancer ; 19(8): 1427-31, 2009 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-20009902

RESUMO

OBJECTIVE: To evaluate cervical intraepithelial neoplasia (CIN) treatment failure among women with an altered Papanicolaou test and treated at a public cervical pathology center in Rio de Janeiro, Brazil. METHODS: An exploratory study was carried out in a cohort of women treated for preinvasive cervical cancer, from 1998 to 2000. Epidemiological, clinical, and sociodemographic data were obtained from medical records. Information related to cytological and histological examinations, classified according to the Bethesda System, were cross-tabulated with reports from the main cervical pathology laboratory at the Brazilian Cancer Institute. Conditional probability for treatment failure (12 and 24 months) and hazard ratios were estimated through Kaplan-Meier (log-rank test, 95%) and Cox regression (entry, or=0.10). RESULTS: Mean (SD) follow-up period was 20.75 (20.53) months, and 449 women were treated for CIN-1 or CIN-2/3. There was an increased probability of treatment failure according to age group (37.19% and 57.44% in 12 and 24 months for women >50 years). Women who smoked for more than 10 years were more likely to present treatment failure compared with those who smoked for up to 10 years (33.56% and 22.01% in 12 months; 53.15% and 42.59% in 24 months, respectively). Women older than 50 years showed an independent risk for treatment failure (adjusted hazard ratio, 1.59; 95% confidence interval, 1.04-2.41) compared with women aged between 10 and 29 years. CONCLUSIONS: Age (>50 years) was statistically associated with treatment failure. Duration of tobacco use (>10 years), CIN-2/3 cytology at treatment, glandular involvement, and having more than 4 sexual partners in a lifetime were also associated with failure, reducing statistical significance after adjustment.


Assuntos
Neoplasia Intraepitelial Cervical/epidemiologia , Neoplasia Intraepitelial Cervical/terapia , Neoplasias do Colo do Útero/epidemiologia , Neoplasias do Colo do Útero/terapia , Adolescente , Adulto , Brasil/epidemiologia , Neoplasia Intraepitelial Cervical/patologia , Criança , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Taxa de Sobrevida , Falha de Tratamento , Neoplasias do Colo do Útero/patologia , Adulto Jovem
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