Perfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRS
Autor(a) principal: | |
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Data de Publicação: | 2015 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da PUC_RS |
Texto Completo: | http://tede2.pucrs.br/tede2/handle/tede/6135 |
Resumo: | Introduction: New drugs have been developed to treat renal cell carcinoma apparently improving overall survival. Methods: This is an observational study in a retrospective cohort. Five hundred nine patients with renal cell carcinoma treated between 2002 and 2012 in Southern Brazil were divided in two groups: patients receiving public health system care and participants in clinical research protocols. Data collected from medical records were: socio-demographic and clinical characteristics, type of surgery and pathological information. Statistical analysis was performed using Chi-square, Fisher exact, Student's t tests; the survival curve was according to Kaplan-Meier method and Cox regression. Significance was considered at p<0.05. Results: Patients were male (68.6%), Caucasian (94.9%), and had no family history of cancer (91.6%). Most cases were submitted to nephrectomy and the most frequent histological type was clear cell carcinoma (90.7%). Global median survival for all patients was 50.2 (45.0-54.7) months. Global survival was different between patients enrolled in clinical trials [142.1 months (95% CI: 94.1- 152.6)] and those treated in the public health system [44.9 months (95% CI: 39.5 - 49.1)] (p<0.001). The unadjusted hazard ratio was 0.24 (0.15-0.37). After adjustment for gender, age, smoking at the time of diagnosis, body mass index, skin color, patient origin, ECOG score, histology and clinical stage, hazard ratio was 0.26 (0.13-0.55) (p<0.001). Conclusion: Renal cell carcinoma patients treated in clinical research protocols have longer survival when compared to patients managed within the public health care system in Brazil. This finding strongly suggests that, in this setting, participation in clinical research protocols should be encouraged. |
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Costa, Bartira Ercília Pinheiro da407.315.450-87http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4782193E7709.955.670-34http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4292638Y4Zamprogna, Luciana2015-06-15T11:52:31Z2015-03-23http://tede2.pucrs.br/tede2/handle/tede/6135Introduction: New drugs have been developed to treat renal cell carcinoma apparently improving overall survival. Methods: This is an observational study in a retrospective cohort. Five hundred nine patients with renal cell carcinoma treated between 2002 and 2012 in Southern Brazil were divided in two groups: patients receiving public health system care and participants in clinical research protocols. Data collected from medical records were: socio-demographic and clinical characteristics, type of surgery and pathological information. Statistical analysis was performed using Chi-square, Fisher exact, Student's t tests; the survival curve was according to Kaplan-Meier method and Cox regression. Significance was considered at p<0.05. Results: Patients were male (68.6%), Caucasian (94.9%), and had no family history of cancer (91.6%). Most cases were submitted to nephrectomy and the most frequent histological type was clear cell carcinoma (90.7%). Global median survival for all patients was 50.2 (45.0-54.7) months. Global survival was different between patients enrolled in clinical trials [142.1 months (95% CI: 94.1- 152.6)] and those treated in the public health system [44.9 months (95% CI: 39.5 - 49.1)] (p<0.001). The unadjusted hazard ratio was 0.24 (0.15-0.37). After adjustment for gender, age, smoking at the time of diagnosis, body mass index, skin color, patient origin, ECOG score, histology and clinical stage, hazard ratio was 0.26 (0.13-0.55) (p<0.001). Conclusion: Renal cell carcinoma patients treated in clinical research protocols have longer survival when compared to patients managed within the public health care system in Brazil. This finding strongly suggests that, in this setting, participation in clinical research protocols should be encouraged.Introdução: Novas drogas têm sido desenvolvidas para o tratamento de carcinoma de células renais, melhorando, aparentemente, a sobrevivência global. Métodos: Este é um estudo observacional em uma coorte retrospectiva. Quinhentos e nove pacientes com carcinoma de células renais, tratados entre 2002 e 2012 num hospital Universitário do sul do Brasil, foram divididos em dois grupos: aqueles que foram tratados pelo sistema de saúde pública e os participantes em protocolos de pesquisa clínica. Os dados coletados a partir dos prontuários foram: características sócio-demográficas e clínicas, tipo de cirurgia e informações patológicas. A análise estatística foi realizada por meio dos testes Qui-quadrado, exato de Fisher, t de Student; a curva de sobrevivência foi realizada de acordo com o método de Kaplan-Meier e regressão de Cox. A significância foi considerada quando p <0,05. Resultados: A maioria dos pacientes era do sexo masculino (68,6%), Caucasianos (94,9%), e não tinham histórico familiar de câncer (91,6%). A maioria dos casos foi submetida à nefrectomia e o tipo histológico mais freqüente foi o carcinoma de células claras (90,7%). A sobrevida global mediana para todos os pacientes foi de 50,2 (45,0-54,7) meses. A sobrevida global foi diferente entre os pacientes incluídos em ensaios clínicos [142,1 meses (IC 95%: 94.1- 152,6)] e aqueles tratados no sistema público de saúde [44,9 meses (IC 95%: 39,5-49,1)] (p <0,001). A taxa de risco não ajustada foi de 0,24 (0,15-0,37); após o ajuste para idade, sexo, tabagismo no momento do diagnóstico, índice de massa corporal, cor da pele, origem do paciente, pontuação ECOG, histologia e estadiamento clínico, a taxa de risco foi de 0,26 (0,13-0,55) (p <0,001). Conclusão: Pacientes com carcinoma de células renais tratados em protocolos de pesquisa clínica têm maior sobrevida quando comparados aos pacientes tratados no âmbito do sistema público de saúde no Brasil. Esse achado sugere fortemente que, neste cenário, a participação em protocolos de pesquisa clínica deve ser incentivada.Submitted by Setor de Tratamento da Informação - BC/PUCRS (tede2@pucrs.br) on 2015-06-15T11:52:31Z No. of bitstreams: 1 470446 - Texto Completo.pdf: 5542034 bytes, checksum: cb2fd7a5960d4cf7f92d7bee885029f6 (MD5)Made available in DSpace on 2015-06-15T11:52:31Z (GMT). No. of bitstreams: 1 470446 - Texto Completo.pdf: 5542034 bytes, checksum: cb2fd7a5960d4cf7f92d7bee885029f6 (MD5) Previous issue date: 2015-03-23application/pdfhttp://tede2.pucrs.br:80/tede2/retrieve/162964/470446%20-%20Texto%20Completo.pdf.jpgporPontifícia Universidade Católica do Rio Grande do SulPrograma de Pós-Graduação em Medicina e Ciências da SaúdePUCRSBrasilFaculdade de MedicinaMEDICINAONCOLOGIANEOPLASIAS RENAISCARCINOMA DE CÉLULAS RENAISNEFROPATIASSOBREVIDACIENCIAS DA SAUDE::MEDICINAPerfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRSinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesis7620745074616285884600600600-8624664729441623247-969369452308786627info:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da PUC_RSinstname:Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)instacron:PUC_RSTHUMBNAIL470446 - Texto Completo.pdf.jpg470446 - Texto Completo.pdf.jpgimage/jpeg3058http://tede2.pucrs.br/tede2/bitstream/tede/6135/4/470446+-+Texto+Completo.pdf.jpgc5474a6d7988de177c2da20a32a647eeMD54TEXT470446 - Texto Completo.pdf.txt470446 - Texto Completo.pdf.txttext/plain87793http://tede2.pucrs.br/tede2/bitstream/tede/6135/3/470446+-+Texto+Completo.pdf.txt01134dd9684aa5d85d533cae42613b14MD53ORIGINAL470446 - Texto Completo.pdf470446 - Texto Completo.pdfapplication/pdf5542034http://tede2.pucrs.br/tede2/bitstream/tede/6135/2/470446+-+Texto+Completo.pdfcb2fd7a5960d4cf7f92d7bee885029f6MD52LICENSElicense.txtlicense.txttext/plain; charset=utf-8610http://tede2.pucrs.br/tede2/bitstream/tede/6135/1/license.txt5a9d6006225b368ef605ba16b4f6d1beMD51tede/61352015-09-29 08:25:25.455oai:tede2.pucrs.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://tede2.pucrs.br/tede2/PRIhttps://tede2.pucrs.br/oai/requestbiblioteca.central@pucrs.br||opendoar:2015-09-29T11:25:25Biblioteca Digital de Teses e Dissertações da PUC_RS - Pontifícia Universidade Católica do Rio Grande do Sul (PUCRS)false |
dc.title.por.fl_str_mv |
Perfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRS |
title |
Perfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRS |
spellingShingle |
Perfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRS Zamprogna, Luciana MEDICINA ONCOLOGIA NEOPLASIAS RENAIS CARCINOMA DE CÉLULAS RENAIS NEFROPATIAS SOBREVIDA CIENCIAS DA SAUDE::MEDICINA |
title_short |
Perfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRS |
title_full |
Perfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRS |
title_fullStr |
Perfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRS |
title_full_unstemmed |
Perfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRS |
title_sort |
Perfil epidemiológico de pacientes com carcinoma de células renais atendidos no Hospital São Lucas da PUCRS |
author |
Zamprogna, Luciana |
author_facet |
Zamprogna, Luciana |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Costa, Bartira Ercília Pinheiro da |
dc.contributor.advisor1ID.fl_str_mv |
407.315.450-87 |
dc.contributor.advisor1Lattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4782193E7 |
dc.contributor.authorID.fl_str_mv |
709.955.670-34 |
dc.contributor.authorLattes.fl_str_mv |
http://buscatextual.cnpq.br/buscatextual/visualizacv.do?id=K4292638Y4 |
dc.contributor.author.fl_str_mv |
Zamprogna, Luciana |
contributor_str_mv |
Costa, Bartira Ercília Pinheiro da |
dc.subject.por.fl_str_mv |
MEDICINA ONCOLOGIA NEOPLASIAS RENAIS CARCINOMA DE CÉLULAS RENAIS NEFROPATIAS SOBREVIDA |
topic |
MEDICINA ONCOLOGIA NEOPLASIAS RENAIS CARCINOMA DE CÉLULAS RENAIS NEFROPATIAS SOBREVIDA CIENCIAS DA SAUDE::MEDICINA |
dc.subject.cnpq.fl_str_mv |
CIENCIAS DA SAUDE::MEDICINA |
description |
Introduction: New drugs have been developed to treat renal cell carcinoma apparently improving overall survival. Methods: This is an observational study in a retrospective cohort. Five hundred nine patients with renal cell carcinoma treated between 2002 and 2012 in Southern Brazil were divided in two groups: patients receiving public health system care and participants in clinical research protocols. Data collected from medical records were: socio-demographic and clinical characteristics, type of surgery and pathological information. Statistical analysis was performed using Chi-square, Fisher exact, Student's t tests; the survival curve was according to Kaplan-Meier method and Cox regression. Significance was considered at p<0.05. Results: Patients were male (68.6%), Caucasian (94.9%), and had no family history of cancer (91.6%). Most cases were submitted to nephrectomy and the most frequent histological type was clear cell carcinoma (90.7%). Global median survival for all patients was 50.2 (45.0-54.7) months. Global survival was different between patients enrolled in clinical trials [142.1 months (95% CI: 94.1- 152.6)] and those treated in the public health system [44.9 months (95% CI: 39.5 - 49.1)] (p<0.001). The unadjusted hazard ratio was 0.24 (0.15-0.37). After adjustment for gender, age, smoking at the time of diagnosis, body mass index, skin color, patient origin, ECOG score, histology and clinical stage, hazard ratio was 0.26 (0.13-0.55) (p<0.001). Conclusion: Renal cell carcinoma patients treated in clinical research protocols have longer survival when compared to patients managed within the public health care system in Brazil. This finding strongly suggests that, in this setting, participation in clinical research protocols should be encouraged. |
publishDate |
2015 |
dc.date.accessioned.fl_str_mv |
2015-06-15T11:52:31Z |
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2015-03-23 |
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Pontifícia Universidade Católica do Rio Grande do Sul |
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Programa de Pós-Graduação em Medicina e Ciências da Saúde |
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PUCRS |
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Brasil |
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Faculdade de Medicina |
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Pontifícia Universidade Católica do Rio Grande do Sul |
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