RESUMO
PURPOSE: This study aims to increase the knowledge about the characteristics of cutaneous melanoma in Argentina, their association with the risk of having Breslow ≥1 mm and mortality trends for the period 2002-2017. PATIENTS AND METHODS: Descriptive statistics and regression analyses were done for 10.199 cases within the Argentine Melanoma Registry in the period 2002-2018. Trends in age-standardised mortality rates (ASMR) were analysed using the Join point Regression Model. RESULTS: Cases showed lesions mainly located in males' trunk (37%) and in females' lower limbs (29%). The level of invasion was higher in males who also showed higher mortality. Cases from the North West and North East regions showed a major risk of Breslow >1 mm and harboured CM in lower limbs more frequently than in other regions. Nearly, 25% of tumours over 2 mm were in cases aged <50 years and 37.6% in patients ≥50 years. In the North West, North East and Patagonia, the frequency of cases in young people was higher than in older people. In 43% of cases, the melanoma subtype was not specified in the report. The number of superficial spreading melanomas, the most common histology, was nearly twice that of Nodular melanomas the following histology in importance (3,403 and 1,754, respectively). Melanoma mortality rates in all Argentine population increased in the elderly. Lower melanoma mortality rates were observed in the North West. In 2007-2017, ASMR decreased significantly in females (average 1.4% p/year) while it increased nonsignificantly in males (0.4% p/year).The tumours with the worst prognosis were associated with the elderly, males, nodular or acrolentiginous morphologies, residing somewhere other than Centro and Patagonia and with tumors located in the head/neck and legs. CONCLUSION: The geographical variations found for melanoma characteristics and their mortality in Argentina, makes it imperative that epidemiological research is continued to avoid generalisations and improve future preventive actions.
RESUMO
The incidence and the mortality of gallbladder cancer (GBC) show significant variation worldwide, with high age-standardized rates in western South America (SA). Due to the lack of effective measures for prevention, the late diagnosis and the small benefit of systemic treatment, GBC has an ominous prognosis and became an important public health problem in this part of the continent, where the most important risk factors are gallstone disease, female gender, age, ethnic groups, and low socioeconomic status. Many genetic abnormalities have been described in series from SA, some of them similar and others unique in comparison to gene alterations in GBC from other regions of the world. Prophylactic cholecystectomy (PC) is one of the strategies to decrease the mortality but its cost-effectiveness is questionable. A way to improve the performance of PC is to identify molecular risk factors that in combination with currently known ones detect patients with very high risk for developing GBC. Also, more research studies are required to better understand the epidemiology and molecular biology in order to improve the prevention and treatment of this lethal disease.
Assuntos
Neoplasias da Vesícula Biliar/epidemiologia , Neoplasias da Vesícula Biliar/prevenção & controle , Feminino , Humanos , Masculino , Fatores de Risco , América do SulRESUMO
PURPOSE: To describe sociodemographic, epidemiologic, and clinical characteristics of patients who were diagnosed with breast cancer and registered in the Institutional Tumor Registry of Argentina (RITA) as of April 2016. METHODS: This was an observational, descriptive case study in patients who were diagnosed with breast cancer between April 2012 and April 2016 and registered in RITA. Quantitative and qualitative analyses were done, including delay from symptoms to first consultation, delay from diagnosis to treatment (opportunities), as well as patients' survival (Kaplan-Meier and log-rank tests). RESULTS: There were 4,883 identified patients and 4,950 tumors. The mean age of patients was 57.6 years (median, 56 years); 60% of patients had completed elementary studies, 46.8% had some health coverage, and 85.4% of diagnoses were made by tumor histology (TNM stage: T2 19%, N0 20%, M0 29.1%; clinical stages II and III: 34.7%). In terms of morphology, 89.6% of primary tumors had malignant behavior (76% ductal, 8% lobular); and for immunohistochemistry, 34.3% were estrogen receptor positive/progesterone receptor positive/human epidermal growth factor receptor 2 negative. The longest delays analyzed were from diagnosis date to the beginning of first treatment. Survival rates were 96% for up to 24 months and 84.7% for up to 36 months. CONCLUSION: For the first time in Argentina, there is systematized information on the care of oncology patients at public health institutions, which is useful for improving patients' care. We found that RITA collects important information for the identification of groups with similar sociodemographic and clinical characteristics that could show different vulnerabilities along the disease process.
Assuntos
Neoplasias da Mama/diagnóstico , Neoplasias da Mama/epidemiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Argentina/epidemiologia , Neoplasias da Mama/mortalidade , Neoplasias da Mama/terapia , Institutos de Câncer , Feminino , Humanos , Pessoa de Meia-Idade , Gradação de Tumores , Estadiamento de Neoplasias , Receptor ErbB-2/metabolismo , Receptores de Estrogênio/metabolismo , Receptores de Progesterona/metabolismo , Sistema de Registros , Taxa de Sobrevida , Resultado do TratamentoAssuntos
Humanos , Feminino , Gravidez , Episiotomia/normas , Parto/efeitos adversos , Canal Anal/lesões , Episiotomia/efeitos adversos , Episiotomia/instrumentação , Metanálise , Estudos Multicêntricos como Assunto , Guias de Prática Clínica como Assunto , Períneo/lesões , Diafragma da Pelve/lesões , Técnicas de Sutura/instrumentação , Técnicas de Sutura/normasAssuntos
Humanos , Feminino , Gravidez , Episiotomia/normas , Parto/efeitos adversos , Canal Anal/lesões , Períneo/lesões , Guias de Prática Clínica como Assunto , Metanálise , Diafragma da Pelve/lesões , Estudos Multicêntricos como Assunto , Episiotomia/efeitos adversos , Episiotomia/instrumentação , Técnicas de Sutura/instrumentação , Técnicas de Sutura/normasRESUMO
La matriz de estrategias combinadas (MEC), instrumento para fijar prioridades en investigación, permite la organización de información procedente de diversas fuentes y la configuración del estado de situación sobre determinada enfermedad desde el punto de vista del individuo, la familia y la comunidad, el ministerio, otras instituciones relacionadas o no con la salud, y las políticas macroeconómicas. Objetivos: Adaptar y validar la MEC como herramienta para establecer prioridades en investigación en salud en Argentina. Metodología: Se analizaron las prioridades de cinco áreas problemáticas: enfermedades transmisibles, factores de riesgo de enfermedades no transmisibles, salud sexual y reproductiva, lesiones y salud del niño y de la niña. Un equipo de trabajo interdisciplinario (ETI) de 19 profesionales fue responsable de la ejecución del protocolo. Expertos en cada tema completaron una encuesta que permitió conocer su perspectiva. Se organizaron 5 talleres abiertos con invitados especiales representantes de distintas dimensiones institucionales. Resultados: Un total de 48 asesores, 81 expertos y 266 participantes de diferentes provincias y de la Ciudad Autónoma de Buenos Aires concurrieron a los talleres donde en pequeños grupos discutieron el proceso de validación de la MEC que sumado a la búsqueda, recuperación y análisis crítico de la información a cargo del ETI permitió construir una matriz para la mayoría de las entidades propuestas inicialmente. Conclusión: El proceso de validación indica que la MEC es una herramienta útil, factible de ser completada, que facilita el diálogo entre diversos actores con diferentes conocimientos, intereses y necesidades en materia de investigación sanitaria.