Tempo de recidiva e sobrevida segundo características tumorais em pacientes com câncer de cavidade oral assistidos em hospital público federal especializado no tratamento de câncer no Rio de Janeiro.

Abstract

The aim of this study was to analyze the time of relapse, survival and prognostic factors in patients who were affected by oral cancer, treated at Instituto Nacional de Câncer José de Alencar Gomes da Silva (INCA) between 1999- 2009.This thesis implies on two articles: (i) specific survival and clinical prognostic factors in cancer patients in the oral cavity and (ii) disease-free survival, specific survival and histopathological prognostic factors in oral cancer that presented relapse. The study was approved by the Research Ethics Committee of the National Cancer Institute (INCA) and financial support granted by Fundação de Amparo à Pesquisa do Estado do Rio de Janeiro. Registries of Department of Pathological Anatomy of INCA (DIPAT), Hospital Cancer Registry (RHC) and medical records of patients were used as sources of data. The study included 996 patients who met the eligibility criteria: oral cavity lesion, squamous cell carcinoma type tumor, curative treatment and without previous treatment or tumor. To estimate disease free and specific survival was used Kaplan-Meier method. To analyze prognostic factors was used Cox risk model. Among men, lymph node involvement at clinical examination associated with prognosis (HR: 1.30, 95% CI:1.04;1.62); Radiotherapy showed a worse prognosis for both sexes (HR: 2.07, 95% CI: 1.54;2.78 in men and HR: 1.96, 95% CI:1.02;3.75 in women) compared to patients whom were treated with salvage surgery, surgery plus adjuvant therapy or radiotherapy with adjuvant therapy. In article two, 93 patients were included who met the inclusion criteria: histopathologicaly proven relapse, surgical or surgical treatment associated with radiotherapy and surgical block availability. Patients classified as recurrence had less time to failure when compared to second primary tumors (mean survival 15 and 50 months, respectively). Histopathological features (invasion pattern, lymphocytic infiltrate and perineural invasion of the primary tumor) are not associated with disease-free nor specific survival. These findings suggest that the diagnosis of the disease in stages is even better in order to minimize deaths from oral cancer.