RESUMO
OBJECTIVE: To evaluate prognostic factor differences between surviving and decreased breast cancer patients in clinical stage IV with supraclavicular or contralateral axilla metastasis when first seen. METHODS: From the clinical records of 13 years (1975-88) two groups of ten patients each were obtained. Group 1 were women alive and free of disease for more than five years. Group 2 had similar characteristics but had died of the disease. In both groups clinical data were evaluated (age, menstrual status and survival); from slides the histologic factors like tumor size, nodal status, fibrosis percentage, inflammatory infiltrate, nuclear grade and necrosis were evaluated; immunohistochemistry of CD34 for angiogenesis, cathepsin D, p53 antioncogen, c-erb-B2 oncogen, epidermic growth factor, estrogen and progesterone receptors and cellular kinetics were performed; Kaplan Meier survival curves were constructed for the factors showing intergroup differences. RESULTS: The factors associated to the living patients were: low inflammatory infiltrate (p = 0.001), low fibrosis (p = 0.007), lower p53 expression (p = 0.03) and positive estrogen receptor (p = 0.03); other factors were marginally associated: positive progesterone receptor (p = 0.07) and having less than 6 positive lymph nodes (p = 0.07).
Assuntos
Neoplasias da Mama/mortalidade , Metástase Linfática , Adulto , Idoso , Axila , Biomarcadores Tumorais/análise , Neoplasias da Mama/química , Neoplasias da Mama/patologia , Neoplasias da Mama/terapia , Intervalo Livre de Doença , Feminino , Fibrose , Humanos , Inflamação , Tábuas de Vida , Menopausa , Pessoa de Meia-Idade , Pescoço , Necrose , Proteínas de Neoplasias/análise , Estadiamento de Neoplasias , Prognóstico , Receptores de Estrogênio/análise , Receptores de Progesterona/análise , Estudos Retrospectivos , Análise de SobrevidaRESUMO
From 1980 to 1991 were received 6,295 patients diagnosed as invasive cervical cancer at the Instituto Nacional de Cancerología of México; from this group, 884 cases were considered as stage IB (12.76%) and 133 cases, adenocarcinoma in 10, adenosquamous carcinoma in 6 and minimal deviation adenocarcinoma (malignant adenoma) in one case. Eighty percent of cases had a less than 2 cm tumor size. Thirteen cases had metastatic pelvic lymph nodes. Mean age 46 years (range 28-64 years), mean operatory time 4:50 hours (range 3-15 hours), average of hemorrhage 1,500 ml (range 300 to 5,000 ml). One patient died from no related cause. Bladder malfunction was observed in 8.4% and uro-vaginal fistula in 6.9% of the cases. Thirteen patients experimented tumor relapsing after 8 to 22 months of follow up. Only 3 out of 7 from that with tumor relapsing were saved with whole pelvic radiotherapy. One hundred-fifteen patients are alive and well after 63 months mean follow-up. Radical hysterectomy plus bilateral lymphadenectomy is an optimal surgical procedure in managing early invasive carcinoma of the cervix uteri.