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Análise retrospectiva das neoplasias de ânus em pacientes atendidos no HC-FMRP-USP de 1979 a 2004 e revisão da literatura Retrospective analysis of patients with anal tumors diagnosed at the school of medicine of Ribeirão Preto Hospital and clinics (HC-FMRP), between 1979 and 2004 and literature review

By Rogério Serafim Parra, Andreza Regina de Brito, José Joaquim Ribeiro da Rocha and Omar Féres

Abstract

Foram analisados, retrospectivamente, 49 casos de pacientes com neoplasia de ânus, sendo 23 de 1979-1996 e 26 de 1997-2004, 49% masculinos e 51% femininos. Em 81,6% dos pacientes o tratamento foi adjuvante, com radioterapia e esquema de NIGRO, 12,2% metástases à distância e 36,7% perderam o seguimento. Óbitos ocorreram em 20,4%. Notou-se diminuição da necessidade da cirurgia de Miles (30,8% vs 43,3%). A perda de seguimento foi menor (19,5% vs 56,5%), mas a mortalidade foi discretamente maior (23,1% vs 17,4%). O tratamento neo-adjuvante com radio e quimioterapia em 96% dos pacientes com neoplasia anal foi capaz de promover remissão da lesão na maioria dos casos (57,5%), confirmados pela biópsia da cicatriz residual, evitando-se amputação cirúrgica do reto. Dados mais recentes mostram que 45% dos pacientes permanecem sem recidiva (seguimento médio 3,5 anos). A alta taxa de mortalidade e o diagnóstico de lesões avançadas podem decorrer da procura tardia do serviço médico.<br>In total, 49 cases of anal tumor were studied, 23 cases from 1979-1996 and 26 cases from 1997-2004. From the cases studied, 49 % were male and 51 % were female patients. Patients that were submitted to radio and chemotherapy by the "nigro scheme" totalized 81.6 %; 12.2 % presented metastasis, 36.7 % lost follow up and 20.4 % died. There was a reduction of the Miles surgery indication (30.8 % vs 43.3 %) and the follow up loss (19.5 % vs 56.5 %). The mortality rate was a little higher (23.1 % vs 17.4 %). Radio and chemotherapy was used in 96 % of patients, and promoted lesion remission in 57.5 % of cases (confirmed by negative anal scar biopsy), avoiding the anal amputation surgery indication. Recent data indicate that 45 % of patients (3.5 years of average follow up) are still with no recidivated tumor. The prevalence of high mortality rates and the diagnosis of high stage lesions are due to a delay of patients in search for a diagnosis. This might be due to a difficult access to a medical service and to the low social-economical level of our patients. These conditions make the diagnosis and treatment of anal tumors difficult, impairing its prognosis

Topics: neoplasia maligna de ânus, incidência, epidemiologia, Anal tumor, casuistic, epidemiology, Diseases of the digestive system. Gastroenterology, RC799-869, Specialties of internal medicine, RC581-951, Internal medicine, RC31-1245, Medicine, R, DOAJ:Gastroenterology, DOAJ:Medicine (General), DOAJ:Health Sciences
Publisher: Cidade Editora Científica Ltda
Year: 2007
DOI identifier: 10.1590/S0101-98802007000200001
OAI identifier: oai:doaj.org/article:31d15aa5397b4b7da3fd139878a66ede
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