Epidemiological Profile Of 175 Patients With Crohn's Disease Submitted To Biological Therapy

Introduction: There is currently an increasing use of biological agents in the management of Crohn's disease (CD). There is lack of data regarding the epidemiological profile of patients on infliximab (IFX) and adalimumab (ADA) for CD in Brazil. Objective: To identify the epidemiological characteristics of patients with CD who underwent biological therapy. Method: Retrospective multicenter study, with CD patients on biological therapy. Analyzed variables: gender, age at treatment initiation, Montreal classification, concomitant perianal disease and smoking status. Results: 175 patients without previous exposure to biological agents were included, 93 (53%) were male. The mean age at treatment initiation was 35.5 (2-79) years old an the mean disease duration was 46.9 (0-480) months. Overall, 117 (66.9%) patients used IFX and 58 (33.1%), ADA. Montreal classification: age at diagnosis - A1 (n=21; 12%), A2 (n=102; 58.3%), and A3 (n=52; 29.7%). CD location - L1 (n=42; 24%), L2 (n=51; 29.1%), L3 (n=81; 46.3%), and L4 (n=1, 0.6%). Phenotype -B1 (n=59; 33.7%), B2 (n=46; 26.3%), and B3 (n=70; 40%). Perianal disease was found in 89 (50.9%) patients. Conclusions: The epidemiological profile of patients was similar to the literature. 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Tratamento cirúrgico do câncer colorretal: resultados a longo prazo e análise da qualidade Surgical treatment of colorectal cancer: long term results and quality control

A obtenção de resultados cada vez melhores no tratamento do câncer colorretal apresenta-se hoje como um desafio devido à sua crescente prevalência em todo o mundo. Diversos estudos têm demonstrado que a qualidade do tratamento cirúrgico instituído representa um dos principais fatores prognósticos, podendo ser esta avaliada através de aspectos como mortalidade operatória, preservação esfincteriana, recorrência local e sobrevida. O objetivo do presente trabalho é apresentar os resultados obtidos a longo prazo no tratamento cirúrgico do câncer colorretal pelo Grupo de Coloproctologia do Departamento de Cirurgia do Hospital Municipal São José, em Joinville, e confrontá-los com a literatura a respeito, visando obter uma avaliação crítica da qualidade do tratamento instituído. Foi realizada uma análise prospectiva de uma série consecutiva de 97 pacientes submetidos ao tratamento cirúrgico do câncer colorretal, com perspectivas curativas e tempo de seguimento médio de 80,8 meses. Foi observada mortalidade operatória em seis pacientes (6,1%), recidiva local para câncer retal e colônico em seis (12,5%) e quatro (9,7%) pacientes, respectivamente, e a necessidade de realização de colostomia definitiva no câncer retal em 14 casos (27%). A sobrevida geral média foi de 48,9 meses. A sobrevida geral de cinco anos para o seguimento oncológico (n=63) foi de 52%, sendo 89% para pacientes estágio 1, 70% para pacientes estágio 2 e 20% para pacientes estágio 3. Concluímos que o tratamento instituído encontra-se dentro dos padrões aceitáveis do ponto de vista da literatura, demonstrando, no entanto, a necessidade de aprimoramento em alguns aspectos específicos.<br>Improvement of results in treatment of colorectal cancer remains a major challenge due to its increasing worldwide prevalence. Several studies have demonstrated the quality of surgical treatment as one of the most important prognostic factors, assessed by parameters such as operative mortality, sphincter preservation, local recurrence and survival rates. The aim of this study is to present the long term results of Coloproctology Group of Department of Surgery of Hospital Municipal São José, in Joinville, Brazil, as well as its quality analysis according to the accepted standards from literature. A prospective analysis of a consecutive series of 97 colorectal cancer patients operated for curative purpose was undertaken, with a mean follow up of 80,8 months. Operative mortality occurred in six patients (6,1%), local recurrence for recatl and colon cancer in six (12,5%) and four (9,7%) patients, respectively, and abdominoperineal resection was performed in 14 cases (27%) for rectal cancer. Mean overall survival was 48,9 months. Five-year overall oncological survival (n=63) was 52%, including 89% for stage1, 70% for stage 2 and 20% for stage 3 patients. We conclude that the results obtained are acceptable for literature standards, but some specific parameters need to be improved