Aim To assess the epidemiological and clinical factors that influence the prognosis of oral and oropharyngeal squamous cell carcinoma (SCC). Methods One hundred and twenty-one cases of oral and oropharyngeal SCC were selected. The survival curves for each variable were estimated using the Kaplan-Meier method. The Cox regression model was applied to assess the effect of the variables on survival. Results Cancers at an advanced stage were observed in 103 patients (85.1%). Cancers on the tongue were more frequent (23.1%). The survival analysis was 59.9% in one year, 40.7% in two years, and 27.8% in 5 years. There was a significant low survival rate linked to alcohol intake (p = 0.038), advanced cancer staging (p = 0.003), and procedures without surgery (p < 0.001). When these variables were included in the Cox regression model only surgery procedures (p = 0.005) demonstrated a significant effect on survival. Conclusion The findings suggest that patients who underwent surgery had a greater survival rate compared with those that did not. The low survival rates and the high percentage of patients diagnosed at advanced stages demonstrate that oral and oropharyngeal cancer patients should receive more attention.
Resumo Objetivo Estimar se variáveis clínicas e epidemiológicas influenciam no atraso do diagnóstico em dois centros de referência. Métodos Foi realizado um estudo analítico longitudinal retrospectivo. Todos os prontuários de pacientes maiores de 18 anos diagnosticados no período de junho de 2005 a junho de 2013 foram analisados por meio do SPSS® 20. Para testar associações entre as variáveis epidemiológicas e clínicas com os atrasos do paciente e do profissional, foram utilizados os testes: ANOVA, t de Student e Kruskal-Wallis. Resultados Foram incluídos no estudo 121 prontuários. Prevaleceram pacientes do sexo masculino, com idade média de 64,3 anos (DP=12,94), pardos, procedentes do interior, analfabetos, tabagistas e etilistas. A grande maioria (85,1%) foi diagnosticada nos estádios avançados. O maior atraso estava relacionado ao paciente, com média de tempo de 197,8 dias (DP=323,9). O atraso no diagnóstico profissional foi de 20 dias (DP=25,9), e aquele relacionado ao sistema de saúde foi de 71,1 dias (DP=71,7). Não houve associação entre as variáveis clínicas/epidemiológicas e o atraso no diagnóstico (do paciente e do profissional). Conclusão De acordo com os resultados do presente estudo, as variáveis clínicas e epidemiológicas não influenciam no atraso do diagnóstico.
Objective: the aim of this study was to analyze possible associations between the epidemiological variables of the study and the clinical stage and malignancy grade of squamous cell carcinomas (SCCs) of the oral cavity and oropharynx, and to evaluate whether there is a correlation between clinical stage and histological grade in SCCs. Material and Methods: retrospective analytical study of SCCs cases diagnosed between June 2005 and December 2013. The data from medical records and histopathological findings of patients over 18 years old were entered into an Excel® spreadsheet and analyzed by SPSS® 20, using the chi-square and Fisher's exact tests to analyse the variables. The level of significance of the tests was 0.05. Results: patients were predominantly black, male, illiterate, in their sixth decade of life, living in country towns and exposed to tobacco and alcohol. There was also predominance of advanced-stage tongue lesions with high-grade malignancy treated with combined radiotherapy and chemotherapy treatment. There was association between exposure to alcohol with advanced stage at diagnosis (p=<0.001). Conclusion: association of alcohol consumption with more advanced lesions at diagnosis underscores the need to address the risk factors more emphatically. Although classic factors implicated in the course of oral and oropharyngeal SCC have been observed, it is remarkable the high frequency of illiterate patients coming from country towns, which could have hampered the access to health care and contributed to a delayed diagnosis and thus, to a poorer prognosis.
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