Retardo diagnóstico e terapêutico em pacientes com câncer da laringe em hospital público de referência

Amar, Ali; Chedid, Helma Maria; Franzi, Sergio Altino; Rapoport, Abrão

doi:10.1590/s1808-86942010000600005

Cited by 16 publications

(7 citation statements)

References 7 publications

(12 reference statements)

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“…The median time treatment intervals we have identified are largely consistent with intervals reported in previous literature for other HNC subsites and may serve as national benchmarks for the treatment of ENB 5,6,8,9,17–22 . The DTI, RTD, and TTP intervals were consistent with other cancers; however, we found the SRT interval to be 55 days, a longer duration than for oropharyngeal cancers associated with HPV and salivary gland cancers, both of which had SRT intervals of 40 and 42 days, respectively.…”

Section: Discussionsupporting

confidence: 86%

Impact of esthesioneuroblastoma treatment delays on overall patient survival

et al. 2022

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Objectives To characterize clinical factors associated with esthesioneuroblastoma treatment delays and determine the impact of these delays on overall survival. Study Design Retrospective database analysis. Methods The 2004–2016 National Cancer Database was queried for patients with esthesioneuroblastoma managed by primary surgery and adjuvant radiation. Durations of diagnosis‐to‐treatment initiation (DTI), diagnosis‐to‐treatment end (DTE), surgery‐to‐RT initiation (SRT), radiotherapy treatment (RTD), and total treatment package (TTP) were analyzed. The cohort was split into two groups for each delay interval using the median time as the threshold. Results A total of 814 patients (39.6% female, 88.5% white) with mean ± SD age of 52.6 ± 15.1 years who underwent both esthesioneuroblastoma surgery and adjuvant radiotherapy were queried. Median DTI, DTE, SRT, RTD, and TTP were 34, 140, 55, 45, and 101 days, respectively. A significant association was identified between increased regional radiation dose above 66 Gy and decreased DTI (OR = 0.54, 95% CI 0.35–0.83, p = 0.01) and increased RTD (OR = 3.94, 95% CI 2.36–6.58, p < 0.001) durations. Chemotherapy administration was linked with decreased SRT (OR = 0.64, 95% CI 0.47–0.89, p = 0.01) and TTP (OR = 0.59, 95% CI 0.43–0.82, p = 0.001) durations. Cox proportional‐hazards analysis revealed that increased RTD was associated with decreased survival (HR = 1.80, 95% CI 1.26–2.57, p < 0.005), independent of age, sex, race, regional radiation dose, facility volume, facility type, insurance status, modified Kadish stage, chemotherapy status, Charlson‐Deyo comorbidity index, and surgical margins. Conclusions Delays during, and prolongation of radiotherapy for esthesioneuroblastoma appears to be associated with decreased survival. Level of Evidence 4 Laryngoscope, 133:764–772, 2023

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Section: Discussionsupporting

confidence: 86%

Impact of esthesioneuroblastoma treatment delays on overall patient survival

et al. 2022

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“…7,11 The diagnosis of laryngeal tumor is in the end made by the consultant and chronic hoarseness is known to be the first symptom to make the practician suspect a laryngeal tumor and even malignancy, in the other hand patients tend to neglect it and this of it as a benign affection that ' s going to resolve spontaneously. 4,8,12 Conversely, when patients take their symptoms seriously and seek medical advice, their condition could be mislabelled. 8 Schwartz and al published in 2009 clinical practice guideline for hoarseness and considered it an option to perform a laryngeal mirror examination or a laryngoscopy, reversing it smith and al find that the balance benefice risk tends to make it a recommendation or a strong recommendation to perform a laryngoscopy or refer for a laryngoscopy.…”

Section: Discussionmentioning

confidence: 99%

“…1,2 Nevertheless, this type of malignant tumors is often diagnosed in its advanced, aggressive stages, which leads to a great morbidity and mortality rates; as the clinical staging is directly related to a poor prognosis. [3][4][5] This problematic has been the subject of multiple papers; studying the overall survival of laryngeal squamous carcinoma. [1][2][3][4][5][6] So, what are the incriminated factors leading to this delayed diagnosis and in consequence poor prognosis?…”

Section: Introductionmentioning

confidence: 99%

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Factors involved in diagnosis delay and poor prognosis in laryngeal squamous carcinoma: a retrospective study about 86 cases

Benhoummad

Rochd

Rizkou

et al. 2022

Int J Otorhinolaryngol Head Neck Surg

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Background: Squamous cell carcinoma of head and neck seems to be the seventh most common histological type worldwide with a great morbidity and mortality rates. Multiple published papers studied the overall survival of laryngeal squamous carcinoma depending on different factors. The aim of the study was to analyze the different factors that could impact the patient and the professional delays, and hence analyze factors related to poor prognosis and overall survival rates.Methods: Retrospective descriptive and analytic study between January 2015 and January 2020 in ENT-HNS department in university hospital Mohammed VI of Marrakech. All patients admitted for confirmed histologically with a primary laryngeal squamous carcinoma and who consented to this study were included in our study, grouping 86 patients.Results: Age and denial of care were the factors related to patient delay (p=0.044), medical doctors (0.030), the first consult decision (0.044) and the malpractice (0.008) were statistically related to the professional delay. The multivariate analysis with disease specific survival found that the tumor location (p=0.022), the disease staging at diagnosis (0.047), the Charlson comorbidity index (p=0.017), the patient delay and professional delay (p<0.001) were associated to a poor survival rate.Conclusions: Patient and professional delays are factors that could be controlled by emphasizing the importance of medical consult when presenting laryngeal symptoms and the essential role of primary care doctors during 1st consult and how crucial it is to make a full examination and even refer patients to specialist when malignancy is suspected.

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“…The severity of comorbidity conditions may be graded according to their impact on the adopted treatment and life expectancy 6 . A recent study 7 on the time elapsed between the diagnosis and the beginning of the laryngeal cancer treatment in a hospital that is a benchmark for these cases found that the average time between the first doctor's appointment and the beginning of treatment was 49 days.…”

Section: Introductionmentioning

confidence: 99%

Pacientes com câncer de laringe no Nordeste: intervenção cirúrgica e reabilitação fonoaudiológica

Silva

Dornelas²,

Freitas

et al. 2016

Rev. CEFAC

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Purpose: to describe the number of cases of patients with laryngeal cancer in the Northeast and the possibilities of surgical and therapeutic interventions funded by the Public Service. Methods: a descriptive epidemiological study, which relied on secondary data obtained via query-based Datasus data, collected data for the period from January 2008 to December 2012 Results: increasing the number of cases of laryngeal cancer over the years, male predominance, increased number of hospitalizations, partial laryngectomy as a medical procedure most used and the most amount of speech associated with SUS was observed in Pernambuco. Conclusion: information strategy for health promotion and prevention of laryngeal cancer can help to minimize or even reverse the spread of the number of cases. Keywords: Laryngeal Neoplasms; Speech, Language and Hearing Sciences; Delivery of Health Care. RESUMOObjetivo: caracterizar a assistência hospitalar em pacientes com câncer de laringe, na perspectiva da intervenção cirúrgica e reabilitação fonoaudiológica ofertada pelo Sistema Único de Saúde (SUS) na região Nordeste. Métodos: estudo epidemiológico descritivo, que contou com dados secundários obtidos via consulta à base de dados DATASUS, tendo levantado informações referentes ao período de janeiro de 2008 a dezembro de 2012. Resultados: aumento do número de casos de câncer de laringe com o passar dos anos, predominân-cia do sexo masculino, aumento no número de internações, laringectomia parcial como procedimento médico mais utilizado e a maior quantidade de fonoaudiólogos vinculados ao SUS foi observada em Pernambuco. Conclusão: a assistência hospitalar aos pacientes com câncer de laringe contempla estratégias como procedimentos cirúrgicos e intervenção fonoaudiológica. Faz-se necessário que essa assistência contemple aspectos direcionados à prevenção de doenças, pois a informação em saúde, por meio de estratégias educativas, pode contribuir para o diagnóstico precoce e tratamento da doença.

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Retardo diagnóstico e terapêutico em pacientes com câncer da laringe em hospital público de referência

Cited by 16 publications

References 7 publications

Impact of esthesioneuroblastoma treatment delays on overall patient survival

Impact of esthesioneuroblastoma treatment delays on overall patient survival

Factors involved in diagnosis delay and poor prognosis in laryngeal squamous carcinoma: a retrospective study about 86 cases

Pacientes com câncer de laringe no Nordeste: intervenção cirúrgica e reabilitação fonoaudiológica

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