BACKGROUNDMelanoma is one of the conditions with greater increase in incidence
worldwide in recent decades. It is a skin cancer with potential high
lethality and predominates in Caucasian adults. Treatment of primary
cutaneous melanoma is essentially surgical and search for sentinel lymph
node can modify the aggressiveness of the treatment.OBJECTIVETo analyze the epidemiological profile of patients diagnosed with primary
cutaneous melanoma, histopathological features and compare with literature
data.METHODSThis is a retrospective, observational, single-center, case series study of
patients with primary cutaneous melanoma, who underwent surgery between
January 2008 and December 2013. The parameters include: Age, sex, clinical
stage, date of surgery, tumor location, histological subtype, condition of
surgical margins, Breslow thickness, mitotic index, presence of ulceration
and metastasis on admission.RESULTSWe included 321 melanoma patients who were treated at Hospital Erasto
Gaertner. The population consisted of 58.9% females and 41.1% males with an
average age of 52.8 ± 16.3 years. As for the clinical stage, 51.1%
were in the initial stage, 24.3% in the clinical stage II (A, B and C),
21.2% in clinical stage III and 3.4% with distant metastases. The most
frequent location of the primary melanoma was the trunk, and the
histological subtype was superficial spreading pattern. Intermediate and
thick melanomas were the most frequent.STUDY LIMITATIONSThis is a retrospective study and some information and data could be
incomplete or absent.CONCLUSIONThe diagnosis and treatment of melanoma in early stages provides less
morbidity and improved survival of patients. Understanding the biological
behavior of tumor and knowing the local epidemiology guide health
strategies.
Background and Objectives
The primary treatment for locally advanced cases of cervical cancer is chemoradiation followed by high‐dose brachytherapy. When this treatment fails, pelvic exenteration (PE) is an option in some cases. This study aimed to develop recommendations for the best management of patients with cervical cancer undergoing salvage PE.
Methods
A questionnaire was administered to all members of the Brazilian Society of Surgical Oncology. Of them, 68 surgeons participated in the study and were divided into 10 working groups. A literature review of studies retrieved from the National Library of Medicine database was carried out on topics chosen by the participants. These topics were indications for curative and palliative PE, preoperative and intraoperative evaluation of tumor resectability, access routes and surgical techniques, PE classification, urinary, vaginal, intestinal, and pelvic floor reconstructions, and postoperative follow‐up. To define the level of evidence and strength of each recommendation, an adapted version of the Infectious Diseases Society of America Health Service rating system was used.
Results
Most conducts and management strategies reviewed were strongly recommended by the participants.
Conclusions
Guidelines outlining strategies for PE in the treatment of persistent or relapsed cervical cancer were developed and are based on the best evidence available in the literature.
Background
Approximately 70% of cancer‐related deaths occur in low‐ and middle‐income countries. In addition to social and racial inequalities, treatment options in these countries are usually limited because of the lack of trained staff and equipment, limited patient access to health services, and a small number of clinical guidelines.
Objectives
The Brazilian Society of Surgical Oncology developed this guideline to address these barriers and guide physicians treating patients with endometrial cancer (EC) in regions with limited resources and few specialized centers.
Methods
The guideline was prepared from 10 January to 25 October 20192019 by a multidisciplinary team of 56 experts to discuss the main obstacles faced by EC patients in Brazil. Thirteen questions considered critical to the surgical treatment of these patients were defined. The questions were assigned to groups that reviewed the literature and drafted preliminary recommendations. Following a review by the coordinators and a second review by all participants, the groups made final adjustments for presentations in meetings, classified the level of evidence, and voted on the recommendations.
Results
For all questions including staging, fertility spearing treatment, genetic testing, sentinel lymph node use, surgical treatment, and other clinical relevant questions, major agreement was achieved by the participants, always using accessible alternatives.
Conclusions
It is possible to provide adequate treatment for most EC patients in resource‐limited areas, but the first option should be referral to specialized centers with more resources.
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