Background: Despite recent advances in diagnosis and treatment, esophageal cancer still has high mortality. Prognostic factors associated with patient and with disease itself are multiple and poorly explored. Aim: Assess prognostic variables in esophageal cancer patients. Methods: Retrospective review of all patients with esophageal cancer in an oncology referral center. They were divided according to histological diagnosis (444 squamous cell carcinoma patients and 105 adenocarcinoma), and their demographic, pathological and clinical characteristics were analyzed and compared to clinical stage and overall survival. Results: No difference was noted between squamous cell carcinoma and esophageal adenocarcinoma overall survival curves. Squamous cell carcinoma presented 22.8% survival after five years against 20.2% for adenocarcinoma. When considering only patients treated with curative intent resection, after five years squamous cell carcinoma survival rate was 56.6 and adenocarcinoma, 58%. In patients with squamous cell carcinoma, poor differentiation histology and tumor size were associated with worse oncology stage, but this was not evidenced in adenocarcinoma. Conclusion: Weight loss (kg), BMI variation (kg/m²) and percentage of weight loss are factors that predict worse stage at diagnosis in the squamous cell carcinoma. In adenocarcinoma, these findings were not statistically significant.
-Background -Most prevalent esophageal neoplasm is squamous cell carcinoma and adenocarcinoma. Other tumors are uncommon and poorly studied. Primary neuroendocrine esophageal neoplasm is a rare carcinoma and most of its therapy management is based on lung neuroendocrine studies. Neuroendocrine tumors can be clustered in the following subtypes: high grade (small cell carcinoma or large cell carcinoma) and low grade (carcinoids). Objective -The present study aims to assess clinical and pathological neuroendocrine esophageal tumors in a single oncologic center.Methods -A retrospective analysis of patients and review of the literatures was performed. Results -Fourteen patients were identified as neuroendocrine tumors, 11 male and 3 female patients. Mean age was 67.3 years old. Ten patients were classified as small cell, 3 as large cell and 1 as carcinoid. Four patients presented squamous cell carcinoma simultaneously and 1 also presented adenocarcinoma. Main sites of metastasis were liver, peritoneum, lung and bones. Most patients died before 2 years of follow-up. Patient with longer survival died at 35 months after diagnosis. Conclusion -Neuroendocrine esophageal tumors are rare; affect mainly men in their sixties or seventies. High grade tumors can be mixed to other subtypes neoplasms, such as adenocarcinoma and squamous cell carcinoma. Most of these patients have poor overall survival rates. HEADINGS -Esophageal neoplasms. Carcinoid tumor. Neuroendocrine carcinoma.
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INTRODUÇÃO: A necessidade de um ensino baseado em comunidade para a formação de profissionais de saúde mais humanizados é evidente e mandatória. A Extensão Médica Acadêmica surge nesse âmbito buscando estimular a formação de profissionais de saúde mais humanizados desde os primeiros anos de faculdade. Estruturado como um projeto de voluntariado que engloba diversos cursos da saúde (fisioterapia, nutrição, fonoaudiologia e medicina), busca-se promover o contato do aluno com a prática profissional, mantendo-o estimulado a estudar, melhorando suas habilidades técnicas e fornecendo atendimento de saúde multiprofissional de qualidade. OBJETIVOS: Analisar a percepção dos membros de medicina quanto ao aprendizado e humanização. Levantar o número de atendimentos e membros por ano nos últimos 6 anos. Analisar a estrutura organizacional do projeto e verificar se atende aos seus objetivos. MÉTODOS: Foram coletados dados dos atendimentos no período de 2009 a 2014, calculando número de atendimentos, número de voluntários por curso, e número de alunos de medicina por ano de graduação. Dados foram obtidos pelo Projeto de Satisfação com questionário respondido por 68 alunos de medicina contendo 5 questões formuladas na escala de Likert de 5 pontos. Utilizamos o Ranking Médio (RM) das respostas para analisar os dados coletados. RESULTADOS: Houve aumento gradativo dos membros, com predomínio de alunos de medicina e dos primeiros anos da faculdade. No primeiro semestre de 2015 existiam 252 acadêmicos, e 40 profissionais. Dos questionários obteve-se um RM de percepção de aprendizado de 4,162 e percepção de humanização de 3,964, sendo 67,6% dos entrevistados alunos do primeiro ano. O total de consultas foi de 1656 e 597 coletas de exames laboratoriais. CONCLUSÃO: A EMA atinge seus objetivos, com um RM de 3,964 na percepção de humanização e 4,162 na de aprendizado. Além disso, observou-se um aumento de voluntários no projeto, e um grande impacto para as comunidades atendidas.
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