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1.
J Cancer Res Clin Oncol ; 146(12): 3313-3322, 2020 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-32617700

RESUMO

BACKGROUND: The clinical behaviour and outcome of young patients with gastroesophageal tumours (GET) is surmised to differ from older patients, yet data on the comparison of these two patient subgroups is scarce. This study focuses on the investigation of the clinical characteristics and survival outcome of younger-age people with GET, when compared to older patients. METHODS: Patients diagnosed with GET at the Medical University of Vienna between 2004 and 2016 were included in this study. Clinical parameters and the overall survival (OS) were compared between young (≤ 45 years) and elderly (≥ 65 years) patients. RESULTS: Among 796 patients, who were eligible for this analysis, fifty-eight patients (7%) were ≤ 45 years at the initial onset of the disease. These 58 young patients were then matched to elderly patients based on the gender, tumour stage, histology and tumour location. The number of metastatic lesions was significantly higher among young patients (p < 0.05). In a non-metastatic setting younger patients showed a significant longer OS than older patients (median 1226 versus 801 days, p = 0.028). Furthermore, young patients with extensive metastatic disease (2 or more metastatic site) had a significantly poorer OS than elderly patients (median 450 versus 646 days, p = 0.033). CONCLUSION: These results indicate that young patients might be diagnosed very late, which might lead to the development of a more aggressive disease compared to older patients, but a relatively long OS when diagnosed and treated in a non-metastatic setting. Thus, screening methods for younger patients might be considerable to enhance the outcome of young patients with GET.


Assuntos
Fatores Etários , Carcinoma/epidemiologia , Neoplasias Gastrointestinais/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Carcinoma/patologia , Carcinoma/terapia , Intervalo Livre de Doença , Feminino , Neoplasias Gastrointestinais/patologia , Neoplasias Gastrointestinais/terapia , Humanos , Masculino , Pessoa de Meia-Idade , Resultado do Tratamento , Adulto Jovem
2.
In Vivo ; 34(3 Suppl): 1667-1673, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: covidwho-527842

RESUMO

BACKGROUND: COVID-19 pandemic required a marked re-allocation of healthcare resources, including at Breast Units. A patient-tailored program was developed to assess its efficacy regarding prevention of COVID-19 infection among patients with breast cancer undergoing surgery and healthcare workers (HCWs). PATIENTS AND METHODS: From March 9th to April 9th 2020, 91 patients were selected for elective surgery by means of: i) Pre-hospital screening aimed at avoiding hospitalization of symptomatic or suspicious COVID-19 patients, and ii) prioritisation of surgical procedure according to specific disease features. RESULTS: Eighty-five patients (93.4%) were fit for surgery, while five patients (5.5%) were temporarily excluded through 'telephone triage'; another two patients were excluded at in-hospital triage. A total of 71 out of 85 patients (83.5%) were diagnosed with invasive cancer, most of whom were undergoing breast-conserving surgery (61 out of 85 patients, 71.8%). The mean in-hospital stay was 2.2 days (SD=0.7 days). After hospital discharge, no patient needed re-admission due to post-operative complications; moreover, no COVID-19 infection among patients or HCWs was detected. CONCLUSION: Safe breast cancer surgery was accomplished for both patients and HCWs by means of a careful preoperative selection of patients and in-hospital preventative measures. This screening program can be transferred to high-volume Breast Units and it may be useful in implementing European Community recommendations for prevention of COVID-19 infection.


Assuntos
Neoplasias da Mama/cirurgia , Carcinoma/cirurgia , Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Controle de Infecções/métodos , Mastectomia/estatística & dados numéricos , Pandemias/prevenção & controle , Seleção de Pacientes , Pneumonia Viral/prevenção & controle , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/enfermagem , Carcinoma/tratamento farmacológico , Carcinoma/epidemiologia , Carcinoma/enfermagem , Técnicas de Laboratório Clínico , Terapia Combinada , Infecções por Coronavirus/diagnóstico , Feminino , Unidades Hospitalares/organização & administração , Humanos , Itália/epidemiologia , Tempo de Internação/estatística & dados numéricos , Metástase Linfática/diagnóstico por imagem , Linfocintigrafia , Mastectomia Segmentar/estatística & dados numéricos , Terapia Neoadjuvante , Alta do Paciente , Equipamentos de Proteção , Biópsia de Linfonodo Sentinela , Avaliação de Sintomas , Telemedicina , Triagem
3.
West Afr J Med ; 37(3): 248-252, 2020.
Artigo em Inglês | MEDLINE | ID: mdl-32476118

RESUMO

OBJECTIVE: Within a multicentre prospective study of prostate cancer genetics, we analysed some parameters of cases seen in our centre over a 2-year period to see if there are any changes in histological grades and age compared to previous studies in this environment. METHODS: Histological grading and scoring had been done using the revised International Society of urologic pathology (ISUP) system and cases were classified into Grade groups. Gleason grades less than 3 were not assigned and Scores less than 6 not assigned. The Prostatic Specific Antigen (PSA) levels as well as the average tumour percentage in the biopsy specimens were determined. RESULTS: A hundred and forty-five (145) patients were seen. The majority of patients seen were in Grade group 5 (30.3%), followed by grade group 4 (26.2%) and then groups 1, 3 and 2 in that order. Patients' ages ranged from 47 years to 86 years, with peak age incidence in the 7th decade. PSA values ranged from 3.6 to 22,130ng/ml and tumour volumes ranged from 5% of biopsy tissue to 95%. The lowest PSA value was seen in a patient in grade group 1 but the highest PSA value was recorded in a patient in Grade group 3. The lowest and highest tumour volumes were seen in patients in grade group 4. The PSA and tumour volumes did not vary in linear fashion with Gleason grade. CONCLUSION: The results show that the majority of patients in Ibadan present with high grade prostatic carcinoma even using the new ISUP grading system but the proportion of highgrade tumours seems higher than in the previous study, likely because more diagnostic tissue has become available per case. Examining a minimum of 12 cores have definitely created an opportunity for proper grading. Peak incidence is in the 7th decade followed by the 8th decade. Very high PSA values recorded in our patients with prostatic carcinoma do not show linear relationship with prostatic carcinoma volume or grade.


Assuntos
Carcinoma/patologia , Antígeno Prostático Específico/sangue , Neoplasias da Próstata/patologia , Distribuição por Idade , Idoso , Idoso de 80 Anos ou mais , Carcinoma/epidemiologia , Hospitais de Ensino , Hospitais Universitários , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Nigéria/epidemiologia , Estudos Prospectivos , Neoplasias da Próstata/epidemiologia
4.
Rev Col Bras Cir ; 47: e20202406, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-32491029

RESUMO

OBJECTIVE: to evaluate the clinical characteristics of patients with colorectal cancer under the age of 50 treated at a public hospital in Brasilia over 5 years. METHODS: we conducted a longitudinal, retrospective study, with 184 patients undergoing surgical procedures at the Asa Norte Regional Hospital (HRAN), including those who underwent only biopsy, between January 2013 and January 2018. We divided the patients into two groups: under the age of 50 (n=39) and age equal to or greater than 50 years (n=145). We compared the groups as to age, sex, symptoms, time between symptom onset and diagnosis, family and personal history, tumor location, histopathological characteristics, applied surgical management, staging and mortality. RESULTS: the group of patients under the age of 50 had more individuals with stage III and IV (p=0.041), more frequent poorly differentiated tumors (10.25% versus 3.52%; p=0.153), and higher incidences of compromised surgical margins (p=0.368), angiolymphatic (p=0.07) and perineural (p=0.007) invasion, which denotes more advanced disease in this group of patients. CONCLUSIONS: the study showed the low effectiveness of population screening methods for colorectal cancer currently used in this population, given the high incidence of the disease and late diagnosis in both groups.


Assuntos
Carcinoma/patologia , Neoplasias Colorretais/patologia , Adulto , Fatores Etários , Brasil/epidemiologia , Carcinoma/epidemiologia , Carcinoma/cirurgia , Colo/patologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/cirurgia , Feminino , Humanos , Estudos Longitudinais , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos Retrospectivos , Fatores de Risco , Adulto Jovem
5.
In Vivo ; 34(3 Suppl): 1667-1673, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-32503827

RESUMO

BACKGROUND: COVID-19 pandemic required a marked re-allocation of healthcare resources, including at Breast Units. A patient-tailored program was developed to assess its efficacy regarding prevention of COVID-19 infection among patients with breast cancer undergoing surgery and healthcare workers (HCWs). PATIENTS AND METHODS: From March 9th to April 9th 2020, 91 patients were selected for elective surgery by means of: i) Pre-hospital screening aimed at avoiding hospitalization of symptomatic or suspicious COVID-19 patients, and ii) prioritisation of surgical procedure according to specific disease features. RESULTS: Eighty-five patients (93.4%) were fit for surgery, while five patients (5.5%) were temporarily excluded through 'telephone triage'; another two patients were excluded at in-hospital triage. A total of 71 out of 85 patients (83.5%) were diagnosed with invasive cancer, most of whom were undergoing breast-conserving surgery (61 out of 85 patients, 71.8%). The mean in-hospital stay was 2.2 days (SD=0.7 days). After hospital discharge, no patient needed re-admission due to post-operative complications; moreover, no COVID-19 infection among patients or HCWs was detected. CONCLUSION: Safe breast cancer surgery was accomplished for both patients and HCWs by means of a careful preoperative selection of patients and in-hospital preventative measures. This screening program can be transferred to high-volume Breast Units and it may be useful in implementing European Community recommendations for prevention of COVID-19 infection.


Assuntos
Neoplasias da Mama/cirurgia , Carcinoma/cirurgia , Infecções por Coronavirus/prevenção & controle , Procedimentos Cirúrgicos Eletivos/estatística & dados numéricos , Controle de Infecções/métodos , Mastectomia/estatística & dados numéricos , Pandemias/prevenção & controle , Seleção de Pacientes , Pneumonia Viral/prevenção & controle , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/tratamento farmacológico , Neoplasias da Mama/epidemiologia , Neoplasias da Mama/enfermagem , Carcinoma/tratamento farmacológico , Carcinoma/epidemiologia , Carcinoma/enfermagem , Técnicas de Laboratório Clínico , Terapia Combinada , Infecções por Coronavirus/diagnóstico , Feminino , Unidades Hospitalares/organização & administração , Humanos , Itália/epidemiologia , Tempo de Internação/estatística & dados numéricos , Metástase Linfática/diagnóstico por imagem , Linfocintigrafia , Mastectomia Segmentar/estatística & dados numéricos , Terapia Neoadjuvante , Alta do Paciente , Equipamentos de Proteção , Biópsia de Linfonodo Sentinela , Avaliação de Sintomas , Telemedicina , Triagem
6.
Am J Surg Pathol ; 44(8): 1005-1016, 2020 08.
Artigo em Inglês | MEDLINE | ID: mdl-32452870

RESUMO

Endocrine mucin-producing sweat gland carcinoma (EMPSGC) is a rare, low-grade adnexal neoplasm with predilection for the periorbital skin of older women. Histologically and immunophenotypically, EMPSGC is analogous to another neoplasm with neuroendocrine differentiation, solid papillary carcinoma of the breast. Both lesions are spatially associated with neuroendocrine mucinous adenocarcinomas of the skin and breast, respectively. EMPSGC is ostensibly a precursor of neuroendocrine-type mucinous sweat gland adenocarcinoma (MSC), a lesion of uncertain prognosis. Non-neuroendocrine MSC has been deemed locally aggressive with metastatic potential, and previous works speculated that EMPSGC-associated (neuroendocrine-type) MSC had similar recurrence and metastatic potential with implications for patient follow-up. Only 96 cases of EMPSGC have been reported (12 cases in the largest case series). Herein, we present 63 cases diagnosed as "EMPSGC" in comparison with aggregated results from known published EMPSGC cases. We aim to clarify the clinicopathologic features and prognostic significance of the neuroendocrine differentiation of EMPSGC and its associated adenocarcinoma and to determine the nosological relevance of EMPSGC association in the spectrum of MSC histopathogenesis. Results established an overall female predominance (66.7%) and average presenting age of 64 years. EMPSGC lesions were associated with adjacent MSC in 33.3% of cases. The recurrence rate for neuroendocrine-type MSC was ~21%, less than the reported 30% for non-neuroendocrine MSC. There were no cases of metastasis. EMPSGC and neuroendocrine-type MSC are distinct entities with more indolent behavior than previously reported, supporting a favorable prognosis for patients.


Assuntos
Biomarcadores Tumorais/análise , Carcinoma/patologia , Mucinas/análise , Neoplasias Císticas, Mucinosas e Serosas/patologia , Neoplasias das Glândulas Sudoríparas/patologia , Idoso , Idoso de 80 Anos ou mais , Carcinoma/química , Carcinoma/epidemiologia , Carcinoma/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Císticas, Mucinosas e Serosas/química , Neoplasias Císticas, Mucinosas e Serosas/epidemiologia , Neoplasias Císticas, Mucinosas e Serosas/terapia , América do Norte , Prognóstico , Estudos Retrospectivos , Neoplasias das Glândulas Sudoríparas/química , Neoplasias das Glândulas Sudoríparas/epidemiologia , Neoplasias das Glândulas Sudoríparas/terapia
7.
Medicine (Baltimore) ; 99(16): e19714, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-32311956

RESUMO

To validate the revised 2018 International Federation of Gynecology and Obstetrics (FIGO) staging system for cervical cancer on the survival of patients who underwent radical hysterectomy for 2009 FIGO stage IB carcinomas.We retrospectively identified and reviewed 251 patients treated with radical hysterectomy for 2009 FIGO stage IB cervical carcinomas from January 2011 to December 2016. The re-staged IB cohort consisted of 2018 FIGO stage IB1 (tumor size <2 cm), IB2 (2-3.9 cm), IB3 (≥4 cm), and IIIC1p (any pelvic nodal metastasis) cervical cancer. The univariate log-rank test and multivariate Cox regression models were performed for all potential clinic pathological risk factors based on cancer stage.On re-staging the 251 patients with 2009 FIGO stage IB using the 2018 FIGO staging system, 96 patients (38.2%) had stage IB1, 109 patients (43.4%) had stage IB2, 28 patients (11.2%) had stage IB3, and 18 patients (7.2%) had stage IIIC1p. The 5-year overall survival (OS) rates of patients with 2018 FIGO stage IB1, IB2, IB3, and IIIC1p were 97.9%, 92.7%, 78.6%, and 61.1%, respectively. The 5-year progression-free survival rates were 97.9%, 92.7%,63.7%, and 20.8%, respectively. Factors significantly affecting OS and disease-free survival were 2018 FIGO stage≥IB3, histologic grade 2-3, and lymph node involvement.The revised 2018 FIGO staging system seemed to accurately reflect the survival rate, with a distinct statistical tendency for poorer 5-year disease-free survival and OS rates with increasing stage. Women with positive lymph nodes in this classification were classified as having stage IIIC disease, which can achieve more realistic survival results than the previous staging system. The prognostic discrimination of histologic grade should be considered when revising the staging system in the future.


Assuntos
Carcinoma/diagnóstico , Carcinoma/epidemiologia , Neoplasias do Colo do Útero/diagnóstico , Neoplasias do Colo do Útero/epidemiologia , Adulto , Idoso , Carcinoma/patologia , Carcinoma/cirurgia , Feminino , Seguimentos , Humanos , Histerectomia , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Análise de Sobrevida , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/cirurgia , Adulto Jovem
8.
Lancet Gastroenterol Hepatol ; 5(6): 537-547, 2020 06.
Artigo em Inglês | MEDLINE | ID: mdl-32192628

RESUMO

BACKGROUND: Long-term colorectal cancer incidence and mortality after colorectal polyp removal remains unclear. We aimed to assess colorectal cancer incidence and mortality in individuals with removal of different histological subtypes of polyps relative to the general population. METHODS: We did a matched cohort study through prospective record linkage in Sweden in patients aged at least 18 years with a first diagnosis of colorectal polyps in the nationwide gastrointestinal ESPRESSO histopathology cohort (1993-2016). For each polyp case, we identified up to five matched reference individuals from the Total Population Register on the basis of birth year, age, sex, calendar year of biopsy, and county of residence. We excluded patients and reference individuals with a diagnosis of colorectal cancer either before or within the first 6 months after diagnosis of the index polyp. Polyps were classified by morphology codes into hyperplastic polyps, sessile serrated polyps, tubular adenomas, tubulovillous adenomas, and villous adenomas. Colorectal cancer cases were identified from the Swedish Cancer Registry, and cause-of-death data were retrieved from the Cause of Death Register. We collected information about the use of endoscopic examination before and after the index biopsy from the Swedish National Patient Registry, and counted the number of endoscopies done before and after the index biopsies. We calculated cumulative risk of colorectal cancer incidence and mortality at 3, 5, 10, and 15 years, and computed hazard ratios (HRs) and 95% CIs for colorectal cancer incidence and mortality using a stratified Cox proportional hazards model within each of the matched pairs. FINDINGS: 178 377 patients with colorectal polyps and 864 831 matched reference individuals from the general population were included in our study. The mean age of patients at polyp diagnosis was 58·6 (SD 13·9) years for hyperplastic polyps, 59·7 (14·2) years for sessile serrated polyps, 63·9 (12·9) years for tubular adenomas, 67·1 (12·1) years for tubulovillous adenomas, and 68·9 (11·8) years for villous adenomas. During a median of 6·6 years (IQR 3·0-11·6) of follow-up, we documented 4278 incident colorectal cancers and 1269 colorectal cancer-related deaths in patients with a polyp, and 14 350 incident colorectal cancers and 5242 colorectal cancer deaths in general reference individuals. The 10-year cumulative incidence of colorectal cancer was 1·6% (95% CI 1·5-1·7) for hyperplastic polyps, 2·5% (1·9-3·3) for sessile serrated polyps, 2·7% (2·5-2·9) for tubular adenomas, 5·1% (4·8-5·4) for tubulovillous adenomas, and 8·6% (7·4-10·1) for villous adenomas compared with 2·1% (2·0-2·1) in reference individuals. Compared with reference individuals, patients with any polyps had an increased risk of colorectal cancer, with multivariable HR of 1·11 (95% CI 1·02-1·22) for hyperplastic polyps, 1·77 (1·34-2·34) for sessile serrated polyps, 1·41 (1·30-1·52) for tubular adenomas, 2·56 (2·36-2·78) for tubulovillous adenomas, and 3·82 (3·07-4·76) for villous adenomas (p<0·05 for all polyp subtypes). There was a higher proportion of incident proximal colon cancer in patients with serrated (hyperplastic and sessile) polyps (52-57%) than in those with conventional (tubular, tubulovillous, and villous) adenomas (30-46%). For colorectal cancer mortality, a positive association was found for sessile serrated polyps (HR 1·74, 95% CI 1·08-2·79), tubulovillous adenomas (1·95, 1·69-2·24), and villous adenomas (3·45, 2·40-4·95), but not for hyperplastic polyps (0·90, 0·76-1·06) or tubular adenomas (0·97, 0·84-1·12). INTERPRETATION: In a largely screening-naive population, compared with individuals from the general population, patients with any polyps had a higher colorectal cancer incidence, and those with sessile serrated polyps, tubulovillous adenomas, and villous adenomas had a higher colorectal cancer mortality. FUNDING: US National Institutes of Health, American Cancer Society, American Gastroenterological Association, Union for International Cancer Control.


Assuntos
Adenoma Viloso/cirurgia , Pólipos Adenomatosos/cirurgia , Carcinoma/epidemiologia , Pólipos do Colo/cirurgia , Neoplasias Colorretais/cirurgia , Adenoma/patologia , Adenoma/cirurgia , Adenoma Viloso/patologia , Pólipos Adenomatosos/patologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/mortalidade , Pólipos do Colo/patologia , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/mortalidade , Neoplasias Colorretais/patologia , Feminino , Humanos , Hiperplasia , Incidência , Armazenamento e Recuperação da Informação , Masculino , Pessoa de Meia-Idade , Mortalidade , Suécia/epidemiologia
9.
Obstet Gynecol ; 135(3): 498-508, 2020 03.
Artigo em Inglês | MEDLINE | ID: mdl-32028491

RESUMO

OBJECTIVE: To perform a systematic review of the literature to estimate the prevalence and outcomes of occult tubal carcinoma in BRCA mutation carriers and high-risk patients undergoing risk-reducing salpingo-oophorectomy. DATA SOURCE: A search was done using OVID MEDLINE, EMBASE, and ClinicalTrials.gov between 1946 and March 2019 with keywords and MeSH terms selected by an expert medical librarian and coauthors. METHODS OF STUDY SELECTION: Two independent reviewers performed study selection with an initial screen on abstracts and a second on full articles. Articles were rejected if they were irrelevant to the study question, pertained to a different population or did not report occult tubal neoplasia. Quality was assessed using methodologic index for nonrandomized studies criteria. TABULATION, INTEGRATION, AND RESULTS: Data were extracted and recorded in an Excel database. Forest plots for the prevalence of occult carcinoma were done using STATA. Among 2,402 studies assessed, 27 met the inclusion criteria for qualitative and quantitative analysis. A total of 6,283 patients underwent risk-reducing salpingo-oophorectomy between 2002 and 2019: 2,894 cases were BRCA1, 1,579 BRCA2, and 1,810 high-risk based on family history. Among these, 75 patients were diagnosed with occult tubal carcinoma at the time of surgery. The pooled prevalence was 1.2% (I=7.1%, P=.363) occurring at a median age of 53.2 years (range 42.4-67). In a subanalysis of 18 studies reporting follow-up data, 10 recurrences (18.7%, 95% CI 7.5-53%) and 24 cases of post-risk-reducing salpingo-oophorectomy peritoneal cancer (0.54%, 95% CI 0.4-1.9%) were reported after a median follow-up of 52.5 months. BRCA1, older age, and previous breast cancer were more often associated with occult malignancy. CONCLUSION: Occult tubal carcinomas found at risk-reducing salpingo-oophorectomy in high-risk patients and BRCA mutation carriers have significant potential for recurrence despite the frequent administration of postoperative chemotherapy.


Assuntos
Carcinoma/epidemiologia , Neoplasias das Tubas Uterinas/epidemiologia , Recidiva Local de Neoplasia/epidemiologia , Procedimentos Cirúrgicos Profiláticos , Feminino , Humanos
10.
Int J Pediatr Otorhinolaryngol ; 131: 109879, 2020 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-31951980

RESUMO

OBJECTIVE: The aim of this study is to determine the relative frequency, demographic distribution and clinicopathological features of pediatric oral and maxillofacial cancer (POMC). METHODS: Medical records were retrospectively reviewed for all cancer cases diagnosed from 1986 to 2016 affecting patients aged 19 years and younger. Demographic variables, anatomical site, and histopathological diagnoses were collected and analyzed by descriptive statistics. RESULTS: Fifty-five (0.77%) POMCs were found among 7181 pediatric malignancies. Mean age at diagnosis was 8 years and patients aged 5-9 years presented the higher prevalence of malignant tumors (40%). White male patients were more frequently affected (78.18% and 65.45%, respectively). The most common cancer type was lymphomas (52.73%) followed by sarcomas (27.27%) and carcinomas (20%). Burkitt lymphoma (32.73%), rhabdomyosarcoma (14.55%), diffuse large B-cell lymphoma (9.09%), and mucoepidermoid carcinoma (9.09%) were the most common histopathological diagnoses. The main affected anatomical site was the oropharynx (38.18%), followed by salivary glands (30.91%), maxillofacial bone (20%), and oral cavity (10.91%). CONCLUSION: POMC has a low incidence; however, highly aggressive tumors, such as lymphomas and sarcomas, are common in this scenario. A better knowledge about the clinicopathological distribution of POMC may contribute to early diagnosis and improve survival rates.


Assuntos
Carcinoma/epidemiologia , Neoplasias Faciais/epidemiologia , Linfoma/epidemiologia , Neoplasias Maxilares/epidemiologia , Neoplasias Bucais/epidemiologia , Sarcoma/embriologia , Adolescente , Adulto , Fatores Etários , Idoso , Brasil/epidemiologia , Carcinoma/patologia , Criança , Pré-Escolar , Neoplasias Faciais/patologia , Feminino , Humanos , Incidência , Lactente , Linfoma/patologia , Masculino , Neoplasias Maxilares/patologia , Pessoa de Meia-Idade , Neoplasias Bucais/patologia , Prevalência , Estudos Retrospectivos , Sarcoma/patologia , Taxa de Sobrevida , Adulto Jovem
11.
J Bras Pneumol ; 46(1): e20180251, 2020.
Artigo em Inglês, Português | MEDLINE | ID: mdl-31967271

RESUMO

OBJECTIVE: To characterize the clinical and histological profile, as well as treatment patterns, of patients with early-stage, locally advanced (LA), or advanced/metastatic (AM) lung cancer, diagnosed between 2000 and 2014, in Brazil. METHODS: This was an analytical cross-sectional epidemiological study employing data obtained for the 2000-2014 period from the hospital cancer registries of two institutions in Brazil: the José Alencar Gomes da Silva National Cancer Institute, in the city of Rio de Janeiro; and the São Paulo Cancer Center Foundation, in the city of São Paulo. RESULTS: We reviewed the data related to 73,167 patients with lung cancer. The proportions of patients with early-stage, LA, and AM lung cancer were 13.3%, 33.2%, and 53.4%, respectively. The patients with early-stage lung cancer were older and were most likely to receive a histological diagnosis of adenocarcinoma; the proportion of patients with early-stage lung cancer remained stable throughout the study period. In those with LA lung cancer, squamous cell carcinoma predominated, and the proportion of patients with LA lung cancer decreased significantly over the period analyzed. Those with AM lung cancer were younger and were most likely to have adenocarcinoma; the proportion of patients with AM lung cancer increased significantly during the study period. Small cell carcinoma accounted for 9.2% of all cases. In our patient sample, the main treatment modality was chemotherapy. CONCLUSIONS: It is noteworthy that the frequency of AM lung cancer increased significantly during the study period, whereas that of LA lung cancer decreased significantly and that of early-stage lung cancer remained stable. Cancer treatment patterns, by stage, were in accordance with international guidelines.


Assuntos
Carcinoma/patologia , Carcinoma/terapia , Neoplasias Pulmonares/patologia , Neoplasias Pulmonares/terapia , Adolescente , Adulto , Distribuição por Idade , Idoso , Brasil/epidemiologia , Carcinoma/epidemiologia , Estudos Transversais , Feminino , Humanos , Neoplasias Pulmonares/epidemiologia , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Estadiamento de Neoplasias , Prevalência , Distribuição por Sexo , Fatores de Tempo , Adulto Jovem
12.
Mymensingh Med J ; 29(1): 48-54, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31915335

RESUMO

One-fourth of all women suffer from breast disease in their lifetime. World Health Organization estimated that over 508,000 women died in 2011 due to breast cancer worldwide.For several years, fine needle aspiration cytology (FNAC) was the most practiced method for the pathological diagnosis of breast lump specially differentiation of benign from malignant. The advent of core needle or True-Cut biopsy (TCB) in the new millennium has resulted in many surgeons switching to TCB since it provides a sufficient amount of tissue for pathologists to make an accurate histological diagnosis.During the study period, patients present with clinically palpable breast lump admitted in different surgicalunits of MMCH, among them 100 patients selected purposively. Then a prospective comparative study was carried out in the Department of Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from September 2017 to February 2018. Out of a total of 100 patients, who presented with suspicious breast lump, as clinically diagnosed 68 patients had benign breast lump and 32 patients had malignant breast lump. FNAC confirmed the diagnosis of breast carcinoma in 27 patients with sensitivity 89.65% and specificity 66.66%. True-cut biopsy confirmed the diagnosis of breast carcinoma in 29 patients with sensitivity 96.66% and specificity 100%. It also gave the definitive histological type and grade which correlated with the final histopathology report in 29 out of the 30 patientsTCB also provides adequate tissue for the evaluation of molecular markers which have extreme therapeutic value.


Assuntos
Biópsia por Agulha/métodos , Biópsia/métodos , Doenças Mamárias/patologia , Neoplasias da Mama/patologia , Mama/patologia , Carcinoma/patologia , Adulto , Bangladesh/epidemiologia , Biópsia por Agulha Fina , Neoplasias da Mama/epidemiologia , Carcinoma/epidemiologia , Feminino , Humanos , Pessoa de Meia-Idade , Valor Preditivo dos Testes , Estudos Prospectivos , Sensibilidade e Especificidade
13.
Adv Anat Pathol ; 27(2): 51-60, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31876536

RESUMO

Since the first description of sinonasal undifferentiated carcinoma (SNUC) as a distinctive highly aggressive sinonasal neoplasm with probable origin from the sinonasal mucosa (Schneiderian epithelium), SNUC has been the subject of ongoing study and controversy. In particular, the SNUC category gradually became a "wastebasket" for any undifferentiated or unclassifiable sinonasal malignancy of definite or probable epithelial origin. However, with the availability of more specific and sensitive immunohistochemical antibodies and increasing implementation of novel genetic tools, the historical SNUC category became the subject of progressive subdivision leading to recognition of specific genetically defined, reproducible subtypes. These recently recognized entities are characterized by distinctive genetic aberrations including NUTM1-rearranged carcinoma (NUT carcinoma) and carcinomas associated with inactivation of different members of the SWI/SNF chromatin-remodeling gene complex such as SMARCB1-deficient and less frequently SMARCA4-deficient carcinoma. The ring became almost closed, with recent studies highlighting frequent oncogenic IDH2 mutations in the vast majority of histologically defined SNUCs, with a frequency of 82%. A review of these cases suggests the possibility that "true SNUC" probably represents a distinctive neoplastic disease entity, morphologically, phenotypically, and genetically. This review addresses this topic from a historical perspective, with a focus on recently recognized genetically defined subsets within the SNUC spectrum.


Assuntos
Biomarcadores Tumorais/genética , Carcinoma/diagnóstico , Carcinoma/epidemiologia , Carcinoma/genética , DNA Helicases/genética , Humanos , Neoplasias do Seio Maxilar/diagnóstico , Neoplasias do Seio Maxilar/epidemiologia , Neoplasias do Seio Maxilar/genética , Proteínas Nucleares/genética , Proteína SMARCB1/genética , Fatores de Transcrição/genética
14.
Eur J Cancer Care (Engl) ; 29(1): e13182, 2020 Jan.
Artigo em Inglês | MEDLINE | ID: mdl-31808599

RESUMO

OBJECTIVES: An increase in global incidence of oesophageal cancer has been reported in the last few decades. We conducted this study to examine trends in oesophageal cancer in Sri Lanka. METHODS: A retrospective cohort evaluation of newly diagnosed patients with oesophageal cancer during 2001-2010 was performed using population-based data published by the Sri Lanka National Cancer Control Programme. RESULTS: A total of 10,626 (male: female = 1:1.06, mean age: 62 years) oesophageal cancers were analysed. Of those, 1,553(14.6%) were classified as non-specific carcinoma. Of the remaining, 88% (n = 7,986) were squamous cell carcinoma (SCC) and 10.5% (n = 956) were adenocarcinoma. The WHO age-standardised incidence was observed to have increased from 5.78 per 100,000 in 2001 (95% CI = 5.41-6.16) to 6.23 per 100,000 in 2010 (95%CI = 5.86-6.60). WHO age-standardised incidence of SCC has increased from 4.09 to 4.97 per 100,000 from 2001 to 2010 (p < .05 for trend, estimated annual percentage change (EAPC) = 3.6, 95% CI = 0.9-6.3) while incidence of adenocarcinoma showed a greater proportional increase from 0.33 to 0.7 per 100,000 from 2001 to 2010 (p < .05 for trend, EAPC = 7.1, 95% CI = 2.1-12.4). CONCLUSIONS: A statistically significant increase in the incidence of oesophageal cancer in Sri Lanka was noted, with greater proportional increases of adenocarcinomas and cancers in men. Further studies including tumour stage and mortality may help better understand changing patterns of disease burden.


Assuntos
Adenocarcinoma/epidemiologia , Neoplasias Esofágicas/epidemiologia , Carcinoma de Células Escamosas do Esôfago/epidemiologia , Adulto , Distribuição por Idade , Idoso , Carcinoma/epidemiologia , Feminino , Humanos , Incidência , Masculino , Pessoa de Meia-Idade , Sistema de Registros , Estudos Retrospectivos , Distribuição por Sexo , Sri Lanka/epidemiologia
15.
Int J Cancer ; 146(10): 2728-2735, 2020 05 15.
Artigo em Inglês | MEDLINE | ID: mdl-31351006

RESUMO

Ghrelin is a hormone produced in the oxyntic glands of the stomach. Previous work by our group has suggested that serum ghrelin concentrations are inversely associated with gastric and esophageal cancer risk. We measured ghrelin concentrations in the Linxian General Population Nutrition Intervention Trial (NIT), and the Shanghai Women's Health Study (SWHS). In NIT, we analyzed serum samples from 298 esophageal squamous cell carcinoma (ESCC) cases, 518 gastric cardia adenocarcinoma (GCA) cases, 258 gastric noncardia adenocarcinoma (GNCA) cases and 770 subcohort controls (case-cohort). In SWHS, we measured ghrelin in plasma samples from 249 GNCA cases and 498 matched controls (nested case-control). Ghrelin was measured using radioimmunoassay. In NIT and SWHS, low ghrelin concentrations were associated with an increased risk of developing GNCA and GCA. The hazard ratio (HR Q1:Q4 ) for GNCA in NIT was 1.35 (95% CI: 0.89-2.05; p-trend = 0.02); the odds ratio in SWHS was 1.66 (95% CI: 1.02-2.70; p-trend = 0.06). Low ghrelin was associated with a twofold increase of GCA (HR Q1:Q4 = 2.00, 95% CI: 1.45-2.77; p-trend<0.001). In contrast, a lower risk of ESCC (NIT ESCC HR Q1:Q4 = 0.65, 95% CI: 0.45-0.92; p-trend = 0.02) was found in NIT. Low baseline ghrelin concentrations were associated with an increased risk for GNCA and GCA in the NIT and the SWHS. In contrast, low ghrelin concentrations at baseline were associated with a reduced risk of developing ESCC in the NIT. Ghrelin may be an early marker of future cancer risk for developing upper gastrointestinal cancer in regions of high incidence.


Assuntos
Carcinoma/sangue , Neoplasias Esofágicas/sangue , Grelina/sangue , Neoplasias Gástricas/sangue , Adulto , Idoso , Carcinoma/epidemiologia , China/epidemiologia , Estudos de Coortes , Neoplasias Esofágicas/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Fatores de Risco , Neoplasias Gástricas/epidemiologia
16.
Support Care Cancer ; 28(3): 1385-1393, 2020 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-31264185

RESUMO

PURPOSE: Knowledge about quality of life (QOL), pain, and psychological factors in patients with primary tumors of the spine is limited, but is important in planning rehabilitation after surgery. Aims of this study were to assess the preoperative levels and improvement after surgery of these factors, and to identify the predictors of postoperative pain and QOL. METHODS: Patients with primary tumors undergoing spine surgery were matched for sex and age with patients with metastatic tumors. QOL was measured at baseline and three months after surgery with the physical (PCS) and mental (MCS) components SF-12 subscales, pain intensity with a numeric rating scale (NRS), depression with the Beck Depression Inventory (BDI). Preoperative SF-12, NRS, and BDI levels and differences in follow-up improvement in SF-12 and NRS were compared across samples. LASSO regressions were performed to find predictors of follow-up SF-12 and NRS. RESULTS: Patients with primary tumors showed better PCS and NRS, and similar BDI and MCS than patients with metastatic tumors. At follow-up, they showed stronger improvement in the MCS and no improvement in the PCS. All QOL scores were below those of the general population. Follow-up PCS was predicted by baseline PCS and BDI; MCS by baseline MCS; pain intensity by baseline pain intensity and BDI. CONCLUSION: Patients with primary tumors of the spine suffer from moderate levels of physical and mental impairment. Depression influences surgical outcomes.


Assuntos
Dor Pós-Operatória/etiologia , Qualidade de Vida , Neoplasias da Coluna Vertebral/psicologia , Neoplasias da Coluna Vertebral/cirurgia , Adulto , Idoso , Carcinoma/epidemiologia , Carcinoma/patologia , Carcinoma/psicologia , Carcinoma/cirurgia , Estudos de Casos e Controles , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Metástase Neoplásica , Dor Pós-Operatória/epidemiologia , Estudos Prospectivos , Fatores de Risco , Neoplasias da Coluna Vertebral/epidemiologia , Neoplasias da Coluna Vertebral/patologia , Resultado do Tratamento
17.
Eur J Surg Oncol ; 46(4 Pt A): 620-625, 2020 04.
Artigo em Inglês | MEDLINE | ID: mdl-31668977

RESUMO

INTRODUCTION: Preoperative body weight and nutritional status are related to prognosis in patients with gastric cancer; however, the prognostic impact of postoperative in these variables is unclear. We aimed to investigate the association of preoperative/postoperative body mass index (BMI) and prognostic nutritional index (PNI) with prognosis in patients with gastric cancer. MATERIALS AND METHODS: We retrospectively 1868 patients with stage II/III gastric cancer treated with gastrectomy between January 2006 and December 2010. We divided the populations into 3 groups according to BMI; underweight, normal, and overweight. Patients were divided into 3 groups according to BMI (underweight, normal-weight, overweight). PNI was classified into low and high (cutoff value; 49.7). The association of preoperative BMI/PNI and their changes (6 months postoperatively) with clinicopathologic characteristics were evaluated. RESULTS: Preoperative underweight and low PNI were related to poor prognosis (log-rank p < 0.001 for both). There was a positive correlation between preoperative BMI and PNI (mean preoperative PNI: 51.13 [underweight], 53.37 [normal-weight], and 55.16 [overweight]; p < 0.001). Preoperative BMI and PNI were independent prognostic factors for disease-free survival along with age and TNM stage (p < 0.001 for both). BMI changes from normal-weight to underweight and from overweight to normal/underweight were related to poor prognosis (log-rank p = 0.021 and p = 0.013, respectively). PNI changes were related to prognosis in both the preoperative low and high PNI groups (p < 0.001 and p = 0.019, respectively). CONCLUSION: Preoperative BMI and PNI and their postoperative changes are related to prognosis in patients with stage II/III gastric cancer. Careful nutritional intervention after gastrectomy can improve prognosis.


Assuntos
Carcinoma/cirurgia , Gastrectomia , Avaliação Nutricional , Sobrepeso/epidemiologia , Período Pré-Operatório , Neoplasias Gástricas/cirurgia , Magreza/epidemiologia , Perda de Peso , Adulto , Idoso , Índice de Massa Corporal , Carcinoma/epidemiologia , Intervalo Livre de Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Período Pós-Operatório , Prognóstico , Estudos Retrospectivos , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/patologia , Carga Tumoral
18.
Am J Epidemiol ; 189(2): 95-107, 2020 02 28.
Artigo em Inglês | MEDLINE | ID: mdl-31509174

RESUMO

Despite research efforts, current knowledge of the etiology of thyroid carcinoma remains limited. To explore the potential role of diet-induced inflammation, we examined the association between differentiated thyroid cancer risk and the energy-adjusted Dietary Inflammatory Index (E-DII) in a population-based case-control study conducted in New Caledonia, a Pacific archipelago with one of the highest recorded thyroid cancer incidence rates in the world. The E-DII was computed from food frequency questionnaire information on usual dietary intake. Logistic regression analyses were performed on data from 324 histologically confirmed cases of papillary or follicular carcinoma, diagnosed from 1993 to 1999, and 402 controls. Positive associations between E-DII and thyroid cancer risk were observed (comparing extreme tertiles, odds ratio = 1.67, 95% confidence interval: 1.08, 2.58; P for trend = 0.002), with stronger associations found for larger carcinomas (P for trend = 0.0005). Stratified analyses showed an increased risk of thyroid cancer associated with the E-DII among Southern province residents (P for trend = 0.003), Melanesian women (P for trend = 0.02), obese participants (P for trend = 0.006), and ever-smokers (P for trend = 0.0005). Our results suggest that a proinflammatory diet-especially when concomitant with other inflammation-inducing conditions or habits (e.g., obesity, smoking)-is associated with increased risk of thyroid carcinoma.


Assuntos
Carcinoma/epidemiologia , Dieta Saudável/estatística & dados numéricos , Dieta/efeitos adversos , Inflamação/epidemiologia , Neoplasias da Glândula Tireoide/epidemiologia , Adulto , Idoso , Carcinoma/etiologia , Estudos de Casos e Controles , Inquéritos sobre Dietas , Feminino , Humanos , Inflamação/etiologia , Modelos Logísticos , Masculino , Pessoa de Meia-Idade , Nova Caledônia/epidemiologia , Razão de Chances , Fatores de Risco , Neoplasias da Glândula Tireoide/etiologia
19.
Acta otorrinolaringol. esp ; 70(6): 315-326, nov.-dic. 2019. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-184876

RESUMO

Introducción y objetivos: El tratamiento de los pacientes con carcinoma de hipofaringe localmente avanzado incluye la cirugía o combinaciones de radioterapia y quimioterapia realizadas en el contexto de protocolos de preservación de órgano. El objetivo del presente estudio es analizar los resultados obtenidos en pacientes con tumores localmente avanzados de hipofaringe tratados en un centro a lo largo de un periodo de 30 años. Métodos: Estudio retrospectivo de 278 pacientes con tumores de hipofaringe T3-T4 tratados durante el periodo 1985-2015 en un hospital terciario. Resultados: Un 15,5% de los pacientes recibieron tratamiento paliativo, un 38,1% cirugía, habitualmente con radioterapia o quimiorradioterapia postoperatoria, y un 46,4% radioterapia o quimiorradioterapia. La supervivencia específica a los 5 años fue del 39,7% (IC 95% 33,7-45,7). La cirugía consiguió un mejor control local de la enfermedad, si bien este mejor control local no se vio reflejado en una mejoría de la supervivencia específica para los pacientes con tumores T3. La supervivencia a los 5 años libre de disfunción laríngea para los pacientes tratados de forma conservadora fue del 36,4%. De acuerdo con los resultados de un análisis multivariante, las variables que se relacionaron con un empeoramiento de la supervivencia específica fueron la categoría de extensión local T4, de extensión regional N2-N3 y la localización del tumor en la pared posterior de la hipofaringe. Conclusiones: No aparecieron diferencias significativas en función del tipo de tratamiento para los pacientes con tumores de hipofaringe T3. Para los pacientes con tumores T4 la cirugía consiguió un incremento significativo de la supervivencia


Introduction and objectives: The treatment of locally advanced carcinomas of the hypopharynx may include surgery or several combinations of radiotherapy and chemotherapy as organ preservation strategies. The objective of the present study is to analyze the results of locally advanced hypopharyngeal carcinoma patients treated in a single centre over a 30-year period. Methods: Retrospective chart review of 278 patients with T3-T4 hypopharyngeal carcinomas treated between 1985 and 2015 at a tertiary institution. Results: As much as 15.5% of the patients received only palliative treatment. Surgery, usually followed by radiotherapy or chemoradiotherapy was offered to 38.1% of the patients, and radiotherapy or chemoradiotherapy alone was offered to the remaining 46.6% of the patients. Cause-specific survival at 5 years was 39.7% (95% CI 33.7-45.7) for the whole sample. Surgery achieved better local control of the disease, but these figures did not translate into an increase of cause-specific survival for T3 tumours. Five-year survival free of laryngeal dysfunction for patients who received conservative treatment was 36.4%. In a multivariate analysis, only T4 local extension, N2-3 category, and posterior hypopharyngeal wall location related significantly with cause-specific survival. Conclusions: There were no significant differences in cause-specific survival related to treatment modality for T3 carcinomas. On the other hand, surgery achieved a significant increase in cause-specific survival for T4 hypopharyngeal carcinomas


Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Carcinoma/epidemiologia , Neoplasias Hipofaríngeas/epidemiologia , Neoplasias Hipofaríngeas/terapia , Carcinoma/terapia , Estudos Retrospectivos , Hipofaringe/patologia , Quimiorradioterapia/tendências , Quimioterapia de Indução , Protocolos de Quimioterapia Combinada Antineoplásica
20.
BMC Public Health ; 19(1): 1341, 2019 Oct 22.
Artigo em Inglês | MEDLINE | ID: mdl-31640610

RESUMO

BACKGROUND: The aim of this pilot study was to assess the feasibility of a large-scale epidemiologic investigation elucidating the quantitative association between occupational exposure to asbestos and ovarian cancer in former German asbestos workers. METHODS: Between December 2017 and May 2018, a random sample of one thousand insured woman registered at the health service of a German trade association as formerly occupationally exposed to asbestos were invited to participate in a pilot study. Participation included a phone interview using a standardised questionnaire. The feasibility of the project was evaluated using a priori defined criteria. They included response, number of cases, eligibility of the questionnaire data for exact estimation of asbestos fibre-years, and availability of relevant medical documentation (imaging procedures, medical reports, and histologic materials). RESULTS: The response (17%) was clearly below the intended number of 60%. With six tumour suspects, of which two could be confirmed by medical documents, the number of cases was within the expected range of two to eleven cases. Exact asbestos fibre-year estimations could be performed for 29% of all interviewees, but only for one suspected case. Medical documentation could be collected for only few participants, while no histology reports could be obtained for all cases. Thus, only the feasibility criterion of the expected number of cases was fulfilled. CONCLUSION: The results of the pilot study indicate that the planned project is feasible only to a very limited extent. For further planning of the study, measures to improve recruitment of participants are necessary.


Assuntos
Asbestos/toxicidade , Carcinoma/epidemiologia , Doenças Profissionais/epidemiologia , Exposição Ocupacional/efeitos adversos , Neoplasias Ovarianas/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Estudos de Viabilidade , Feminino , Alemanha/epidemiologia , Humanos , Pessoa de Meia-Idade , Exposição Ocupacional/estatística & dados numéricos , Projetos Piloto , Fatores de Risco
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