ABSTRACT
Introduction: Oral cavity cancer (OCC) is one of the 10 most common types of tumors in the world. Surgical resection is the most indicated initial treatment, followed by adjuvant therapy, depending on tumor stage. A few studies have suggested that patients treated in high-volume hospitals present better oncologic outcomes; however, particularly in continental countries, some patients are treated in regional hospitals. Objective: To evaluate the results of OCC patients treated in low-volume regional hospitals. Methods: This is a retrospective longitudinal study conducted with patients diagnosed with OCC and operated on in a low-volume hospital between January 2003 and December 2018. Results: 174 patients with OCC were treated at the institution - an average of 11 patients/year. The most common tumor location was the tongue (48.2%), followed by the lip (18.2%). Squamous cell carcinomas were the most frequent (94.7% of patients). Adjuvant radiotherapy and chemotherapy were performed in 46.7 and 31.9% of patients, respectively. Almost 21% of patients had some postoperative complication. Specific survival of 62.6% and global survival of 58.2% after 3 years were similar to the results reported in high-volume centers. Disease-free survival was 45.8% in the same period. Conclusion: Low-volume hospitals qualified for oncological treatments can present outcomes similar to those of high-volume centers, and are thus a regional option for patients with OCC.
ABSTRACT
O presente artigo teve como objetivo avaliar e comparar as cirurgias realizadas para correção de hipospádia em três hospitais de Santa Catarina no período de 2010 a 2017. Foi realizado um estudo retrospectivo, descritivo e de abordagem quantitativa, com dados secundários de prontuários. A população do estudo foi composta por 179 pacientes de dois hospitais públicos (A e B) e um particular. Os resultados encontrados mostraram que 73,2% dos pacientes apresentaram-se com hipospádia distal. A técnica mais utilizada foi Snodgrass, representando 70,4% dos casos. A média de idade dos pacientes quando da primeira cirurgia foi de 34 meses, maior no hospital público B. Apenas 19,7%, dos 76 pacientes analisados, fizeram uso de testosterona tópica no pré-operatório, maioria do hospital particular. Entre aqueles analisados para infecção do trato urinário, 81 prontuários foram analisados e destes, 14,8% tiveram essa infecção, majoritariamente do hospital público A. Da amostra, 50 pacientes necessitaram reoperar, o que representa 28,9%. O motivo mais comum para reoperação foi a presença de fistula uretrocutânea (46%), seguida de estenose uretral (18%), não havendo diferença significativa entre a média de reoperações por hospitais. Concluiu-se que a idade da primeira cirurgia foi maior do que a indicada na literatura. Houve maior prevalência de hipospádia distal, sob correção pela técnica de Snodgrass. O uso de hormônio ocorreu predominantemente nos pacientes do hospital particular. A taxa de infecção do trato urinário do estudo foi maior do que o encontrado na literatura. O principal motivo para reoperação foi a presença de fistula uretrocutânea.
The present paper aims evaluate and compare the hypospadia surgery in three hospitals in the Santa Catarina between 2010 and 2017. This is an observational, retrospective and quantitative approach, with secondary data collection obtained through the analysis of medical records. The study population consisted of 179 patients from two public hospitals (A and B) and one private hospital. The results demonstrated that 73,2% of the patients presented with distal hypospadia. The technique most used was Snodgrass procedure, representing 70,4% of the cases. The mean age of the patients at the first surgery was 34 months, highest in the public hospital B. Only 19.7% of the 76 patients used preoperative hormone. Among those analyzed for urinary tract infection, 14,8% had this infection, mostly from the public hospital A. Of the study population, 50 needed to reoperate, which represents 28,9%. The most common reason for reoperation was the presence of fistula (46%). In our research, there was no significant difference between the mean number of reoperations per hospital. It was concluded that the age of the first surgery was higher than that indicated in the literature and there was a higher prevalence of distal hypospadia. The most underwent Snodgrass technique. The use of hormone occurred predominantly in the patients of the private hospital. The urinary tract infection rate of the study was higher than that found in the literature. The main reason for reoperation was the presence of urethrocutaneous fistula.