Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado
Autor(a) principal: | |
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Data de Publicação: | 2008 |
Tipo de documento: | Dissertação |
Idioma: | por |
Título da fonte: | Biblioteca Digital de Teses e Dissertações da UERJ |
Texto Completo: | http://www.bdtd.uerj.br/handle/1/4270 |
Resumo: | Prostate cancer is the most incident malignant neoplasia among Brazilian men. Currently, great part of these tumors is confined to the prostate at the moment of the diagnosis. However, many tumors is clinically classified as local diseases, actually has already extra-prostatic extension, making the curative therapies ineffective. On the other hand, many patients with cancer without clinical significance are unnecessarily treated, because of the limited prognostic ability of the clinical stage. To determine the 5 and 10 years survival and to evaluate the clinical prognostic factors (pre-treatment) for patients with histologic diagnosis of adenocarcinoma of the prostate, in early clinical stages (I and II), in a hospital cohort of patients treated in the National Institute of Cancer, Rio de Janeiro, registered from 1990 to 1999. Kaplan-Meier survival functions were estimated, using the date of the histologic diagnosis as the initial time of follow-up and, as events, the deaths due to prostate cancer . To evaluate the prognostic factors, the hazard ratios (HR) were calculated, with confidence intervals of 95%, following the Cox s proportional hazards model. The following variables were analyzed as independent prognostic factors: age, color, degree of instruction, year of first treatment, histologic differentiation grade of the biopsy specimens (Gleason), clinical stage and pretreatment PSA. The assumption of proportionality of risks was assessed using Schoenfeld s residuals analysis and, the influence of outliers in the model fitness, was addressed using martingale and score residuals. The study s cohort included 258 patients with the study s eligibility criteria, of which 46 had died during the follow-up time. The overall survival rate was of 88% for 5 years and 71% for 10 years. Age of 80 years or more, Gleason score higher than 6, PSA levels higher than 40ng/ml, B2 stage and white race were independent makers of bad prognosis. Classics prognostic factors were useful in the estimate of the prognostic in this cohort. The study s results showed that, for patients diagnosed in early stages, the socio-economic factors analyzed did not influence the prognostic. Other studies must be carried out, in the country, in order to investigate the differences in the prognostic in relation to the ethnicity. |
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Silva, Gulnar Azevedo ehttp://lattes.cnpq.br/5225298757437978Teixeira, Maria Teresa Bustamantehttp://lattes.cnpq.br/4231160378291465Rebelo, Marise Soutohttp://lattes.cnpq.br/9634170020045412Sichieri, Roselyhttp://lattes.cnpq.br/4204048575326745http://lattes.cnpq.br/6181149173563038Santos, Arn Migowski Rocha dos2020-07-05T16:07:04Z2014-07-092008-03-27SANTOS, Arn Migowski Rocha dos. Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado. 2008. 112 f. Dissertação (Mestrado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2008.http://www.bdtd.uerj.br/handle/1/4270Prostate cancer is the most incident malignant neoplasia among Brazilian men. Currently, great part of these tumors is confined to the prostate at the moment of the diagnosis. However, many tumors is clinically classified as local diseases, actually has already extra-prostatic extension, making the curative therapies ineffective. On the other hand, many patients with cancer without clinical significance are unnecessarily treated, because of the limited prognostic ability of the clinical stage. To determine the 5 and 10 years survival and to evaluate the clinical prognostic factors (pre-treatment) for patients with histologic diagnosis of adenocarcinoma of the prostate, in early clinical stages (I and II), in a hospital cohort of patients treated in the National Institute of Cancer, Rio de Janeiro, registered from 1990 to 1999. Kaplan-Meier survival functions were estimated, using the date of the histologic diagnosis as the initial time of follow-up and, as events, the deaths due to prostate cancer . To evaluate the prognostic factors, the hazard ratios (HR) were calculated, with confidence intervals of 95%, following the Cox s proportional hazards model. The following variables were analyzed as independent prognostic factors: age, color, degree of instruction, year of first treatment, histologic differentiation grade of the biopsy specimens (Gleason), clinical stage and pretreatment PSA. The assumption of proportionality of risks was assessed using Schoenfeld s residuals analysis and, the influence of outliers in the model fitness, was addressed using martingale and score residuals. The study s cohort included 258 patients with the study s eligibility criteria, of which 46 had died during the follow-up time. The overall survival rate was of 88% for 5 years and 71% for 10 years. Age of 80 years or more, Gleason score higher than 6, PSA levels higher than 40ng/ml, B2 stage and white race were independent makers of bad prognosis. Classics prognostic factors were useful in the estimate of the prognostic in this cohort. The study s results showed that, for patients diagnosed in early stages, the socio-economic factors analyzed did not influence the prognostic. Other studies must be carried out, in the country, in order to investigate the differences in the prognostic in relation to the ethnicity.O câncer de próstata é a neoplasia mais incidente entre os homens brasileiros. Atualmente, grande parte destes tumores é confinada à próstata no momento do diagnóstico. No entanto, muitos tumores clinicamente classificados como localizados não o são de fato, levando a indicações terapêuticas curativas não efetivas. Por outro lado, muitos pacientes com câncer sem significância clínica são tratados desnecessariamente em função da limitação prognóstica do estadiamento clínicos (pré-tratamento) de pacientes com diagnóstico histológico de adenocarcinoma de próstata localizado (estágios I e II), em coorte hospitalar composta por pacientes tratados no Instituto Nacional de Câncer, Rio de Janeiro, matriculados entre 1990 a 1999. As funções de sobrevida foram calculadas empregando-se o estimados de Kaplan-Meier tomando-se como início a data do diagnóstico histológico e como eventos os óbitos cuja causa básica foi o câncer de próstata. Para avaliação dos fatores prognósticos clínicos foram calculadas as hazard ratios (HR), com intervalos de confiança de 95%, seguindo-se o modelo de riscos proporcionais de Cox. Foram analisadas como fatores prognósticos independentes as variáveis: idade, cor, grau de instrução, data do primeiro tratamento, grau de diferenciação celular d o tumor primário biopsiado (Gleason), estadiamento clínico e PSA total pré-tratamento. O pressuposto dos riscos proporcionais foi avaliado pela análise dos resíduos de Schoenfeld e a influência de valores aberrantes pelos resíduos martingale e escore. Foram selecionados 258 pacientes pelos critérios de elegibilidade do estudo, dos quais 46 foram a óbito durante o período de seguimento. A sobrevida global foi de 88% em 5 anos e de 71% em 10 anos. Idade maior que 80 anos, classificação de Gleason maior que 6, PSA maior que 40ng/ml, estádio B2 e cor branca foram marcadores independentes de pior prognóstico. Fatores prognósticos clássicos na literatura foram úteis na estimativa do prognóstico nesta coorte hospitalar. Os resultados mostram que para pacientes diagnosticados em fases iniciais, os fatores sócio-econômico analisados, não influenciaram o prognóstico. Outros estudos devem ser conduzidos no país para investigar as diferenças no prognóstico em relação à etnia.Submitted by Boris Flegr (boris@uerj.br) on 2020-07-05T16:07:04Z No. of bitstreams: 1 Arn Migowsk Rocha dos Santos-Dissertacao.pdf: 2353156 bytes, checksum: e9d0b64ed318b86ade3f017dedb3d1d0 (MD5)Made available in DSpace on 2020-07-05T16:07:04Z (GMT). No. of bitstreams: 1 Arn Migowsk Rocha dos Santos-Dissertacao.pdf: 2353156 bytes, checksum: e9d0b64ed318b86ade3f017dedb3d1d0 (MD5) Previous issue date: 2008-03-27application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Saúde ColetivaUERJBRCentro Biomédico::Instituto de Medicina SocialProstatic neoplasmPrognosisProstate-specific antigenNeoplasias prostáticasAntígeno prostático específicoPrognósticoCNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIASobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizadoSurvival and prognostic factors in a hospital cohort of patients with localized prostate cancerinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALArn Migowsk Rocha dos Santos-Dissertacao.pdfapplication/pdf2353156http://www.bdtd.uerj.br/bitstream/1/4270/1/Arn+Migowsk+Rocha+dos+Santos-Dissertacao.pdfe9d0b64ed318b86ade3f017dedb3d1d0MD511/42702024-02-26 20:29:16.786oai:www.bdtd.uerj.br:1/4270Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T23:29:16Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false |
dc.title.por.fl_str_mv |
Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado |
dc.title.alternative.eng.fl_str_mv |
Survival and prognostic factors in a hospital cohort of patients with localized prostate cancer |
title |
Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado |
spellingShingle |
Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado Santos, Arn Migowski Rocha dos Prostatic neoplasm Prognosis Prostate-specific antigen Neoplasias prostáticas Antígeno prostático específico Prognóstico CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA |
title_short |
Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado |
title_full |
Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado |
title_fullStr |
Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado |
title_full_unstemmed |
Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado |
title_sort |
Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado |
author |
Santos, Arn Migowski Rocha dos |
author_facet |
Santos, Arn Migowski Rocha dos |
author_role |
author |
dc.contributor.advisor1.fl_str_mv |
Silva, Gulnar Azevedo e |
dc.contributor.advisor1Lattes.fl_str_mv |
http://lattes.cnpq.br/5225298757437978 |
dc.contributor.referee1.fl_str_mv |
Teixeira, Maria Teresa Bustamante |
dc.contributor.referee1Lattes.fl_str_mv |
http://lattes.cnpq.br/4231160378291465 |
dc.contributor.referee2.fl_str_mv |
Rebelo, Marise Souto |
dc.contributor.referee2Lattes.fl_str_mv |
http://lattes.cnpq.br/9634170020045412 |
dc.contributor.referee3.fl_str_mv |
Sichieri, Rosely |
dc.contributor.referee3Lattes.fl_str_mv |
http://lattes.cnpq.br/4204048575326745 |
dc.contributor.authorLattes.fl_str_mv |
http://lattes.cnpq.br/6181149173563038 |
dc.contributor.author.fl_str_mv |
Santos, Arn Migowski Rocha dos |
contributor_str_mv |
Silva, Gulnar Azevedo e Teixeira, Maria Teresa Bustamante Rebelo, Marise Souto Sichieri, Rosely |
dc.subject.eng.fl_str_mv |
Prostatic neoplasm Prognosis Prostate-specific antigen |
topic |
Prostatic neoplasm Prognosis Prostate-specific antigen Neoplasias prostáticas Antígeno prostático específico Prognóstico CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA |
dc.subject.por.fl_str_mv |
Neoplasias prostáticas Antígeno prostático específico Prognóstico |
dc.subject.cnpq.fl_str_mv |
CNPQ::CIENCIAS DA SAUDE::SAUDE COLETIVA::EPIDEMIOLOGIA |
description |
Prostate cancer is the most incident malignant neoplasia among Brazilian men. Currently, great part of these tumors is confined to the prostate at the moment of the diagnosis. However, many tumors is clinically classified as local diseases, actually has already extra-prostatic extension, making the curative therapies ineffective. On the other hand, many patients with cancer without clinical significance are unnecessarily treated, because of the limited prognostic ability of the clinical stage. To determine the 5 and 10 years survival and to evaluate the clinical prognostic factors (pre-treatment) for patients with histologic diagnosis of adenocarcinoma of the prostate, in early clinical stages (I and II), in a hospital cohort of patients treated in the National Institute of Cancer, Rio de Janeiro, registered from 1990 to 1999. Kaplan-Meier survival functions were estimated, using the date of the histologic diagnosis as the initial time of follow-up and, as events, the deaths due to prostate cancer . To evaluate the prognostic factors, the hazard ratios (HR) were calculated, with confidence intervals of 95%, following the Cox s proportional hazards model. The following variables were analyzed as independent prognostic factors: age, color, degree of instruction, year of first treatment, histologic differentiation grade of the biopsy specimens (Gleason), clinical stage and pretreatment PSA. The assumption of proportionality of risks was assessed using Schoenfeld s residuals analysis and, the influence of outliers in the model fitness, was addressed using martingale and score residuals. The study s cohort included 258 patients with the study s eligibility criteria, of which 46 had died during the follow-up time. The overall survival rate was of 88% for 5 years and 71% for 10 years. Age of 80 years or more, Gleason score higher than 6, PSA levels higher than 40ng/ml, B2 stage and white race were independent makers of bad prognosis. Classics prognostic factors were useful in the estimate of the prognostic in this cohort. The study s results showed that, for patients diagnosed in early stages, the socio-economic factors analyzed did not influence the prognostic. Other studies must be carried out, in the country, in order to investigate the differences in the prognostic in relation to the ethnicity. |
publishDate |
2008 |
dc.date.issued.fl_str_mv |
2008-03-27 |
dc.date.available.fl_str_mv |
2014-07-09 |
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2020-07-05T16:07:04Z |
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info:eu-repo/semantics/publishedVersion |
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info:eu-repo/semantics/masterThesis |
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masterThesis |
status_str |
publishedVersion |
dc.identifier.citation.fl_str_mv |
SANTOS, Arn Migowski Rocha dos. Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado. 2008. 112 f. Dissertação (Mestrado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2008. |
dc.identifier.uri.fl_str_mv |
http://www.bdtd.uerj.br/handle/1/4270 |
identifier_str_mv |
SANTOS, Arn Migowski Rocha dos. Sobrevida e fatores prognósticos em uma coorte hospitalar de pacientes com câncer de próstata localizado. 2008. 112 f. Dissertação (Mestrado em Ciências Humanas e Saúde; Epidemiologia; Política, Planejamento e Administração em Saúde; Administra) - Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2008. |
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http://www.bdtd.uerj.br/handle/1/4270 |
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Universidade do Estado do Rio de Janeiro |
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