RESUMO
In numerous types of cancer, the primary tumor site can show a correlation with disease behavior and survival outcomes. In salivary gland tumors (SGTs) this association remains controversial. This study assessed the association between primary sites of SGTs and prognosis. Studies from five databases were assessed and a meta-analysis was performed using studies that presented 95 % confidence interval (95 % CI), hazard ratio (HR) and survival analysis. Gathered information from 46,361 patients showed that site had a prognostic impact on SGTs. Tumors involving minor salivary glands showed worse overall survival (HR = 1.60; 95 % CI = 1.17-2.19; p = 0.003), disease-specific survival (HR=1.63; 95 % CI = 1.12-2.37; p = 0.01), and cause-specific survival (HR=2.10; 95 % CI = 1.72-2.55; p = 0.00001). Tumors from major salivary glands showed better recurrence-free survival (HR=2.31; 95 % CI = 1.77-3.02; p = 0.00001), and locoregional control of disease (HR=2.66; 95 % CI = 1.20-5.91; p = 0.02). Our results showed that the primary site of SGTs has an impact on patient prognosis.
Assuntos
Neoplasias das Glândulas Salivares , Humanos , Prognóstico , Modelos de Riscos Proporcionais , Estudos Retrospectivos , Neoplasias das Glândulas Salivares/diagnóstico , Neoplasias das Glândulas Salivares/epidemiologia , Neoplasias das Glândulas Salivares/terapia , Análise de SobrevidaRESUMO
ABSTRACT INTRODUCTION: Frozen section is recommended in several situations to: establish the nature of a lesion; establish the presence of a lesion; confirm the presence of a benign lesion; confirm that sufficient tissue is present for diagnosis; establish the grade of the lesion; determine the organ of origin and determine the adequacy of margins. OBJECTIVES: To evaluate the accuracy of frozen section biopsy in multiple organs and analyze possible factors in discrepancy. METHODS: A retrospective study was carried out during a five-year period at a teaching hospital of Recife, Pernambuco, Brazil. The diagnoses of frozen section were compared with results obtained in the permanent section and classified as concordant or discordant. The discordant cases were reviewed by a pathologist and subdivided into false positives and false negatives. Possible reasons for discrepancy were indicated. RESULTS: A total of 1.226 specimens were analyzed, of which 1.181 (96.33%) were concordant and 45 (3.67%) were discordant. After the review of the discordant cases, 39 remained, six (15.4%) were false positives and 33 (84.6%) were false negatives. The tissue that had most false-positive results was mammary sentinel lymph node (3/1.2%), whereas ovarian showed most false negative outcomes with 17 specimens (51.51% of all false negatives). The possible reasons for discrepancy were sampling error, misunderstanding and complexity of the diagnosis. CONCLUSION: The frozen section accuracy of 96.3% found in our study is similar to specialized literature and does not seem to depend on the tissue analyzed.
RESUMO INTRODUÇÃO: O exame intraoperatório por congelação (EIC) visa avaliar histológica e intraoperatoriamente um pequeno fragmento de tecido ou órgão lesado no qual haja dúvida diagnóstica. Entre as indicações do EIC estão a determinação da natureza e a extensão da lesão, com consequente diferenciação entre lesões benignas e malignas, além da análise das margens cirúrgicas. OBJETIVOS: Avaliar a acurácia do EIC em múltiplos órgãos e analisar possíveis fatores de interferência. MÉTODOS: Foi realizado um estudo retrospectivo em um período de cinco anos (entre janeiro de 2011 e março de 2016) em um hospital de ensino da cidade do Recife, Pernambuco, Brasil. Os resultados dos EICs foram comparados com os laudos finais após o processamento histopatológico e classificados como concordantes ou discordantes. Os casos discordantes foram revistos por patologista e subdivididos em falso-positivos e falso-negativos. Possíveis causas para a discordância dos exames foram levantadas. RESULTADOS: Foram analisadas 1.226 peças cirúrgicas, das quais 1.181 (96, 33%) foram concordantes e 45 (3, 67%), discordantes. Após reavaliação dos casos discordantes, 39 permaneceram, sendo seis (15, 4%) falso-positivos e 33 (84, 6%) falso-negativos. A estrutura que mais apresentou resultado falso-positivo foi o linfonodo sentinela mamário (3/1, 2%), enquanto o ovário foi o órgão com mais resultados falso-negativos, com 17 amostras, 51, 51% de todos os casos negativos. As possíveis causas para a discordância foram tamanho da amostra, limitação do método e complexidade do diagnóstico. CONCLUSÃO: A acurácia do EIC encontrada neste estudo foi de 96, 3% e é semelhante à literatura especializada.
RESUMO
Los tumores cardíacos primarios son una afección rara, con incidencias menores al 0.3% en series de necropsias. Objetivos: Determinar las características demográficas, clínicas, terapéuticas y evolución de los pacientes con tumor cardíaco atendidos en un hospital general. Material y métodos: Estudio retrospectivo y descriptivo, tipo serie de casos. Se revisó la base de datos del Servicio para identificar los pacientes con diagnóstico final de tumor cardíaco, desde enero de 2008 a septiembre de 2015. Se revisaron las historias clínicas disponibles y se obtuvo el reporte de patología de los pacientes. Se determinaron las características clínicas de la población. Resultados: Se encontraron 10 pacientes que contaban con datos clínicos y de patología completos. La localización más común fue la aurícula izquierda. Los síntomas iniciales principales fueron disnea y síndrome de falla cardíaca congestiva. Las causas de muerte no pudieron ser identificadas. Conclusiones: La población de pacientes analizada tiene una distribución comparable con los reportes a nivel mundial. La neoplasia cardíaca más común fue el mixoma localizado en la aurícula izquierda. (AU)
Primary heart tumors are rare conditions with an incidence of less than 0.3% in necropsy studies. Objectives: To determine demographic, clinical and therapeutic features of primary heart tumors in a general hospital. Methods: A retrospective and descriptive study was carried out from January 2008 to September 2015. A hospital data base was reviewed to identify patients with the diagnosis of primary heart tumors, clinical charts and pathology reports were reviewed. Results: 10 patients with complete information were found. The most common location was the left atrium. Dyspnea and congestive heart failure were the main clinical onset manifestations. Causes of death could not be determined. Conclusions: The most common heart tumor was left atrial myxoma which correlates with what is reported worldwide. (AU)
Assuntos
Humanos , Masculino , Feminino , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias Cardíacas , Estudos de Casos e Controles , Epidemiologia Descritiva , Estudos RetrospectivosRESUMO
OBJETIVO: Determinar la clínica asociada a la localización del cáncer de colon en pacientes del Hospital Nacional Arzobispo Loayza durante el periodo mayo 2009 - setiembre 2013. MATERIAL Y MÉTODOS: estudio transversal que analizó información de 114 pacientes con neoplasia maligna primaria de colon, de los cuales 42 cumplieron los criterios de inclusión; internados en el Servicio 6-II del Departamento de Cirugía General del Hospital Nacional Arzobispo Loayza entre mayo 2009 y setiembre 2013. RESULTADOS: La media de edad fue de 60.5 años, y predominó el género femenino con 66.7%. El 100% de los tipos histológicos fue adenocarcinoma. El colon derecho resultó afectado en 61.9%, el izquierdo en 33,3% y un 4,8% presentó localización mixta. En la topografía, se halló 33,3% en colon ascendente y 21,4% en colon sigmoides. Los síntomas más frecuentes fueron dolor abdominal (76,2%), pérdida de peso (69%) y anemia (64%). Para el colon derecho, hubo 13 veces más riesgo de presentar astenia, y 4.44 veces más riesgo de presentar anemia (p<0,05). CONCLUSIÓN: La localización de cáncer de colon más frecuente fue en el colon derecho, el cual se asoció significativamente a la presencia de astenia y anemia en el cuadro clínico. Los síntomas más presentados fueron el dolor abdominal y la pérdida de peso, en cualquiera de sus localizaciones. Todos los casos fueron de adenocarcinoma. (Horiz Med 2015; 15(2): 49-55)
OBJECTIVE: To determine the association between the clinical characteristics and the location of colon cancer in patients hospitalized at "Hospital Nacional Arzobispo Loayza", during May 2009 - September 2013. MATERIAL AND METHODS: transversal study of 144 patients with primary colon cancer, of which 42 patients met the inclusion criteria; hospitalized in the 6-II Wing of the Department of General Surgery at "Hospital Nacional Arzobispo Loayza", between May 2009 and September 2013. RESULTS: the mean age was 60.5 years, and 66.7% of the cases were women. 100% of histologic types were adenocarcinoma. The right colon was affected in 61.9% of the cases; the left colon in 33.3%, and a mixed location in 4,8%. Regarding the topography, 33,3% of the cases were found in the ascending colon and 21,4% in the sigmoid colon. The most frequent symptoms were abdominal pain (76.2%), weight loss (69%) and anemia (64%). For right colon cancer, fatigue was 13 times more likely to appear, and anemia was 4.44 times more likely (p< 0.05). CONCLUSION: the most common location for cancer was in the right colon, and it was associated significantly with the presence of fatigue and anemia among the clinical characteristics. The most frequent symptoms were abdominal pain and weight loss, in any location. All cases were adenocarcinoma. (Horiz Med 2015; 15(2): 49-55)
Assuntos
Humanos , Masculino , Feminino , Idoso , Sintomas Cancerínicos , Neoplasias do Colo , Relatos de Casos , Estudos TransversaisRESUMO
Background: Maps have played a critical role in public health since 1855, when John Snow associated a cholera outbreak with contaminated water source in London. After cardiovascular diseases, cancer is the second leading cause of death in Chile. Cancer was responsible for 22.7 percent of all deaths in 1997-2004 period. Aim To describe the geographical distribution of stomach, trachea, bronchi and lung cancer mortality. Material and methods: Mortality statistics for the years 1997-2004, published by the National Statistics Institute and Chilean Ministry of Health, were used. The standardized mortality ratio (SMR) for sex and age quinquennium was calculated for 341 counties in the country. A hierarchical Bayesian analysis of Poisson regression models for SMR was performed. The maps were developed using adjusted SMR (or smoothed) by the Poisson model. Results: There is an excess mortality caused by stomach cancer in south central Chile, from Teno to Valdivia. There is an excess mortality caused by trachea, bronchi and lung cancer in northern Chile, from Copiapó to Iquique. Conclusions: The geographical analysis of mortality caused by cancer shows cluster of counties with an excess risk. These areas should be considered for health care decision making and resource allocation.