Introduction To analyze COVID-19 mortality in cancer patients and associated factors such as age, sex, type of insurance, situation at COVID-19 diagnosis, and cancer histology during the pandemic at a cancer center in Brazil. Methods Cross-sectional study carried out from April 02, 2020 to August 31, 2020 at A.C. Camargo Cancer Center (ACCCC), in São Paulo, Brazil. Cases were extracted from the Hospital Cancer Registry. COVID-19 lethality rates by histology were calculated; multiple logistic regression was used to identify factors associated with COVID-19 mortality. The log-rank test was applied to compare the survival curves for each variable. Results Of the 411 patients analyzed, 51 (12.4%) died due to COVID-19. Death occurred at an average age of 63 years. The fatality rate was higher for lung (0.333) and hematological (0.213) cancers and was associated with age over 60 years. The greatest chances of death from COVID-19 were in cases of lung (odds ratio, OR, 4.05, 95% confidence interval, CI 1.33–12.34) and hematological (OR 2.17, 95% CI 0.96–4.90) cancers, and in patients currently undergoing cancer treatment (OR 2.77, 95% CI 1.25–6.13). There were no statistical differences in survival by sex, age group, type of insurance, situation at the diagnosis of COVID-19, and histology of cancer for COVID-19. Conclusions Mortality due to COVID-19 in cancer patients is heterogeneous. These findings reinforce the need for individualized strategies for the management of different types of cancer that reduce the risk of death from COVID-19.
Gastric cancer (GC) is the fifth most common type of cancer worldwide with high incidences in Asia, Central, and South American countries. This patchy distribution means that GC studies are neglected by large research centers from developed countries. The need for further understanding of this complex disease, including the local importance of epidemiological factors and the rich ancestral admixture found in Brazil, stimulated the implementation of the GE4GAC project. GE4GAC aims to embrace epidemiological, clinical, molecular and microbiological data from Brazilian controls and patients with malignant and pre-malignant gastric disease. In this letter, we summarize the main goals of the project, including subject and sample accrual and current findings.
Objective: This study aimed to analyze the prognosis of women with breast cancer by molecular subtypes, sociodemographic variables, and clinical and treatment characteristics. Methods: This hospital-based retrospective cohort study analyzed 1,654 women over 18 years of age diagnosed with invasive breast cancer from 2000 to 2018. Data were extracted from Brazil’s Oncocenter Foundation of São Paulo. The variables analyzed were age, histology, molecular subtypes, clinical staging, treatment type, and diagnosis-to-treatment time. Cox regression analysis was applied to estimate death risk. Results: Women with HER-2-positive (nonluminal) and triple-negative molecular subtypes were more than twice more likely to be at risk of death, with adjusted hazard ratio — HRadj=2.30 (95% confidence interval — 95%CI 1.34–3.94) and HRadj=2.51 (95%CI 1.61–3.92), respectively. A delayed treatment associated with an advanced clinical stage at diagnosis increased fourfold the risk of death (HRadj=4.20 (95%CI 2.36–7.49). Conclusion: In summary, besides that interaction between advanced clinical stage and longer time between diagnosis and treatment, HER-2-positive (nonluminal) and triple-negative phenotypes were associated with a worse prognosis. Therefore, actions to reduce barriers in diagnosis and treatment can provide better outcome, even in aggressive phenotypes.
Background: Studies that analyze biomarkers as prognostic factors are scarce due to the high cost of the examination in low-income populations. Objective: The aim of this study was to describe the sociodemographic variables, clinical, treatment characteristics, and molecular subtype from women with breast cancer through probabilistic and deterministic record linkage between Hospitalar Cancer Registry and Immunohistochemistry Laboratory database at the Oncocenter Foundation of São Paulo (FOSP). Methods: To obtain a complete follow-up of the patients, a link was made between the two bases of FOSP. The deterministic linkage, using the examination number, was applied between the database composed of hormonal receptors and the Ki-67 antigen versus the database formed by the HER-2 receptor, stored in the immunohistochemistry laboratory’s (FOSP) information system. The probabilistic linkage was performed on the program OpenReclink III, version 3.1.615. The variables used in the matching process were the patient’s name and date of birth. As for blocking, the variables were soundex of the first name, soundex of last name. Confirmatory variables for acceptance of a true match were, when available, mother’s name, home address, Public Health System (SUS) card, and/or another personal identification document. Results: As result, 1,654 patients were matched. The average age was 56.8 (SD=13.2), with a median age of 56, varying between 22 and 96 years. Of these, 48% completed middle school. As for clinical characteristics, most tumors were of the ductal type (71.9%); and 7.2% of patients were presented with distant metastasis at diagnosis. Among the biomarkers, there was 25.9% for ER−, 33.9% for PR−, 85.5% negative HER-2, and 68.3% Ki-67 (≥14%). Of the molecular subtypes, the Luminal B (Her2−) phenotype was more frequent among patients and 15.2% were triple negative. Conclusion: The linkage techniques contributed with the completeness of information, contributing in defining the vital status of the patient.
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