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
Inês Vaz Luís1,6,
, Rita Macedo2,6, Encarnação Teixeira3,6, Renato Sotto-Mayor4,6, A Bugalho de Almeida5,6
Corresponding author
inesvazluis@gmail.com
Correspondência/Correspondence to 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.
Correspondência/Correspondence to 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.
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
6 Centro onde o trabalho foi realizado/Work undertaken at, Serviço de Pneumologia I, Hospital de Santa Maria/Faculdade de Medicina de Lisboa, Av. Prof. Egas Moniz, 1643-035 Lisboa
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Prof. Egas Moniz, 1643-035 Lisboa" "etiqueta" => "<span class="elsevierStyleSup">6</span>" "identificador" => "aff0030" ] ] "correspondencia" => array:1 [ 0 => array:3 [ "identificador" => "cor0005" "etiqueta" => "⁎" "correspondencia" => "Correspondência/Correspondence to 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." ] ] ] ] "titulosAlternativos" => array:1 [ "en" => array:1 [ "titulo" => "Clinical characteristics of patients with lung cancer and metachronous or synchronous tumours with other locations" ] ] "pdfFichero" => "main.pdf" "tienePdf" => true "fechaRecibido" => "2009-07-27" "fechaAceptado" => "2009-09-30" "PalabrasClave" => array:1 [ "pt" => array:2 [ 0 => array:3 [ "clase" => "keyword" "identificador" => "xpalclavsec160784" "palabras" => array:5 [ 0 => "Multiple cancers" 1 => "metachronous cancer" 2 => "synchronous cancer" 3 => "lung cancer" 4 => "follow-up" ] ] 1 => array:4 [ "clase" => "keyword" "titulo" => "Palavras-chave" "identificador" => "xpalclavsec160785" "palabras" => array:5 [ 0 => "Neoplasias múltiplas" 1 => "neoplasia metácrona" 2 => "neoplasia síncrona" 3 => "neoplasia do pulmão" 4 => "vigilância" ] ] ] ] "tieneResumen" => true "resumen" => array:2 [ "pt" => array:2 [ "titulo" => "Resumo" "resumen" => "<p id="spar0005" class="elsevierStyleSimplePara elsevierViewall">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 neopla- sia 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<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1046) no período referido, 4,2% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>44) tinham evidência de duas neoplasias. A maioria (88,6%) dos doentes eram homens, com idade média elevada (70,1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 anos). Oitenta e seis por cento (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>38) tinham hábitos tabágicos e 65,4% dos doentes com registo de história familiar de neoplasia (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>26) tinham história familiar relevante (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>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<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8,24 meses (max: 32; min: 1), permanecendo vivos quatro doentes.</p><p id="spar0010" class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] "en" => array:2 [ "titulo" => "Abstract" "resumen" => "<p id="spar0015" class="elsevierStyleSimplePara elsevierViewall">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.</p><p id="spar0020" class="elsevierStyleSimplePara elsevierViewall">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<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>44) multiple cancers among the registered cases (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>1046), 88.6% males, (high) mean age 70.1<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>10 years old. About 86% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>38) of the patients were smokers or ex-smokers. From the patients with record of family history, 65.4% (n<span class="elsevierStyleHsp" style=""></span>=<span class="elsevierStyleHsp" style=""></span>17) had relevant family history of cancer. The majority of the first malignancy diagnosed was prostate, colon, head and neck and bladder.</p><p id="spar0025" class="elsevierStyleSimplePara elsevierViewall">Lung cancer was essentially the second malignancy. The mean time lag between the two diagnoses was 62.9<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>64.9 months (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<span class="elsevierStyleHsp" style=""></span>±<span class="elsevierStyleHsp" style=""></span>8.24 months (max. 32, min. 1), with four patients still surviving.</p><p id="spar0030" class="elsevierStyleSimplePara elsevierViewall">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.</p>" ] ] "bibliografia" => array:2 [ "titulo" => "Bibliografia/Bibliography" "seccion" => array:1 [ 0 => array:2 [ "identificador" => "bibs0005" "bibliografiaReferencia" => array:23 [ 0 => array:3 [ "identificador" => "bib1" "etiqueta" => "1." 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ISSN: 21735115Original language: Portuguese
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