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        "resumen" => "<span id="as0005" class="elsevierStyleSection elsevierViewall"><p id="sp0005" class="elsevierStyleSimplePara elsevierViewall">O cancro do pulm&#227;o &#233; a causa mais comum de morte por doen&#231;a oncol&#243;gica&#46; Os doentes com diagn&#243;stico de neoplasia &#8211; qualquer que seja a localiza&#231;&#227;o &#8211; t&#234;m risco acrescido de desenvolver um segundo tumor&#46; Pretendeu-se caracterizar uma popula&#231;&#227;o com neoplasia do pulm&#227;o e o diagn&#243;stico s&#237;ncrono ou met&#225;crono de tumor prim&#225;rio com outra localiza&#231;&#227;o&#46; Foi feito um estudo retrospectivo&#44; referente ao per&#237;odo de 2000-2007&#44; analisando-se os processos cl&#237;nicos de doentes seguidos na Unidade de Pneumologia Oncol&#243;gica do nosso hospital em que estavam referenciadas duas neoplasias&#46; Dos doentes seguidos na Unidade &#40;n&#61;1046&#41; no per&#237;odo referido&#44; 4&#44;2&#37; &#40;n&#61;44&#41; tinham evid&#234;ncia de duas neoplasias&#46; A maioria &#40;88&#44;6&#37;&#41; dos doentes eram homens&#44; com idade m&#233;dia elevada &#40;70&#44;1&#177;10 anos&#41;&#46; Oitenta e seis por cento &#40;n&#61;38&#41; tinham h&#225;bitos tab&#225;gicos e 65&#44;4&#37; dos doentes com registo de hist&#243;ria familiar de neoplasia &#40;n&#61;26&#41; tinham hist&#243;ria familiar relevante &#40;n&#61;17&#41;&#46; A doen&#231;a oncol&#243;gica manifestou-se em primeiro lugar na pr&#243;stata&#44; c&#243;lon&#44; cabe&#231;a e pesco&#231;o ou bexiga&#46; O cancro do pulm&#227;o foi em geral a segunda neoplasia&#46; O intervalo de tempo m&#233;dio entre a primeira e a segunda neoplasia foi de 62&#44;9&#177;64&#44;9 meses &#40;max&#58; 240&#44; min&#58; 0&#41;&#44; sendo que geralmente a segunda neoplasia foi detectada em est&#225;dio avan&#231;ado&#46; A sobreviv&#234;ncia m&#233;dia foi de 8&#44;6&#177;8&#44;24 meses &#40;max&#58; 32&#59; min&#58; 1&#41;&#44; permanecendo vivos quatro doentes&#46;</p><p id="sp0105" class="elsevierStyleSimplePara elsevierViewall">Os presentes dados levam-nos a sugerir vigil&#226;ncia cl&#237;nica prolongada em doentes com diagn&#243;stico pr&#233;vio de cancro&#46; Sugerimos um algoritmo que possibilite vigiar melhor estes doentes e estudo prospectivo para verificar se existem marcadores moleculares nesta popula&#231;&#227;o&#46;</p><p id="sp0010" class="elsevierStyleSimplePara elsevierViewall"><span class="elsevierStyleBold">Rev Port Pneumol 2010&#59; XVI &#40;3&#41;&#58; 391-405</span></p></span>"
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Vol. 16. Issue 3.
Pages 391-405 (May - June 2010)
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Vol. 16. Issue 3.
Pages 391-405 (May - June 2010)
Artigo Original/Original Article
Open Access
Características clínicas de doentes com neoplasia do pulmão e neoplasias primárias síncronas ou metácronas com outras localizações
Clinical characteristics of patients with lung cancer and metachronous or synchronous tumours with other locations
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Inês Vaz Luís1,
Corresponding author
inesvazluis@gmail.com

Correspondência/Correspondence to Inês Vaz Luís, Serviço de Oncologia Médica, Hospital de Santa Maria/Faculdade de Medicina de Lisboa, Av. Prof. Egas Moniz, 1643-035 Lisboa, Telefone/Telephone: 21-7985257, Telemóvel/Mobile: 91-9129631.
, Rita Macedo2, Encarnação Teixeira3, Renato Sotto-Mayor4, A. Bugalho de Almeida5
1 Interna do Serviço de Oncologia Médica, Hospital de Santa Maria (HSM) – Centro Hospitalar Lisboa Norte (CHLN)/Resident, Medical Oncology Unit, Hospital de Santa Maria (HSM), Centro Hospitalar Lisboa Norte (CHLN)
2 Assistente Eventual de Pneumologia/Future Pulmonolgy Consultant
3 Assistente Hospitalar Graduada de Pneumologia/Consultant, Pulmonology Specialist
4 Chefe de Serviço de Pneumologia/Head, Pulmonology Unit
5 Director de Serviço, Professor da Faculdade de Medicina da Universidade de Lisboa/Unit Director, Professor, Medical School, Universidade de Lisboa Serviço de Pneumologia I, HSM – CLHN, Lisboa
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O cancro do pulmão é a causa mais comum de morte por doença oncológica. Os doentes com diagnóstico de neoplasia – qualquer que seja a localização – têm risco acrescido de desenvolver um segundo tumor. Pretendeu-se caracterizar uma população com neoplasia do pulmão e o diagnóstico síncrono ou metácrono de tumor primário com outra localização. Foi feito um estudo retrospectivo, referente ao período de 2000-2007, analisando-se os processos clínicos de doentes seguidos na Unidade de Pneumologia Oncológica do nosso hospital em que estavam referenciadas duas neoplasias. Dos doentes seguidos na Unidade (n=1046) no período referido, 4,2% (n=44) tinham evidência de duas neoplasias. A maioria (88,6%) dos doentes eram homens, com idade média elevada (70,1±10 anos). Oitenta e seis por cento (n=38) tinham hábitos tabágicos e 65,4% dos doentes com registo de história familiar de neoplasia (n=26) tinham história familiar relevante (n=17). A doença oncológica manifestou-se em primeiro lugar na próstata, cólon, cabeça e pescoço ou bexiga. O cancro do pulmão foi em geral a segunda neoplasia. O intervalo de tempo médio entre a primeira e a segunda neoplasia foi de 62,9±64,9 meses (max: 240, min: 0), sendo que geralmente a segunda neoplasia foi detectada em estádio avançado. A sobrevivência média foi de 8,6±8,24 meses (max: 32; min: 1), permanecendo vivos quatro doentes.

Os presentes dados levam-nos a sugerir vigilância clínica prolongada em doentes com diagnóstico prévio de cancro. Sugerimos um algoritmo que possibilite vigiar melhor estes doentes e estudo prospectivo para verificar se existem marcadores moleculares nesta população.

Rev Port Pneumol 2010; XVI (3): 391-405

Palavras-chave:
Neoplasias múltiplas
neoplasia metácrona
neoplasia síncrona
neoplasia do pulmão
vigilância
Abstract

Lung cancer is the leading form of cancer death worldwide. Cancer patients are at a high risk of developing a second cancer. The present study attempts to determine the characteristics of a population with lung cancer diagnosed with another cancer.

We analysed records of patients from the Department of Lung Oncology of our hospital from 2000 to 2007 who were identified as having two or more tumours. We found 4.2% (n=44) multiple cancers among the registered cases (n=1046), 88.6% males, (high) mean age 70.1±10years old. About 86% (n=38) of the patients were smokers or ex-smokers. From the patients with record of family history, 65.4% (n=17) had relevant family history of cancer. The majority of the first malignancy diagnosed was prostate, colon, head and neck and bladder.

Lung cancer was essentially the second malignancy. The mean time lag between the two diagnoses was 62.9±64.9months (max. 240, min. 0), with the second cancer usually detected at an advanced stage. The mean survival of patients who had a second primary lung cancer was 8.6±8.24months (max. 32, min. 1), with four patients still surviving.

Our results suggest that extended follow-up is needed in these patients, using screening strategies which follow international recommendations, and with control of carcinogenic risk factors such as smoking. We suggest a tailored risk algorithm and a further study to assess if there are particular molecular markers in these patients.

Rev Port Pneumol 2010; XVI (3): 391-405

Key-words:
Multiple cancers
metachronous cancer
synchronous cancer
lung cancer
follow-up
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