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Doctoral Thesis
DOI
https://doi.org/10.11606/T.6.2020.tde-24032020-115625
Document
Author
Full name
Maria Lúcia Marçal Mazza Sundefeld
Institute/School/College
Knowledge Area
Date of Defense
Published
São Paulo, 1999
Supervisor
Committee
Gotlieb, Sabina Lea Davidson (President)
Corrente, Jose Eduardo
Kowalski, Luiz Paulo
Latorre, Maria do Rosário Dias de Oliveira
Saliba, Orlando
Title in Portuguese
Análise de sobrevida de pacientes diagnosticados com carcinoma espinocelular de boca, em Araçatuba, de 1980 a 1995
Keywords in Portuguese
Análise de Sobrevida
Câncer de Boca
Carcinoma Espinocelular
Fatores Prognósticos
Razão de Risco
Abstract in Portuguese
Objetivo: Analisar as probabilidades acumuladas de sobrevida dos pacientes diagnosticados com carcinoma espinocelular de boca, em Araçatuba, entre 1980 e 1995, e observados até dezembro de 1997, estabelecendo os fatores prognósticos significativos para o óbito. Método: O estudo se desenvolveu em uma coorte de 177 pacientes diagnosticados com carcinoma espinocelular de boca, na Faculdade de Odontologia de Araçatuba, UNESP, entre 1980 e 1995. Para avaliar a associação entre as variáveis independentes e o óbito, foram realizados testes de significância pela distribuição x2 e pelo Exato de Fisher. A taxa de sobrevida foi estimada pelo método de produto limite de Kaplan-Meier. Os fatores prognósticos foram estimados pelo modelo de riscos proporcionais de Cox, calculando-se Razão da Função de Risco (HR). Resultados: As probabilidades acumuladas de sobrevida foram iguais a 74%, 61% e 53,5%, respectivamente, para um, dois e cinco anos de seguimento. Para os casos em estádio N, as taxas de sobrevida foram 45,7%, 25,3% e 17 ,4%, respectivamente, até um, dois e cinco anos após o diagnóstico. Pacientes no estádio I apresentaram sobrevida em 5 anos de 95,6%. Fatores prognósticos estatisticamente significantes foram: estadiamento clínico da doença no momento do diagnóstico e localização anatômica do tumor. A estimativa da Razão das Funções de Riscos de morrer em pacientes diagnosticados no estádio III foi igual a 3,9, isto é, o risco é praticamente três vezes maior que o daqueles em estádio I; da mesma forma, o risco de morrer dos diagnosticados em estádio IV (HR= 1 0,85) é cerca de dez vezes ao daqueles em estádio I. Conclusões: O fator prognóstico de maior Razão de Risco foi estadiamento clínico no momento do diagnóstico. Sexo, idade, raça, hábito de beber e fumar e câncer na família não influenciaram a taxa de sobrevida. Relativamente às localizações, a região jugal, palato duro, gengiva e lingua apresentaram as maiores Razões de Risco.
Title in English
Survival analysis in patients diagnosed with squamous cell carcinoma of the mouth, in Araçatuba, São Paulo State, Brazil, from 1980 to 1995
Keywords in English
Oral Cancer
Prognostic Factors
Risk Ratio
Squamous Cell Carcinoma
Survival Analysis
Abstract in English
Objective: To analyze accumulated survival prohahilities in patients diagnosed with squamous cell carcinoma of the mouth, in Araçatuha, São Paulo State, Brazil, between 1980 and 1995, and followed-up until December of 1997. Methods: This study was applied in a cohort of 177 patients diagnosed with squamous cell carcinoma of the mouth, at the School of Dentistry, UNESP, in Araçatuha, São Paulo State, Brazil, between 1980 and 1995. Chi-squared or Fisher significance tests were performed to assess the association between independent variables and death. Survival was estimated using the Kaplan-Meier Product-Limit Method. Prognostic factors were estimated by Cox's proportional hazard ratio method, calculating risk ratios. Results: The accumulated survival probabilities were 74%, 61% and 53.5%, respectively, for one, two and five years follow-up. For cases in the stage N, the survival rates were 45.7%, 25.3% and 17.4%, respectively, for one, two and five years after diagnosis. Patients in stage I presented a five-year survival rate of 95.6%. Clinical staging of the disease at diagnosis and anatomic localization of the tumor were statistically significant prognostic factors. The estimated risk ratio for death in patients diagnosed in stage III was 3,9; therefore, for these patients the risk of dying is tree times higher than for those in stage I. Similarly, the risk of death for cases diagnosed in stage IV is approximately ten times that for patients in stage I (HR=10,85). Conclusions: Clinical staging at diagnosis was the prognostic factor with the greatest risk ratio. Gender, age, race, alcohol and smoke habits and cancer in family did not influence the survival rate. The sites: cheek, hard palate, gum and tongue presented higher risk ratios.
 
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Publishing Date
2020-03-24
 
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