RESUMO
BACKGROUND: Population-based cancer registries (PBCRs) are the primary source of information for cancer surveillance and monitoring. Currently, there are 30 active PBCRs in Brazil. The objective of this study was to analyze the data quality of five gastrointestinal cancers (esophagus, stomach, colorectal, liver, and pancreas) according to the criteria of comparability, validity, completeness, and timeliness in Brazilian cancer registries. METHODS: This study included data from Brazilian PBCRs with more than ten years of historical data starting in the year 2000, regardless of the type of defined geographical coverage (state, metropolitan region, or capital), totaling 16 registries. Brazilian PBCRs were evaluated based on four international data quality criteria: comparability, validity (accuracy), completeness, and timeliness. All cancer cases were analyzed, except for nonmelanoma skin cancer cases (C44) and five gastrointestinal tumors (esophageal cancer, stomach cancer, colorectal cancer, liver cancer, and pancreatic cancer) per cancer registry and sex, according to the available period. RESULTS: The 16 Brazilian PBCRs represent 17% of the population (36 million inhabitants in 2021) according to data from 2000 to 2018. There was a variation in the incidence in the historical series ranging from 12 to 19 years. The proportion of morphologically verified (MV%) cases varied from 74.3% (Manaus) to 94.8% (Aracaju), and the proportion of incidentally reported death certificate only (DCO%) cases varied from 3.0% (São Paulo) to 23.9% (Espírito Santo). High-lethality malignant neoplasms, such as liver and pancreas, had DCO percentages greater than 30% in most cancer registries. The sixteen registries have more than a 48-month delay in data release compared to the 2022 calendar year. CONCLUSION: The studied Brazilian cancer registries met international comparability criteria; however, half of the registries showed indices below the expected levels for validity and completeness criteria for high-lethality tumors such as liver and pancreas tumors, in addition to a long delay in data availability and disclosure. Significant efforts are necessary to ensure the operational and stability of the PBCR in Brazil, which continues to be a tool for monitoring cancer incidence and assessing national cancer control policies.
Assuntos
Confiabilidade dos Dados , Neoplasias Gastrointestinais , Sistema de Registros , Humanos , Sistema de Registros/estatística & dados numéricos , Brasil/epidemiologia , Neoplasias Gastrointestinais/epidemiologia , Masculino , Feminino , Incidência , Neoplasias Pancreáticas/epidemiologia , Vigilância da PopulaçãoRESUMO
INTRODUCTION: Ultra-processed food (UPF) intake has been associated with a higher risk of obesity, hypertension, type 2 diabetes, and cardiovascular diseases. The initial data on the relationship between UPF consumption and cancer risk were derived from retrospective observational studies with conflicting results. This systematic review and meta-analysis of prospective cohort studies aimed to investigate the association between UPF consumption and gastrointestinal cancer risk. METHODS: PubMed, Embase, and Cochrane databases were searched for prospective cohort studies that compared the highest vs the lowest level of UPF consumption according to NOVA food classification and reported the risk of gastrointestinal cancers by subsite. The association with cancer was quantified as hazard ratios (HR) using a random-effects model. RESULTS: Five prospective cohort studies were included in this review comprising 1,128,243 participants (241,201 participants in the highest and 223,366 in the lowest levels of UPF consumption). The mean follow-up ranged from 5.4 to 28 years. The highest UPF consumption was significantly associated with an increased risk of colorectal cancer (HR 1.11; 95% confidence interval [CI] 1.03-1.21; P = 0.01; I2 = 31%), colon cancer (HR 1.12; 95% CI 1.02-1.23; P = 0.02; I2 = 0%), and non-cardia gastric cancer (HR 1.43; 95% CI 1.02-2.00; P = 0.04; I2 = 0%) compared with the lowest UPF intake. However, no association was found between high UPF consumption and hepatocellular, esophageal, pancreatic, gastric cardia, and rectal cancer. DISCUSSION: The highest level of UPF consumption was significantly associated with colorectal and non-cardia gastric cancer.
Assuntos
Fast Foods , Neoplasias Gastrointestinais , Humanos , Neoplasias Gastrointestinais/epidemiologia , Neoplasias Gastrointestinais/etiologia , Fast Foods/efeitos adversos , Fatores de Risco , Neoplasias Colorretais/epidemiologia , Neoplasias Colorretais/etiologia , Neoplasias Gástricas/epidemiologia , Neoplasias Gástricas/etiologia , Alimento ProcessadoRESUMO
BACKGROUND & AIMS: Obesity and non-alcoholic fatty liver disease (NAFLD) are known risk factors for gastrointestinal (GI) cancers. However, GI carcinogenesis in lean NAFLD patients remains unclear. This systematic review and meta-analysis aims to investigate the association between lean NAFLD and GI cancer risk. METHODS: PubMed, Embase and Cochrane Library databases were systematically searched (from inception date to April 2023) for cohort studies assessing GI cancers in lean (body mass index [BMI] < 25 kg/m2 or < 23 kg/m2 in Asians) and non-lean (BMI ≥25 kg/m2 or ≥ 23 kg/m2 in Asians) NAFLD individuals. Data from eligible studies were extracted, and meta-analysis was carried out using a random effects model to obtain risk ratios (RRs) with 95% confidence intervals (CIs). Subgroup analyses, meta-regressions and sensitivity analyses were also performed. This study was registered in PROSPERO (CRD42023420902). RESULTS: Eight studies with 56,745 NAFLD individuals (11% were lean) and 704 cases of incident GI cancers were included. Lean NAFLD was associated with higher risk of hepatic (RR 1.77, 95% CI 1.15-2.73), pancreatic (RR 1.97, 95% CI 1.01-3.86) and colorectal cancers (RR 1.53, 95% CI 1.12-2.09), compared to non-lean NAFLD. No significant differences were observed for oesophagus, gastric, biliary and small intestine cancers. CONCLUSIONS: This study shows that lean NAFLD patients have an increased risk of liver, pancreatic and colorectal cancers compared to non-lean NAFLD patients, emphasizing the need to explore tailored cancer prevention strategies for this specific patient group. Further research is required to explore the mechanisms underlying the association between lean NAFLD and specific GI cancers.
Assuntos
Neoplasias Colorretais , Neoplasias Gastrointestinais , Hepatopatia Gordurosa não Alcoólica , Humanos , Hepatopatia Gordurosa não Alcoólica/complicações , Hepatopatia Gordurosa não Alcoólica/epidemiologia , Fatores de Risco , Neoplasias Gastrointestinais/epidemiologia , Neoplasias Gastrointestinais/complicações , Neoplasias Colorretais/complicaçõesRESUMO
Introdução: Para garantir o melhor atendimento aos pacientes portadores de tumores gastrointestinais, caracterizados de alta complexidade, o Tumor Board (TB) traz benefícios já destacados em literatura diante à decisão entre as diversas opções de terapias multimodais que crescem nas últimas décadas1,5-8. As condutas recomendadas pelos especialistas devem ser acompanhadas para identificar barreiras que possam interferir na execução do melhor cuidado para o paciente decidido previamente. Objetivo: Avaliar o perfil epidemiológico, a aderência às condutas recomendadas, o motivo da não realização e sobrevida dos casos de pacientes discutidos em Tumor Boards de Oncologia Gastrointestinal (TGI): TB Aparelho Digestivo Alto e Tumores Colorretais no AC Camargo Cancer Center. Métodos: Estudo retrospectivo de pacientes discutidos nas reuniões de TB do aparelho digestivo alto e tumores colorretais de 1 de Abril de 2019 à 1 de Abril de 2020. Dados epidemiológicos, se a conduta de TB foi realizada, o motivo da não realização, o status de vida em 90 dias após decisão de TB e quantas vezes cada paciente foi discutido em reunião foram coletados. As variáveis categóricas foram comparadas pelo teste de qui-quadrado e teste exato de fisher. A análise de regressão logística foi realizada para avaliar fatores associados à não realização da conduta TB. Resultados: 658 casos, 553 pacientes, predominantemente do sexo masculino (51%), com neoplasia maligna do cólon (17%), não tabagistas (65%), não etilistas (75%), com estadiamento IV (41%), com comorbidades (63%). A conduta do TB é realizada em 83% dos casos e o motivo mais evidente para o não cumprimento das condutas é a perda de seguimento (48%). O núcleo TB de tumores colorretais apresentou 1,6 vezes mais chance da não realização da conduta determinada em TB (Odds Ratio = 1,61), enquanto a ausência da equipe solicitada na discussão foi associada a 3 vezes mais chance relativa (Odds Ratio = 3,02) de não seguir com conduta recomendada. Os pacientes de fonte pagadora particular possuíam 5 vezes mais chance da não realização da conduta quando comparado aos pacientes de convênio (Odds Ratio = 5,27) e os casos referentes aos pacientes SUS mostraram que estes apresentam 52% mais probabilidade de realização da conduta em relação aos pacientes de convênio (Odds Ratio = 0,48). Em 90 dias após a discussão do caso em TB, 94,7% dos pacientes estavam vivos, a mediana de vida foi 87 dias. Conclusão: A conduta do TB é realizada na maior parte dos casos e o motivo mais evidente para o não cumprimento das condutas é a perda de seguimento.
Introduction: To ensure the best care for patients with gastrointestinal tumors, characterized by high complexity, the Tumor Board (TB) brings benefits already highlighted in the literature before the decision between the various options of multimodal therapies that have grown in recent decades 1,5-8. The procedures recommended by specialists should be followed to identify barriers that may interfere with the execution of the best care for the patient previously decided. Objective: To evaluate the epidemiological profile, adherence to recommended management, reasons for non-performance and survival of cases of patients discussed on Gastrointestinal: TB Upper gastrointestinal tract and Colorectal Oncology Tumor Boards at the AC Camargo Cancer Center. Methods: Retrospective study of patients discussed at upper digestive tract TB and colorectal tumor boards from April 1, 2019 to April 1, 2020. Epidemiological data, whether TB management was performed, the reason for nonperformance, life status in 90 days after TB decision, and how many times each patient was discussed in meeting were collected. Categorical variables were compared by chi-square test and Fisher's exact test. Logistic regression analysis was performed to assess factors associated with not performing TB management. Results: 658 cases, 553 patients, predominantly male (51%), with colon malignancy (17%), non-smokers (65%), non-drinkers (75%), staged IV (41%), with comorbidities (63%). TB management is performed in 83% of cases and the most obvious reason for noncompliance with management is loss to follow-up (48%). Colorectal tumor TB core had 1.6 times more chance of not performing the determined TB management (Odds Ratio = 1.61), while absence of the requested team in the discussion was associated with 3 times more relative chance (Odds Ratio = 3.02) of not following through with recommended management. Private payer patients were 5 times more likely to not perform the recommended management when compared to health insurance patients (Odds Ratio = 5.27) and SUS patients were 52% more likely to perform the management when compared to health insurance patients (Odds Ratio = 0.48). In 90 days after the TB case discussion, 94.7% of the patients were alive, the median life span was 87 days. Conclusion: TB management is performed in most cases and the most evident reason for noncompliance is loss of follow-up.
Assuntos
Humanos , Masculino , Feminino , Adolescente , Adulto , Pessoa de Meia-Idade , Idoso , Idoso de 80 Anos ou mais , Neoplasias Gastrointestinais/epidemiologia , Análise de SobrevidaRESUMO
Introducción: Los tumores del estroma gastrointestinal son neoplasias de comportamiento benigno o maligno. Se originan de las células intersticiales de Cajal del tubo digestivo. Objetivo: Describir dos formas distintas de presentación clínica de los tumores del estroma gastrointestinal. Casos clínicos: El caso 1, paciente femenina de 65 años de edad que acudió por síntomas compresivos del tubo digestivo superior a causa de un gastrointestinal gástrico. El caso 2, paciente masculino de 56 años de edad que acudió por sangrado de tubo digestivo medio ocasionado por un gastrointestinal intestinal. Conclusiones: Los tumores del estroma gastrointestinal tienen distinta presentación clínica. Su tratamiento es esencialmente quirúrgico y en algunos casos complementados con terapia molecular dirigida(AU)
Introduction: Gastrointestinal stromal tumors are neoplasms of benign or malignant behavior. They originate from the interstitial cells of Cajal in the digestive tract. Objective: The objective of this work is to describe two different forms of clinical presentation. Case report: case 1: 65-year-old female patient who presented for compression symptoms of the upper digestive tract due to gastric GIST; case 2: 56-year-old male who presented with bleeding from the middle digestive tract caused by intestinal GIST. Conclusions: GISTs have different clinical presentation. Its treatment is essentially surgical and in some cases supplemented with targeted molecular therapy(AU)
Assuntos
Humanos , Masculino , Feminino , Pessoa de Meia-Idade , Idoso , Tumores do Estroma Gastrointestinal/cirurgia , Células Intersticiais de Cajal , Terapia de Alvo Molecular , Relatório de Pesquisa , Neoplasias Gastrointestinais/epidemiologiaRESUMO
OBJECTIVE: The aim of this study was to evaluate the association between preoperative nutritional status and health-related quality of life (HRQoL) in patients with gastrointestinal cancer who were admitted for elective surgical treatment. METHODS: This was a cross-sectional study in which patients with a diagnosis of gastrointestinal cancer were evaluated before a surgical procedure. The nutritional assessment included subjective global assessment (SGA) and measurements of weight loss percentage, bioelectrical impedance, and functional capacity. HRQoL was evaluated by the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire-Core 30 (EORTC QLQ-C30). Statistical analyses were performed with a significance level of 5%. The sample size was calculated based on a pilot study. RESULTS: We evaluated 132 patients, the majority of whom were men. The median age of the patients was 62 y, and the most prevalent tumors were in the colon, rectum, and anus (52.3%). The SGA highlighted the high prevalence of malnutrition (69.9%), which was confirmed by the rates of weight loss (73.8%) and the low fat-free mass index (56.8%). Malnourished patients and patients with severe weight loss had worse functional, symptom, global health and quality of life scores (P < 0.05). Malnutrition, according to the SGA, decreased physical function and role performance scores by 9 and 20 points, respectively (P < 0.05). CONCLUSION: Malnutrition, assessed by various tools, was associated with poor HRQoL of surgical patients with gastrointestinal cancer.
Assuntos
Neoplasias Gastrointestinais , Desnutrição , Estudos Transversais , Feminino , Neoplasias Gastrointestinais/complicações , Neoplasias Gastrointestinais/epidemiologia , Neoplasias Gastrointestinais/cirurgia , Humanos , Masculino , Desnutrição/diagnóstico , Desnutrição/epidemiologia , Desnutrição/etiologia , Avaliação Nutricional , Estado Nutricional , Projetos Piloto , Qualidade de VidaRESUMO
Gastrointestinal neoplasms (GIN) are uncommon in dogs, but they mainly show malignant behavior and poor prognosis. The types of GIN in dogs and their frequency, as well as their epidemiological and histopathological characteristics were analyzed through a retrospective study of biopsies from 24.711 dogs from 2005 to 2017. Additionally, histological sections of neoplasms were subjected to immunohistochemistry (IHC) using antibodies against pancytokeratin, vimentin, smooth muscle actin, c-Kit, S-100, CD31, CD79αcy, and neuron-specific enolase. Of the total samples from dogs analyzed, 88 corresponded to GIN. Neoplasms occurred more frequently in purebred dogs (64.8%, 57/88), males (53.4%, 47/88), with a median age of 10 years. The intestine was affected by 84.1% (74/88) of the cases. Of these, the large intestine was the most affected (67.6%, 50/74). Most of the neoplasms had malignant behavior (88.6%, 78/88). Regarding the classification of neoplasms, 46.6% (41/88) of the diagnoses corresponded to epithelial, 46.6% (41/88) were mesenchymal, 5.7% (5/88) were hematopoietic, and 1.1% (1/88) was neuroendocrine. The most frequently diagnosed neoplasms were papillary adenocarcinoma (19.3%, 17/88), leiomyosarcoma (17.0%, 15/88), gastrointestinal stromal tumors (GISTs) (12.5%, 11/88), and leiomyoma (5.0%, 8/88). Adenocarcinomas were located mainly in the rectum, whereas leiomyosarcomas and GISTs developed mainly in the cecum. Epithelial neoplasms showed a greater potential for lymphatic invasion whereas mesenchymal neoplasms appeared to be more expansive with intratumoral necrosis and hemorrhage. Immunohistochemistry was found to be an important diagnostic technique for the identification of infiltrating cells in carcinomas and an indispensable technique for the definitive diagnosis of sarcomas.(AU)
Neoplasmas gastrointestinais (NGI) são pouco comuns em cães, mas possuem principalmente comportamento maligno e prognóstico reservado. Os tipos de NGI em cães e sua frequência, bem como características epidemiológicas e histopatológicas foram analisados por meio de um estudo retrospectivo dos exames de biópsias de 24.711 cães entre os anos de 2005 a 2017. Adicionalmente, cortes histológicos de NGI foram submetidos à técnica de imuno-histoquímica (IHQ), utilizando os anticorpos anti-pancitoqueratina, vimentina, actina de músculo liso, c-Kit, S-100, CD31, CD79αcy e enolase neurônio específica. Do total de cães analisados, 88 corresponderam a NGI não linfoides. Os neoplasmas ocorreram com maior frequência em cães de raça pura (64,8%, 57/88), machos (53,4%, 47/88), com mediana de idade de 10 anos. O intestino foi acometido em 84,1% dos casos (74/88). Destes, o intestino grosso foi o segmento mais afetado (67,6%, 50/74). A maior parte dos neoplasmas tinha comportamento maligno (88,6%, 78/88). Quanto à classificação, 46,6% (41/88) dos diagnósticos corresponderam a neoplasmas epiteliais, 46,6% (41/88) mesenquimais, 5,7% (5/88) hematopoiéticos e 1,1% (1/88), neuroendócrino. Os neoplasmas mais frequentemente diagnosticados foram adenocarcinoma papilar (19,3%, 17/88), leiomiossarcoma (17,0%, 15/88), tumor estromal gastrointestinal (GIST) (12,5%, 11/88) e leiomioma (12,5%, 8/88). Adenocarcinomas localizavam-se principalmente no reto, enquanto leiomiossarcoma e GISTs desenvolveram-se principalmente no ceco. Os neoplasmas epiteliais demonstraram um potencial maior de invasão linfática enquanto que os mesenquimais aparentaram ser mais expansivos, com necrose e hemorragia intratumorais. A imuno-histoquímica mostrou ser uma técnica diagnóstica importante para a identificação de células neoplásicas infiltravas no caso dos carcinomas e uma técnica indispensável para o diagnóstico definitivo de sarcomas.(AU)
Assuntos
Animais , Cães , Neoplasias Gástricas/veterinária , Neoplasias Gastrointestinais/patologia , Neoplasias Gastrointestinais/veterinária , Neoplasias Gastrointestinais/epidemiologia , Neoplasias Intestinais/veterinária , Imuno-Histoquímica/veterinária , Adenocarcinoma Papilar/veterinária , Carcinoma de Células Acinares/veterinária , Adenocarcinoma Mucinoso/veterinária , Neoplasias Gastrointestinais/diagnóstico , Leiomiossarcoma/veterináriaRESUMO
Gastrointestinal neoplasms (GIN) are uncommon in dogs, but they mainly show malignant behavior and poor prognosis. The types of GIN in dogs and their frequency, as well as their epidemiological and histopathological characteristics were analyzed through a retrospective study of biopsies from 24.711 dogs from 2005 to 2017. Additionally, histological sections of neoplasms were subjected to immunohistochemistry (IHC) using antibodies against pancytokeratin, vimentin, smooth muscle actin, c-Kit, S-100, CD31, CD79αcy, and neuron-specific enolase. Of the total samples from dogs analyzed, 88 corresponded to GIN. Neoplasms occurred more frequently in purebred dogs (64.8%, 57/88), males (53.4%, 47/88), with a median age of 10 years. The intestine was affected by 84.1% (74/88) of the cases. Of these, the large intestine was the most affected (67.6%, 50/74). Most of the neoplasms had malignant behavior (88.6%, 78/88). Regarding the classification of neoplasms, 46.6% (41/88) of the diagnoses corresponded to epithelial, 46.6% (41/88) were mesenchymal, 5.7% (5/88) were hematopoietic, and 1.1% (1/88) was neuroendocrine. The most frequently diagnosed neoplasms were papillary adenocarcinoma (19.3%, 17/88), leiomyosarcoma (17.0%, 15/88), gastrointestinal stromal tumors (GISTs) (12.5%, 11/88), and leiomyoma (5.0%, 8/88). Adenocarcinomas were located mainly in the rectum, whereas leiomyosarcomas and GISTs developed mainly in the cecum. Epithelial neoplasms showed a greater potential for lymphatic invasion whereas mesenchymal neoplasms appeared to be more expansive with intratumoral necrosis and hemorrhage. Immunohistochemistry was found to be an important diagnostic technique for the identification of infiltrating cells in carcinomas and an indispensable technique for the definitive diagnosis of sarcomas.(AU)
Neoplasmas gastrointestinais (NGI) são pouco comuns em cães, mas possuem principalmente comportamento maligno e prognóstico reservado. Os tipos de NGI em cães e sua frequência, bem como características epidemiológicas e histopatológicas foram analisados por meio de um estudo retrospectivo dos exames de biópsias de 24.711 cães entre os anos de 2005 a 2017. Adicionalmente, cortes histológicos de NGI foram submetidos à técnica de imuno-histoquímica (IHQ), utilizando os anticorpos anti-pancitoqueratina, vimentina, actina de músculo liso, c-Kit, S-100, CD31, CD79αcy e enolase neurônio específica. Do total de cães analisados, 88 corresponderam a NGI não linfoides. Os neoplasmas ocorreram com maior frequência em cães de raça pura (64,8%, 57/88), machos (53,4%, 47/88), com mediana de idade de 10 anos. O intestino foi acometido em 84,1% dos casos (74/88). Destes, o intestino grosso foi o segmento mais afetado (67,6%, 50/74). A maior parte dos neoplasmas tinha comportamento maligno (88,6%, 78/88). Quanto à classificação, 46,6% (41/88) dos diagnósticos corresponderam a neoplasmas epiteliais, 46,6% (41/88) mesenquimais, 5,7% (5/88) hematopoiéticos e 1,1% (1/88), neuroendócrino. Os neoplasmas mais frequentemente diagnosticados foram adenocarcinoma papilar (19,3%, 17/88), leiomiossarcoma (17,0%, 15/88), tumor estromal gastrointestinal (GIST) (12,5%, 11/88) e leiomioma (12,5%, 8/88). Adenocarcinomas localizavam-se principalmente no reto, enquanto leiomiossarcoma e GISTs desenvolveram-se principalmente no ceco. Os neoplasmas epiteliais demonstraram um potencial maior de invasão linfática enquanto que os mesenquimais aparentaram ser mais expansivos, com necrose e hemorragia intratumorais. A imuno-histoquímica mostrou ser uma técnica diagnóstica importante para a identificação de células neoplásicas infiltravas no caso dos carcinomas e uma técnica indispensável para o diagnóstico definitivo de sarcomas.(AU)
Assuntos
Animais , Cães , Neoplasias Gástricas/veterinária , Neoplasias Gastrointestinais/patologia , Neoplasias Gastrointestinais/veterinária , Neoplasias Gastrointestinais/epidemiologia , Neoplasias Intestinais/veterinária , Imuno-Histoquímica/veterinária , Adenocarcinoma Papilar/veterinária , Carcinoma de Células Acinares/veterinária , Adenocarcinoma Mucinoso/veterinária , Neoplasias Gastrointestinais/diagnóstico , Leiomiossarcoma/veterináriaRESUMO
PURPOSE OF REVIEW: The purpose of this review is to review the past year's literature to provide comprehensive information to researchers, physicians, and the general public regarding the epidemiology, diagnosis, and treatment of gastrointestinal stromal tumors (GISTs). Common ground as well as divergent viewpoints will be highlighted and discussed. RECENT FINDINGS: The diagnosis of GISTs may involve imaging tests such as computed tomorgraphy scan and MRI, endoscopy with or without endoscopic ultrasound, and biopsy. Only biopsy, however, can yield a positive diagnosis. As most GISTs express KIT protein, immunostaining for KIT and/or molecular genetic testing for mutations in KIT can diagnose 95% of GISTs. Regorafenib, a drug that inhibits various protein genes that lead to GIST development is a relatively new treatment modality. SUMMARY: The current review should enable clinicians to best select the diagnostic and treatment approaches to GIST.
Assuntos
Neoplasias Gastrointestinais/patologia , Neoplasias Gastrointestinais/terapia , Tumores do Estroma Gastrointestinal/patologia , Tumores do Estroma Gastrointestinal/terapia , Compostos de Fenilureia/administração & dosagem , Piridinas/administração & dosagem , Biópsia por Agulha , Terapia Combinada , Intervalo Livre de Doença , Detecção Precoce de Câncer , Feminino , Neoplasias Gastrointestinais/diagnóstico , Neoplasias Gastrointestinais/epidemiologia , Tumores do Estroma Gastrointestinal/diagnóstico , Tumores do Estroma Gastrointestinal/epidemiologia , Humanos , Imuno-Histoquímica , Masculino , Invasividade Neoplásica/patologia , Estadiamento de Neoplasias , Medição de Risco , Análise de SobrevidaRESUMO
BACKGROUND: Studies that describe metastases to the gastrointestinal (GI) tract are restricted to small case series. An increase in the frequency of this condition is expected, so it would be useful to better characterize the endoscopic aspects of metastasis to the GI tract. The aims of this study were to describe the frequency and endoscopic features of the lesions, and to analyze the survival rate after diagnosis of metastasis. METHODS: This was a retrospective, single-center, observational study, conducted between 2009 and 2017.âPatients with metastasis to the GI tract were included. RESULTS: 95 patients were included. Melanoma (25.3â%), lung (15.8â%), and breast (14.7â%) were the most frequent primary tumors. The most common endoscopic presentation was a solitary, ulcerated lesion in the gastric body. Conventional biopsy was diagnostic in 98.9â% of the cases. The mean and median survival rates were 13.3 months (95â% confidence interval [CI] 8.2â-â18.3) and 4.7 months (95â%CI 3.7â-â5.6), respectively. Palliative treatment with chemo- and/or radiotherapy after the diagnosis of the metastasis was related to a higher survival rate. CONCLUSIONS: Melanoma, lung, and breast cancer were the most common primary tumors to metastasize to the GI tract. The endoscopic features could not predict the primary site of the tumor. The finding of metastasis in the GI tract is related to the final stage of the cancer disease but patients who received palliative treatment with chemo- and/or radiotherapy after diagnosis of GI metastasis had higher survival rates.