Neoplasia avançada de esôfago: diagnóstico ainda muito tardio

Thuler, Fernanda Prata Borges Martins; Forones, Nora Manoukian; Ferrari, Ângelo Paulo

doi:10.1590/s0004-28032006000300010

Cited by 14 publications

(16 citation statements)

References 27 publications

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“…Uma vez que o tratamento curativo não é mais possível, o alívio da disfagia e a melhora da qualidade de vida tornam-se os objetivos principais da terapêutica. 15 No estudo apresentado também encontrou-se apenas um caso de câncer de intestino delgado, o que vai de encontro ao levantamento realizado pelo "National Cancer Institute" que confirma sua baixa prevalência, representando cerca de menos de 1% dos cânceres nos EUA. 16 Baseado em dados do World Journal Gastrointestinal Oncology (2011) o prognóstico normalmente é reservado, uma sobrevida global de menos de 30% em 5 anos.…”

Section: Discussionunclassified

Overall survival of gastrointestinal cancer patients in a countryside city of Minas Gerais

Mendes¹,

Santos²,

Assis³

et al. 2018

Revista Médica De Minas Gerais

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Introduction: Gastrointestinal cancers survival studies are important in evaluating efficacy of treatments and probable prognostic. Objective: To correlate clinical and socio-epidemiological variables with the survival of patients diagnosed with cancer of the gastrointestinal tract in a hospital in a countryside city of Minas Gerais. Methods: Retrospective, cross-sectional, clinical study carried out through the analysis of 426 medical records of patients diagnosed with gastrointestinal tract cancer from 2010 to 2014. Patients were selected by checking Hospital Cancer Records. The conditional probability of survival was calculated using the Kaplan-Meier method. Results: Most patients were male (62.29%), 70 to 95 years (29.39%), fair-skinned (65.80%),low education level (54.39%), from the Unified Health System (78.29%) with no history of tobacco (44.59%) or alcoholic consumption (60.00%). The most affected site was the large intestine (35.14%), and the predominant stage was stage III (53.28%). The overall survival was 16.5%. Conclusion: Variables relevant to survival were cancer site, educational level, history of tabagism, origin of cancer, clinical staging and basis for diagnosis. Esophagus cancer presented the lowest survival time, with a median of 248 days.

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Section: Discussionunclassified

Overall survival of gastrointestinal cancer patients in a countryside city of Minas Gerais

Mendes¹,

Santos²,

Assis³

et al. 2018

Revista Médica De Minas Gerais

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“…All patients were male. This gender specificity is probably related with tobacco and alcohol consumption of male patients (6,11,15) . Gastrostomy should performed be as early as possible.…”

Section: Discussionmentioning

confidence: 97%

Percutaneous endoscopic gastrostomy for nutritional palliation of upper esophageal cancer unsuitable for esophageal stenting

Grilo

Santos

Fonseca

2012

Arq. Gastroenterol.

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-Context -Esophageal cancer is often diagnosed at an advanced stage and has a poor prognosis. Most patients with advanced esophageal cancer have significant dysphagia that contributes to weight loss and malnutrition. Esophageal stenting is a widespread palliation approach, but unsuitable for cancers near the upper esophageal sphincter, were stents are poorly tolerated. Generally, guidelines do not support endoscopic gastrostomy in this clinical setting, but it may be the best option for nutritional support. Objective -Retrospective evaluation of patients with dysphagia caused advanced esophageal cancer, no expectation of resuming oral intake and with percutaneous endoscopic gastrostomy for comfort palliative nutrition. Method -We selected adult patients with unresecable esophageal cancer histological confirmed, in whom stenting was impossible due to proximal location, and chemotherapy or radiotherapy were palliative, using gastrostomy for enteral nutrition. Clinical and nutritional data were evaluated, including success of gastrostomy, procedure complications and survival after percutaneous endoscopic gastrostomy, and evolution of body mass index, albumin, transferrin and cholesterol. Results -Seventeen males with stage III or IV squamous cell carcinoma fulfilled the inclusion criteria. Mean age was 60.9 years. Most of the patients had toxic habits. All underwent palliative chemotherapy or radiotherapy. Gastrostomy was successfully performed in all, but nine required prior dilatation. Most had the gastrostomy within 2 months after diagnosis. There was a buried bumper syndrome treated with tube replacement and four minor complications. There were no cases of implantation metastases or procedure related mortality. Two patients were lost and 12 died. Mean survival of deceased patients was 5.9 months. Three patients are alive 6, 14 and 17 months after the gastrostomy procedure, still increasing the mean survival. Mean body mass index and laboratory parameters were roughly stable 1 and 3 months after the gastrostomy procedure. Conclusions -In patients with advanced upper esophageal cancer where only palliative treatment is possible, nutritional support is easily achieved with percutaneous endoscopic gastrostomy, allowing patients to be at homes, surviving a significant period of time. Percutaneous endoscopic gastrostomy feeding should be considered as standard definitive nutritional palliation in patients with upper esophageal cancer, unsuitable for esophageal stenting. HEADINGS -Gastrostomy. Esophageal neoplasms. Nutritional support.

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“…Late diagnosis is one of the factors responsible for this scenario, and thus, most patients are provided with palliative therapy. 18 The presence of comorbidities is considered to be an important prognostic factor in cancer cases, as are the assessment and evolution of these conditions and their severity. Some authors have indicated that studies based on retrospective hospital-based cohorts have signifi cant limitations with regard to correlating these smokingrelated clinical conditions with certain outcomes, as concluded by Tho et al 19 Even though the comorbidity frequency data from the present study did not allow any correlation between the presence of these conditions and greater use of healthcare resources, a considerable proportion of the patients presented comorbidities associated with the diagnosis of cancer, notably heart and lung diseases.…”

Section: Discussionmentioning

confidence: 99%

Custo do tratamento de pacientes com histórico de tabagismo em hospital especializado em câncer

Pinto

Ugá

2011

Rev. Saúde Pública

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OBJECTIVE:To describe the costs of treating lung, laryngeal and esophageal cancer among patients with histories of smoking. METHODS:A longitudinal non-concurrent study on three cohorts with histories of smoking at a specialized hospital was carried out in the city of Rio de Janeiro, Southeastern Brazil, between 2000 and 2006. The sample was composed of 127 cases of lung cancer, 80 of laryngeal cancer and 35 of esophageal cancer. These cancers were selected through analyzing the frequencies and monetary values of the hospital admissions, weighted according to the fraction attributable to smoking among the population. Data were gathered from the medical fi les. Patients were classifi ed according to their smoking profi le, primary diagnosis, stage and comorbidities. The statistical analysis included the log-normal distribution to adjust for cost values and the Spearman correlation. RESULTS:The patients were heavy smokers and were diagnosed at advanced stages. The burden from smoking was high, and 92%, 72% and 94% of lung, laryngeal and esophageal cancer patients, respectively, were diagnosed at advanced stages. The most frequent comorbidities were heart diseases and respiratory diseases. The mean costs of lung, laryngeal and esophageal cancers were R$ 28,901, R$ 37,529 and R$ 33,164, respectively. The main cost drivers were radiotherapy and hospitalization. There was an association between advanced stage and lower cost for lung and esophageal cancer. CONCLUSIONS:Since radiotherapy and hospitalization were the main total cost drivers, patients at more severe stages presented lower costs, probably because of the reduction in the number of therapeutic options.

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Neoplasia avançada de esôfago: diagnóstico ainda muito tardio

Cited by 14 publications

References 27 publications

Overall survival of gastrointestinal cancer patients in a countryside city of Minas Gerais

Overall survival of gastrointestinal cancer patients in a countryside city of Minas Gerais

Percutaneous endoscopic gastrostomy for nutritional palliation of upper esophageal cancer unsuitable for esophageal stenting

Custo do tratamento de pacientes com histórico de tabagismo em hospital especializado em câncer

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