A carregar...
Publicação
Tumores germinais : a experiência do CHLN - HSM
| Nome: | Descrição: | Tamanho: | Formato: | |
|---|---|---|---|---|
| 784.51 KB | Adobe PDF |
Autores
Orientador(es)
Resumo(s)
Introdução: A neoplasia do testículo constitui 1% de todas as neoplasias diagnosticadas em indivíduos do sexo masculino e tem um pico de incidência entre os 15 e os 44 anos, tendo esta aumentado globalmente, sobretudo nos últimos 50 anos. As neoplasias dividem-se em germinativas (98%) e não germinativas (2%), dividindo-se as primeiras em seminomas e NSGCT (carcinomas embrionários, coriocarcionomas, teratomas, tumores do saco vitelino e tumores mistos). O estadiamento segue a classificação TNMS, que usa como marcadores tumorais a AFP, a β-hCG e a LDH. A classificação IGCCC determina o prognóstico e sobrevivência a 5 anos. Apesar da elevada incidência em indivíduos jovens, as taxas de cura e sobrevivência são muito favoráveis – em 95% da totalidade e 80% dos doentes com doença metastática, é expectável uma cura.
Objectivos e métodos: Realizou-se uma análise retrospectiva dos tumores germinativos no Serviço de Oncologia do CHLN entre os anos de 2010 e 2014, avaliando-se as características epidemiológicas dos casos acompanhados e comparando-as com as tendências globais.
Resultados e discussão: O estudo incluiu 37 doentes que foram seguidos ao longo de 5 anos (2010-2014). A idade média de diagnóstico foi de 31,2 anos (mínima - 18 anos; máxima - 53 anos). Nenhum doente apresentava antecedentes pessoais de criptorquidia. Os seminomas representaram 54,05% (n=20) dos diagnósticos, sendo os restantes 45,95% (n=17) NSGCT (32,43% (n=12) carcinoma mistos; 10,81% (n=4) carcinoma embrionário; 2,70% (n=1) teratoma). Todos os marcadores tumorais demostraram uma diminuição progressiva ao longo do tempo, excepto a AFP nos seminomas. A primeira linha terapêutica foi BEP em 45,0% (n=9) e 94,12% (n=16), carboplatina em 30,0% (n=6) e 0% (n=0) dos seminomas e NSGCT, respectivamente. Uma segunda e terceira linhas tearpêuticas foram realizadas em 10,53% (n=5) e 5,26% (n=3) dos doentes, respectivamente. A taxa de mortalidade foi de 8,11% (n=3). A maioria dos dados vão ao encontro das tendências globais. Propomos um estudo mais alargado para uma melhor compreensão da realidade portuguesa.
Introduction: Testicular cancer makes up 1% of all cancers diagnosed in males, with a peak in incidence between the ages of 15 and 44. Incidence has progressively and globally risen in the last 50 years. Testicular cancer can be divided into germ cell tumours (98%) and non-germ cell tumours (2%), the former being divided into seminomas and NSGCT (embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, teratoma, Leydig cell tumours and mixed tumours). Staging follows the TNMS-score, and AFP, β-hCG and LDH are used as tumour markers. The IGCCC classification determines prognosis and 5-year survival rates. Despite the high incidence in young males, the cure and survival rates are very promising – in 95% of the total and in 80% of patients with metastatic disease, a cure can be expected. Goals and methods: A retrospective study was conducted, which analysed germ cell tumours followed in the Oncology Department of CHLN between the years of 2010 and 2014. Epidemiologic features were analysed and compared to global data. Results and discussion: The study included 37 patients with a follow-up time of 5 years (2010-2014). The mean age of diagnosis was 31.2 years (minimum – 18 years; maximum – 53 years). No patient had a personal history of cryptorchidism. Seminomas represented 54.05% (n=20) of diagnoses, whereas NSGCT comprised the leftover 45.95% (n=17) (32,43% (n=12) mixed cell carcinoma; 10,81% (n=4) embryonal carcinoma; 2,70% (n=1) teratoma 31.58% (n=12). All tumour markers progressively declined over time, except AFP in seminomas. The first course of treatment was BEP in 45.0% (n=9) and 94.12% (n=16) and carboplatin in 30.0% (n=6) and 0% (n=0) of seminomas and NSGCT, respectively. A second and third course of treatment were needed in 10.53% (n=5) and 5.26% (n=3) of patients, respectively. Overall mortality rate was 8.11% (n=3). The majority of data are in agreement with global trends. We propose a larger study, in order to better understand the Portuguese reality.
Introduction: Testicular cancer makes up 1% of all cancers diagnosed in males, with a peak in incidence between the ages of 15 and 44. Incidence has progressively and globally risen in the last 50 years. Testicular cancer can be divided into germ cell tumours (98%) and non-germ cell tumours (2%), the former being divided into seminomas and NSGCT (embryonal carcinoma, yolk sac carcinoma, choriocarcinoma, teratoma, Leydig cell tumours and mixed tumours). Staging follows the TNMS-score, and AFP, β-hCG and LDH are used as tumour markers. The IGCCC classification determines prognosis and 5-year survival rates. Despite the high incidence in young males, the cure and survival rates are very promising – in 95% of the total and in 80% of patients with metastatic disease, a cure can be expected. Goals and methods: A retrospective study was conducted, which analysed germ cell tumours followed in the Oncology Department of CHLN between the years of 2010 and 2014. Epidemiologic features were analysed and compared to global data. Results and discussion: The study included 37 patients with a follow-up time of 5 years (2010-2014). The mean age of diagnosis was 31.2 years (minimum – 18 years; maximum – 53 years). No patient had a personal history of cryptorchidism. Seminomas represented 54.05% (n=20) of diagnoses, whereas NSGCT comprised the leftover 45.95% (n=17) (32,43% (n=12) mixed cell carcinoma; 10,81% (n=4) embryonal carcinoma; 2,70% (n=1) teratoma 31.58% (n=12). All tumour markers progressively declined over time, except AFP in seminomas. The first course of treatment was BEP in 45.0% (n=9) and 94.12% (n=16) and carboplatin in 30.0% (n=6) and 0% (n=0) of seminomas and NSGCT, respectively. A second and third course of treatment were needed in 10.53% (n=5) and 5.26% (n=3) of patients, respectively. Overall mortality rate was 8.11% (n=3). The majority of data are in agreement with global trends. We propose a larger study, in order to better understand the Portuguese reality.
Descrição
Trabalho Final do Curso de Mestrado Integrado em Medicina, Faculdade de Medicina, Universidade de Lisboa, 2017
Palavras-chave
Tumor testículo Tumor germinativo Terapêutica Epidemiologia Oncologia