RESUMO
BACKGROUND AND AIMS: Thrombocytosis is frequently observed in patients with malignancy. We undertook this study to determine the prognostic value of thrombocytosis in patients with rectal cancer. METHODS: We performed a retrospective study of patients undergoing low anterior resection for rectal cancer between January 2000 and March 2007. Preoperative platelet count was measured before surgery. Postoperative platelets were determined 1 month after surgery. Two-tailed p values <0.05 were considered statistically significant. RESULTS: One hundred sixty three patients with rectal cancer were included in the study. Preoperative platelet count >350,000 was found in 8% of patients. Postoperative platelet count >350,000 was found in 6% of patients. Distant metastases were found in 17 patients (10.4%). Significant variables in the multivariate analyses were preoperative platelets >350,000 (p = 0.001), postoperative platelets >350,000 (p = 0.002), carcinoembryonic antigen >13 ng/dL (p = 0.003). Patients with preoperative platelet count <350,000 showed a 5-year survival rate of 81%, whereas patients with platelet count >350,000 had a 25-month survival [95% confidence interval (CI): 20-26]; p <0.001. Patients with postoperative platelets <350,000 showed a 5-year survival rate of 80%, whereas patients with platelets >350,000 showed a 3-year survival rate of 37.5% (p <0.05). CONCLUSIONS: Pre- or postoperative platelet count >350,000 is associated with poor survival in patients with rectal cancer. The measurement of platelets is a clinical marker useful to define the prognosis for patients with rectal cancer.
Assuntos
Carcinoma/sangue , Neoplasias Retais/sangue , Trombocitose/etiologia , Adulto , Idoso , Idoso de 80 Anos ou mais , Carcinoma/secundário , Carcinoma/cirurgia , Feminino , Humanos , Estimativa de Kaplan-Meier , Neoplasias Hepáticas/epidemiologia , Neoplasias Hepáticas/secundário , Neoplasias Pulmonares/epidemiologia , Neoplasias Pulmonares/secundário , Masculino , México/epidemiologia , Pessoa de Meia-Idade , Contagem de Plaquetas , Prognóstico , Neoplasias Retais/patologia , Neoplasias Retais/cirurgia , Estudos Retrospectivos , Taxa de Sobrevida , Trombocitose/epidemiologia , Adulto JovemRESUMO
BACKGROUND: Breast cancer is the leading cause of death from malignancy in women. The incidence increases with age, but the relationship between age and survival of breast cancer patients is not well defined. It is observed that young women with breast cancer have patterns more aggressive biological. OBJECTIVE: To determine the frequency, sociodemographic, clinical and histopathological features of breast cancer in women under 40 years attending a specialist breast unit in Mexico City. PATIENTS AND METHOD: Transversal, descriptive and retrospective study of patients under 40 years of age with breast cancer treated between 2005 and 2010. RESULTS: 1430 cases were diagnosed with breast cancer five years with a mean age of 53.64 +/- 11.87 years (range 23 to 93 years), 142 cases were women under 40 years of age (10%). The auto-detection of a breast lump was the most frequent clinical manifestation (50%). CONCLUSION: The prevalence of clinical stage III in this age group suggests the difficulty of diagnosis, the high breast density, which is one factor limiting studies of screening with mammography, it diminishes their effectiveness in early detection of breast cancer.
Assuntos
Neoplasias da Mama/epidemiologia , Carcinoma Ductal de Mama/epidemiologia , Carcinoma Lobular/epidemiologia , Adulto , Distribuição por Idade , Idade de Início , Idoso , Protocolos de Quimioterapia Combinada Antineoplásica/uso terapêutico , Neoplasias da Mama/diagnóstico por imagem , Neoplasias da Mama/terapia , Carcinoma Ductal de Mama/diagnóstico por imagem , Carcinoma Ductal de Mama/terapia , Carcinoma Lobular/diagnóstico por imagem , Carcinoma Lobular/cirurgia , Carcinoma Lobular/terapia , Quimioterapia Adjuvante/estatística & dados numéricos , Terapia Combinada , Estudos Transversais , Feminino , Humanos , Mamografia , Mastectomia/métodos , México/epidemiologia , Pessoa de Meia-Idade , Neoplasias Hormônio-Dependentes/diagnóstico por imagem , Neoplasias Hormônio-Dependentes/epidemiologia , Neoplasias Hormônio-Dependentes/terapia , Ovariectomia/estatística & dados numéricos , Prevalência , Radioterapia Adjuvante/estatística & dados numéricos , Estudos Retrospectivos , Fatores de Risco , Fatores Socioeconômicos , Adulto JovemRESUMO
BACKGROUND: in patients with early-stage cervical cancer (FIGO IA, IB2 and IIA), the incidence of lymph node metastases is up to 15%; the majority of early cervical cancer patients with pelvic and para-aortic lymphadenectomy does not benefit with the procedure and are at risk of associated morbidity (linfocyst, lymphedema, vascular or nerve damage). OBJECTIVE: To describe the experience and usefulness of lymphatic mapping and sentinel lymph node with total laparoscopic radical hysterectomy in early stage cervical cancer. PATIENTS AND METHOD: Retrospective study in patients with diagnosis of cervical cancer in early stage, submitted to laparoscopic radical hysterectomy with lymphatic mapping and sentinel lymph node biopsy. We analyzed sentinel lymph node identification, false negative rate and surgical variables. RESULTS: in 36 months 15 patients were included, two in IA2 FIGO stage, twelve IB1 and one IIA; thirteen patients were mapping with combined technique and two only with dye. The sentinel lymph node identification rate was 87% (two failures in the patients using only blue dye); the false negative rate was 0%. CONCLUSION: Laparoscopic radical hysterectomy with lymphatic mapping is a secure technique for patients with early stage cervical cancer; it allows the correct identification of lymph node status as the principal prognostic factor. We recommend the use of combined technique (radiocolloid tracer and blue dye) for best rate sentinel lymph node identification.
Assuntos
Adenocarcinoma/cirurgia , Carcinoma de Células Escamosas/cirurgia , Histerectomia/métodos , Laparoscopia/métodos , Excisão de Linfonodo/métodos , Biópsia de Linfonodo Sentinela/métodos , Neoplasias do Colo do Útero/cirurgia , Adenocarcinoma/patologia , Adulto , Carcinoma de Células Escamosas/patologia , Corantes , Feminino , Humanos , Metástase Linfática/diagnóstico por imagem , Metástase Linfática/patologia , Estadiamento de Neoplasias , Complicações Pós-Operatórias , Cintilografia , Compostos Radiofarmacêuticos , Estudos Retrospectivos , Corantes de Rosanilina , Tecnécio , Neoplasias do Colo do Útero/patologiaRESUMO
BACKGROUND: Laparoscopic surgery for cervical cancer (CC) study and treatment is one of the main achievements in last years. OBJECTIVE: Describe the feasibility and experience of laparoscopic procedures for CC staging and treatment. PATIENTS AND METHOD: A retrospective analysis of 75 patients with CC in different stages was done, group I included CC in situ patients treated with type I Piver hysterectomy, in group 2, patients with early CC treated with type II or III radical hysterectomy with pelvic lymphadenectomy and para-aortic lymph node sampling, and group 3 patients with locally advanced CC submitted to pelvic and para-aortic lymphadenectomy. We analyzed operating time, bleeding, hospital stay, conversion to laparotomy, late complications and tumor recurrence. RESULTS: Thirty patients were included in group 1, 31 in group 2 and 14 in group 3, mean operating time was 143, 270 and 136 minutes, bleeding 170, 460 and 80 mL, hospital stay was 1.6, 3.6 and 1.5 days and conversion to laparotomy was 3%, 9.7% and 0%, respectively for each group. CONCLUSION: Laparoscopy is a safe procedure for the staging and treatment of cervical cancer in its different stages.
Assuntos
Laparoscopia , Neoplasias do Colo do Útero/patologia , Neoplasias do Colo do Útero/terapia , Adulto , Idoso , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Estudos RetrospectivosRESUMO
INTRODUCTION: Standard care of patients with oral tongue-invasive squamous cell carcinoma in early stages is local resection and neck dissection. Traditionally, tumor resection was performed with hemiglossectomy (tongue resection in lingual long axis), which implied morbidity for deglutition and speech. Although surgical margins are sufficient, they are usually larger than necessary. OBJECTIVE: To know functional results and surgical margins in patients with T1-T2 oral tongue cancer submitted to transverse glossectomy (TG). MATERIAL AND METHODS: We analyzed charts of patients with T1-T2 oral tongue squamous cell carcinoma treated by TG during a 2-year period. We studied surgical margins, deglutition, speech intangibility, performance status and patient satisfaction. RESULTS: We included 20 patients: 12 women and eight men, with mean age of 45 years. Tumor-thickness mean was 8 mm; 19 patients showed free tumor margins in definitive histology study with mean of 1.8 cm three-dimensionally. In one patient, frozen sections were free-of-tumor, but definitive study showed a microscopic area of squamous cell carcinoma in surgical margin. All patients preserved > 50% of oral tongue and all showed lingual tip deviation and short tongue. None required nasogastric tube for feeding and speech was intelligible in all patients. CONCLUSIONS: TG provided sufficient surgical margin in all patients in this series without important morbidity and with good functional result; thus, TG is an alternative to classic vertical hemiglossectomy for patients in early stages of tongue mobile cancer.