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Cancro de origem desconhecida
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Introdução: «Cancro de origem desconhecida» refere-se a neoplasias metastáticas nas quais não se deteta o tumor primário. Estas têm um caráter muito agressivo e sobrevida curta. A heterogeneidade do grupo impõe investigação para identificar subtipos que permitam aplicar estratégias terapêuticas mais dirigidas.
Métodos: Estudo descritivo retrospetivo que incidiu sobre todos os casos diagnosticados
como cancro de origem desconhecida seguidos no Serviço de Oncologia Médica do CHLN / HSM no período compreendido entre 1 de janeiro de 2010 e 31 de dezembro de
2012. Analisaram-se as caraterísticas clínicas, fez-se uma análise bibliográfica e comparou-se com as guidelines da ESMO.
Resultados: Vinte e nove casos cumpriam os critérios de elegibilidade. A idade mediana de aparecimento foi 65 anos e houve um ligeiro predomínio do sexo masculino. A maioria era carcinoma com baixo grau de diferenciação (41%) ou adenocarcinoma bem ou moderadamente diferenciado (28%). Cerca de um terço dos casos apresentava caraterísticas específicas. A sobrevida global mediana, em relação à data de diagnóstico,
foi de 4,6 meses. A sobrevida global ao 1 ano de 17.4%.
Conclusão: Os cancros de origem desconhecida surgem principalmente em idosos, apresentam sobrevida diferente consoante as suas caraterísticas mas sempre curta e a terapêutica é pouco eficaz.
Introduction: «Cancer of unknown primary” (CUP) refers to metastatic cancer in which the primary tumor cannot be identified. This group of cancers is very aggressive implying very short survival times. The group heterogeneity prompts investigations in order to detect subtypes of tumors that allow the development of specific therapeutic strategies. Methods: Descriptive and retrospective study of all cases with diagnosis of cancer of unknown primary followed in the medical oncology department of Hospital de Santa Maria between January 1st 2010 and December 31st 2012. Clinical characteristics were analyzed, compared with ESMO guidelines and the rest of the medical literature. Results: Twenty-nine cases followed eligibility criteria. Median age of the subjects was 65 years old and there was a small predominance of male patients. Most tumors were carcinomas with poor differentiation (41%) or moderate to well differentiated adenocarcinomas (28%). About a third of all cases belonged to ESMO’s group of specific CUP. Median overall survival from date of diagnosis was 4,6 months. Overall survival at 1-year was 17.4%. Conclusion: Cancers of unknown primary occur mainly in the elderly, have different survival times according to their characteristics but invariably short and therapeutic strategies have not been successful till present.
Introduction: «Cancer of unknown primary” (CUP) refers to metastatic cancer in which the primary tumor cannot be identified. This group of cancers is very aggressive implying very short survival times. The group heterogeneity prompts investigations in order to detect subtypes of tumors that allow the development of specific therapeutic strategies. Methods: Descriptive and retrospective study of all cases with diagnosis of cancer of unknown primary followed in the medical oncology department of Hospital de Santa Maria between January 1st 2010 and December 31st 2012. Clinical characteristics were analyzed, compared with ESMO guidelines and the rest of the medical literature. Results: Twenty-nine cases followed eligibility criteria. Median age of the subjects was 65 years old and there was a small predominance of male patients. Most tumors were carcinomas with poor differentiation (41%) or moderate to well differentiated adenocarcinomas (28%). About a third of all cases belonged to ESMO’s group of specific CUP. Median overall survival from date of diagnosis was 4,6 months. Overall survival at 1-year was 17.4%. Conclusion: Cancers of unknown primary occur mainly in the elderly, have different survival times according to their characteristics but invariably short and therapeutic strategies have not been successful till present.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2015
Palavras-chave
Neoplasias primárias desconhecidas Oncologia Idoso