Clinical Oncology Letters
https://clinicaloncologyletters.com/article/5c70077f0e88256c4c8e6fd5
Clinical Oncology Letters
Artigo Original

Perfil Epidemiológico e análise de sobrevida de pacientes com neoplasia de ovário refratário à platina atendidos em um hospital público em Santo André-SP

Epidemiologic profile and survival analysis of patients with platinum resistant ovarian cancer in a public hospital of the city of Santo Andre-SP

Sette CV, Penido BB, Schoueri JH, Camargo CR, Santi PX, Trufelli DC, Cubero DI, del Giglio A

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Resumo

Introdução: O câncer de ovário é a segunda neoplasia ginecológica mais comum e ocupa a primeira posição no que diz respeito à letalidade.Pacientes portadores de câncer de ovário resistente à platina tem pior prognóstico e não são passíveis de cura. Estas pacientes apresentam sobrevida livre de progressão (SLP) de 3 a 4 meses e sobrevida global (SG) de 9 a 12 meses na maioria dos estudos clínicos de fase III Objetivos: Avaliar fatores epidemiológicos e a sobrevida de pacientes com neoplasia de ovário refratária à platina (RP) de um hospital público de Santo André-SP-Brasil e correlacioná-los com os dados apresentados em estudos internacionais. Método: Trata-se de um estudo descritivo, cujos dados utilizados são provenientes de pacientes com câncer de ovário atendidas no serviço de oncologia de um hospital universitário em Santo André-SP entre julho de 2008 e maio de 2015. Apenas pacientes com diagnóstico de câncer de ovário RP foram incluídos no estudo. Resultados: Um total de 29 pacientes com câncer de ovário RP foram incluídas, com mediana de idade de 56 anos, sendo 43% do tipo histológico seroso e aproximadamente 60% pouco diferenciado. Cerca de 60% já eram avançadas ao diagnóstico e quase 80% com ECOG 0 ao diagnóstico. Entretanto, quando se tornaram refratárias à platina, 58% já apresentava ECOG igual ou maior que 2. Em relação à quimioterapia, 80% recebeu carboplatina e paclitaxel como tratamento inicial. No período estudado, 25 pacientes evoluíram à óbito, com mediana de sobrevida global de 41 meses e, considerando o tempo após RP, a sobrevida foi de 6 meses, sendo a principal causa de óbito as complicações relacionadas à suboclusão intestinal e ascite. Conclusão: Os dados aqui apresentados demonstram que as pacientes tratadas fora de um estudo clínico e num hospital do sistema público brasileiro apresentam evolução menos favorável do que a população tratada dentro de protocolos clínicos.

Palavras-chave

Neoplasias Ovarianas; Carboplatina; Cisplatina; Resistência à Medicamentos; Análise de Sobrevida.

Abstract

Introduction: Ovarian cancer is the second most common gynecological neoplasia and the leading one in lethality. Patients with platinum resistant (PR) ovarian cancer present worse prognosis and are incurable. These patients present 3 to 4 months of progression-free survival (PFS) and 9 to 12 months of over-all survival (OS) in most phase III clinical trials. Aim: Evaluate epidemiologic factors and survival rates of patients with platinum resistant ovarian cancer assisted at a public hospital in Santo Andre-SP-Brazil and correlate them with international data. Methods: This is a descriptive study, and the data is provenient from patients diagnosed with ovarian cancer assisted at the oncology service of a university hospital in Santo Andre-SP-Brazil between July 2008 and May 2015. Only patients diagnosed with PR ovarian cancer were included in the study, and Kaplan-Meier curves with log rank tests and Cox Regression model were used for the survival analysis. Results: 29 PR patients were included in the study, being that 56 years old was the median age, 43% of the histologic classifications were serosal and 60% of all cases were low differentiated. Around 60% of them were advanced at diagnosis and almost 80% were ECOG 0. However, when they became resistant to platinum, 58% were ECOG equal or smaller than 2. Regarding chemotherapy, 80% of them received Carboplatin or Paclitaxel as initial treatment. During the period studied, 25 patients died, and the median of OS was of 41 months. Considering the time after PR, the survival was 6 months, with the main cause of death being complications related to bowel sub occlusion and ascites. Conclusion: The data presented here shows that the patients assisted by the Brazilian public health service at a reference university service had worse prognosis that the one described in international studies.

Keywords

Ovarian Neoplasm; Carboplatin; Cisplatin; Drug Resistance; Survival Analysis

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