RESUMO
INTRODUCTION: Breast-conserving surgery (BCS) is the standard of care for treatment of early breast cancer. Factors associated with poor cosmetic results are not well described. The aim of the present study was to evaluate factors associated with breast asymmetry after BCS for invasive breast cancer. MATERIAL AND METHODS: Patients who underwent unilateral BCS for invasive breast cancer and completed at least six months after radiation therapy were included. After informed consent, patients answered a validated questionnaire for breast symmetry. Demographic, clinical-pathological and surgical variables were recorded. Bilateral breast volume was measured in office and volume difference > 20% was considered objective asymmetry. Variables were analyzed with χ(2) test and significance was considered at p < 0.05. RESULTS: One-hundred and thirtythree patients were included. Mean patient age was 56 ± 9 years. Most patients were married (78%) with educational level of high school or greater (50.8%). Mean body mass index (BMI) was 25 ± 8. Twelve percent of patients underwent ≥ 2 surgical procedures. Eighty-one percent of patients had tumors > 1 cm. Twenty-two percent of patients had objective breast asymmetry and 27% perceived themselves with asymmetry. There were no significant relationship between objective and subjective asymmetry. The only variable significantly associated with perception of breast asymmetry was educational level ≥ high school. CONCLUSIONS: There was no relationship between subjective and objective breast asymmetry after BCS, suggesting that cosmetic results are mainly related to patient subjective perception. The only variable associated with subjective breast asymmetry was high educational level, possibly because higher cosmetic expectations in this group of patients.
Assuntos
Neoplasias da Mama/cirurgia , Mama/patologia , Mastectomia Segmentar , Idoso , Imagem Corporal , Mama/efeitos da radiação , Neoplasias da Mama/patologia , Neoplasias da Mama/radioterapia , Escolaridade , Estética , Feminino , Humanos , Mastectomia Segmentar/psicologia , Pessoa de Meia-Idade , Tamanho do Órgão , Satisfação do Paciente , Radioterapia Adjuvante/efeitos adversos , Fatores Socioeconômicos , Inquéritos e QuestionáriosRESUMO
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
PURPOSE: Areas of lower enhancement on computed tomography are frequently seen in renal-cell carcinoma. We investigated whether tumor enhancement on the most prominent hypodense areas correlates with the nuclear grade and other pathologic variables. METHODS: From 2004 to 2009, all consecutive patients with a preoperative tomography who underwent radical or partial nephrectomy for renal-cell carcinoma at our tertiary referral center were retrospectively analyzed. Enhancement of the entire tumor on the slice with most prominent areas of lower enhancement was determined. RESULTS: Forty-eight patients were included. Clear-cell carcinoma comprised 91.6 %. Mean areas of lower enhancement for nuclear grade tumors 1-4 were 67.4, 38.7, 27.9, and 15.1 HU, respectively. Areas of lower enhancement negatively correlated with size, nuclear grade, T stage, and pathological stage. Tumors with extension beyond Gerota's fascia (10.5 vs. 35.9 HU, p < 0.001) and positive surgical margins (21.2 vs. 34.8 HU, p = 0.04) had more prominent areas of lower enhancement than organ-confined tumors. When comparing nuclear grade 1-3 to nuclear grade 4 tumors, these areas were significantly lower in the later (36.5 vs. 15.1 HU, p < 0.001). Receiver-operating characteristics curves for detecting nuclear grade 4 showed an area under the curve of 0.808 (95 % CI 0.659-0.957). CONCLUSIONS: Lower enhancement of the entire tumor at the point where hypodense tumor areas are more predominant on tomography is associated with higher nuclear grade and more advanced stage.