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3.
Ciudad Autónoma de Buenos Aires; Comisión Nacional de Evaluación de Tecnologías de Salud; Marzo 2021. 29 p. (Informe de Evaluación de Tecnologías Sanitarias N°12, 12).
Monography in Spanish | LILACS, BINACIS, ARGMSAL | ID: biblio-1151677

ABSTRACT

El presente informe es producto del trabajo colaborativo de la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC), dependiente del Ministerio de Salud de la Nación y creada por RM N° 623/2018. La CONETEC realiza evaluaciones y emite recomendaciones a la autoridad sanitaria sobre la incorporación, forma de uso, financiamiento y políticas de cobertura de las tecnologías sanitarias desde una perspectiva global del sistema de salud argentino. En sus evaluaciones y recomendaciones, la CONETEC tiene en cuenta criterios de calidad, seguridad, efectividad, eficiencia y equidad, evaluados bajo dimensiones éticas, médicas, económicas y sociales. Sus resultados son consensuados mediante discusiones públicas y ponderados a través de un marco de valor explícito, con la participación de todos los actores involucrados en el proceso de toma de decisiones en salud. Los informes y recomendaciones de esta comisión surgen de este proceso público, transparente y colaborativo, siendo de libre consulta y acceso para toda la sociedad.


Subject(s)
Melanoma , Melanoma/epidemiology
4.
Ciudad Autónoma de Buenos Aires; Comisión Nacional de Evaluación de Tecnologías de Salud; Marzo 2021. 28 p. (Informe de Evaluación de Tecnologías Sanitarias N°13, 13).
Monography in Spanish | LILACS, BINACIS, ARGMSAL | ID: biblio-1151676

ABSTRACT

El presente informe es producto del trabajo colaborativo de la Comisión Nacional de Evaluación de Tecnologías de Salud (CONETEC), dependiente del Ministerio de Salud de la Nación y creada por RM N° 623/2018. La CONETEC realiza evaluaciones y emite recomendaciones a la autoridad sanitaria sobre la incorporación, forma de uso, financiamiento y políticas de cobertura de las tecnologías sanitarias desde una perspectiva global del sistema de salud argentino. En sus evaluaciones y recomendaciones, la CONETEC tiene en cuenta criterios de calidad, seguridad, efectividad, eficiencia y equidad, evaluados bajo dimensiones éticas, médicas, económicas y sociales. Sus resultados son consensuados mediante discusiones públicas y ponderados a través de un marco de valor explícito, con la participación de todos los actores involucrados en el proceso de toma de decisiones en salud. Los informes y recomendaciones de esta comisión surgen de este proceso público, transparente y colaborativo, siendo de libre consulta y acceso para toda la sociedad


Subject(s)
Nivolumab , Melanoma , Melanoma/diagnosis , Melanoma/epidemiology
5.
An. bras. dermatol ; 96(1): 34-39, Jan.-Feb. 2021. tab, graf
Article in English | LILACS | ID: biblio-1152787

ABSTRACT

Abstract Background: Malignant skin melanoma is a serious public health problem, especially among the elderly population. Knowing the dynamics of the mortality rates of this disease in Brazil is essential to support the creation of public health policies. Objective: To analyze the temporal trend of mortality from malignant skin melanoma in elderly people in Brazil, from 2001 to 2016. Methods: This was a descriptive analytical study of mortality rates from malignant skin melanoma in the elderly. The data were obtained from the Mortality Information System, and information related to the population was obtained from the 2010 population census and population estimates from the Brazilian Institute of Geography and Statistics. Mortality coefficients were calculated and simple linear regression analysis of the coefficients was performed by sex and macro-region. Results: A total 12,712 deaths due to malignant skin melanoma in the elderly were registered. The majority (56.8%) occurred in the male population. In females, a tendency of increase in mortality rates due to malignant skin melanoma was observed in the Northeast (p ≤ 0.001), Midwest (p = 0.002), and Brazil as a whole (p = 0.003). In males, an upward trend was observed in all regions, except for the Southeast region. For both sexes, there was also an upward trend in all regions, with the exception of the Southeast region. Study limitations: Secondary databases are directly influenced by the quality of death certificate completion and their heterogeneous scope in Brazilian regions. Conclusion: The increase in mortality indicates a potential public health challenge for the coming decades. The prevention of skin cancer among the elderly should become a priority, mainly through the implementation of preventive measures.


Subject(s)
Humans , Male , Female , Aged , Skin Neoplasms/epidemiology , Melanoma/epidemiology , Brazil/epidemiology , Linear Models , Regression Analysis , Mortality
7.
Pesqui. vet. bras ; 40(8): 614-620, Aug. 2020. tab
Article in English | LILACS, VETINDEX | ID: biblio-1135671

ABSTRACT

ABSTRACT: The present study aimed to describe the occurrence and epidemiological features of skin neoplasms diagnosed in dogs in the metropolitan region of Goiânia, Goiás state, Brazil. Diagnoses from dog biopsies from 2011 to 2016 provided by a private veterinary pathology laboratory were analyzed. The main diagnoses were mast cell tumor, hemangiosarcoma, squamous cell carcinoma, malignant melanoma, and hemangioma. Highest frequency of neoplasms was found in female dogs, dogs aged > 8 years, and purebred dogs, particularly the American Pit Bull Terriers and the Poodles. Most common sites affected by the neoplasms were the limb and the head. Using multiple correspondence analysis, groups of neoplasms were found to be associated with different epidemiological features and the size of the neoplasms was associated with the biological behavior. The results of this study described predispositions and verified the importance of different types of skin neoplasms in dogs in the region being studied.(AU)


O objetivo deste estudo foi determinar a prevalência e as características epidemiológicas das neoplasias cutâneas em cães na região metropolitana de Goiânia, Goiás. Foram analisados os diagnósticos de um laboratório do setor privado de 2011 a 2016. Mastocitoma, hemangiossarcoma, carcinoma de células escamosas, melanoma maligno e hemangioma representaram os principais diagnósticos. A maioria dos casos ocorreram em cães de raças definidas, fêmeas e com idade >8 anos. American Pit Bull Terrier e Poodle foram as raças mais encontradas. As neoplasias acometeram principalmente regiões de membros e cabeça. Pela análise de correspondência múltipla, associou-se os grupos de neoplasias com diferentes características epidemiológicas e o tamanho da neoplasia com o comportamento biológico. A comparação dos resultados com pesquisas prévias possibilitou confirmar predisposições previamente descritas e verificar a importância dos diferentes tipos de neoplasias cutâneas em cães na região estudada.(AU)


Subject(s)
Animals , Male , Female , Dogs , Skin Neoplasms/veterinary , Skin Neoplasms/epidemiology , Carcinoma, Squamous Cell/epidemiology , Mastocytoma/epidemiology , Hemangioma/epidemiology , Hemangiosarcoma/epidemiology , Melanoma/epidemiology , Carcinoma, Squamous Cell/veterinary , Mastocytoma/veterinary , Hemangioma/veterinary , Hemangiosarcoma/veterinary , Melanoma/veterinary
8.
Rev. argent. cir ; 112(2): 157-164, 2020. tab
Article in English, Spanish | LILACS | ID: biblio-1125796

ABSTRACT

Antecedentes: los melanomas en cabeza y cuello (MCC) han sido asociados con factores pronósticos diferentes de aquellos en otras localizaciones. Objetivo: comparar características demográficas, clínicas y resultados del tratamiento quirúrgico de pacientes con MCC y pacientes con melanomas en tronco y extremidades (MTE). Material y métodos: se llevó a cabo una revisión retrospectiva de las historias clínicas de pacientes operados por melanoma entre enero de 2012 y diciembre de 2017. Quince pacientes (22,3%) tuvieron MCC y 52 (77,7%) MTE. Resultados: ambos grupos tuvieron edad similar (63,8 ± 21,1 versus 58,5 ± 16), pero los MCC mostraron una tendencia con predominio masculino (80% versus 61,3%). Los MCC tuvieron menor espesor tumoral que los MTE (2,07 versus 5,5 mm) y mayor porcentaje de melanoma in situ, 5 (33,3%) versus 8 (15,3%), pero requirieron vaciamientos ganglionares más a menudo (33% versus 25%) así como reconstrucción del defecto primario con colgajos locales y miocutáneos. Durante el seguimiento, en el grupo de MCC, dos pacientes desarrollaron recidivas locales que fueron extirpadas, y otros tres desarrollaron metástasis a distancia en pulmón, intestino delgado y abdomen y fallecieron por la enfermedad; en el grupo de MTE un paciente tuvo recidiva local y cinco fallecieron de metástasis sistémicas. El tamaño de la muestra no permitió aplicar pruebas de significación entre las diferencias encontradas. Conclusión: los MCC se presentan en un amplio rango de edad y estadios, y tuvieron algunas diferencias clínicas con el MTE. Los defectos producidos por la extirpación de la lesión primaria requieren procedimientos reconstructivos más complejos la mayoría de las veces y se aconseja un abordaje multidisciplinario.


Background: Head and neck melanomas (HNMs) have been associated with prognostic factors different from those on other locations. Objective: The goal of the present study was to compare the demographic and clinical characteristics and the outcomes of surgical treatment between patients with HNM and those with trunk and extremity melanoma (TEM). Material and methods: The clinical records of patients undergoing surgery for melanoma between October 2014 and April 2018 were retrospectively reviewed. Fifteen patients (22.3%) had HNM and 52 (77.7) presented TEM. Results: There were no differences in age between both groups (63.8 ± 21.1 versus 58.5 ± 16), but there was a trend toward higher percentage of men in the HNM group (80% versus 61.3%). Patients with HNM had lower tumor thickness than those with TEM (2.07 versus 5.5 mm), higher incidence of melanoma in situ [5 (33.3%) versus 8 (15.3%)]; lymph node resection was more common (33% versus 25%) as well as reconstruction of the primary defect with local and musculocutaneous flaps. During follow-up, two patients in the HNM group developed local recurrences that were excised and three presented distant metastases in the lung, small bowel and abdomen and finally died due to the disease. In the TEM group, one patient had local recurrence and five died due to systemic metastases. The sample size was not sufficient to assess statistically significant differences. Conclusion: Head and neck melanomas occur in a wide age range and stages and has some clinical differences with TEM. The defects produced after the excision of the primary lesion often require more complex procedures and should be managed with a multidisciplinary approach.


Subject(s)
Humans , Male , Female , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Head and Neck Neoplasms/epidemiology , Melanoma/epidemiology , Cross-Sectional Studies , Retrospective Studies , Sentinel Lymph Node Biopsy , Extremities/pathology , Torso/pathology , Margins of Excision , Melanoma/surgery
9.
Rev. méd. Urug ; 36(2): 146-154, 2020. tab, graf
Article in Spanish | LILACS, BNUY | ID: biblio-1115817

ABSTRACT

Resumen: El melanoma cutáneo es el tumor que más ha aumentado en incidencia en los últimos años. Presenta alta letalidad en estadios avanzados. En nuestro país el promedio anual de casos sería de 129 en hombres, 117 en mujeres, con 50 y 30 muertes anuales respectivamente. Objetivo: describir y analizar el perfil clínico-epidemiológico y sobrevida de una cohorte de pacientes portadores de melanoma cutáneo asistidos en dos centros de referencia en Montevideo en el período comprendido entre 2008 y 2017. Método: se realizó un estudio descriptivo, retrospectivo, observacional de cohortes históricas en base a revisión de historias clínicas de los pacientes con diagnóstico de melanoma cutáneo asistidos en el Servicio de Oncología del Hospital de Clínicas y en la Unidad de Oncología cutánea del Instituto Nacional del Cáncer en el período comprendido entre 2008 y 2017, con un seguimiento de los casos hasta el 31 de julio de 2018. Resultados: se analizaron 173 pacientes, mediana de edad 61,2 años (14-89), 50,3% de sexo masculino y 49,7% de sexo femenino. La forma anátomo-clínica nodular fue la más frecuente (32,7%), seguida de la extensiva superficial (28,9%), siendo el resto menos frecuentes. No fue alcanzada la mediana de sobrevida global (SVG), siendo la tasa de SVG a cinco años de 68,5% y a diez años de 54,5%. La mediana de SVG en EIV fue de 12 meses (IC 95% 8,5-21,5). Conclusiones: los resultados de nuestra serie en SVG son similares a los reportados a nivel mundial, al igual que en la mayoría de las características clínico-epidemiológicas. Se trata del primer trabajo con reporte de sobrevida en melanoma cutáneo en nuestro país.


Summary: Cutaneous melanoma is the tumour whose incidence has increased the most in recent years. This condition is highly lethal in advanced stages. In our country the annual average of cases adds up to 129 in men and 117 in women, there being 50 and 30 respectively, every year. Objective: to describe and analyse the clinical and epidemiological profile and survival in a cohort of patients who are carriers of cutaneous melanoma and were assisted in two reference centers in Montevideo between 2008 and 2017. Methods: we conducted a descriptive, retrospective, observational study of historical cohorts, based on a review of the medical records in patients with a diagnosis of cutaneous melanoma assisted in the Oncology Service of the University Hospital and the Skin Oncology Unit of the National Cancer Institute between 2008 and 2017, with a follow-up until March 31, 2018. Results: 173 pacientes were analysed, median age was 61.2 years old (14-89), 50.3% were men and 49.7% were women. Nodular anatomo-clinical presentation was the most frequent form (32.7%), followed by superficial spreading (28.9%), other forms being less frequent. Median global survival was not achieved, global survival after 5 years being 68.5% and 54.5% after 10 years. Median global survival in Stage 4 was 12 months (IC 95% 8.5-21.5). Conclusions: the results in our series are similar to those reported internationally, in terms of global survival, the same as in most of the clinical an epidemiological characteristics. This is the first study with a cutaneous melanoma survival report in our country.


Resumo: O melanoma cutâneo é o tumor cuja incidência mostrou o maior incremento nos últimos anos. Nos estádios avançados apresenta alta letalidade. No Uruguai a média anual de casos seria de 129 em homens, 117 em mulheres, com 50 e 30 casos anuais respectivamente. Objetivo: descrever e analisar o perfil clínico-epidemiológico e a sobrevida de uma coorte de pacientes portadores de melanoma cutâneo atendidos em dois centros de referência em Montevidéu no período 2008- 2017. Métodos: um estudo descritivo, retrospectivo, observacional de coortes históricas foi realizado baseado na revisão dos prontuários dos pacientes com diagnóstico de melanoma cutâneo atendidos no Serviço de Oncologia do Hospital de Clínicas e na Unidade de Oncologia cutânea do Instituto Nacional del Cáncer no período 2008-2017, com um seguimento até 31/07/2018. Resultados: foram analisados 173 pacientes, com mediana de idade 61,2 anos (14-89), sendo 50,3% do sexo masculino e 49,7% feminino. A forma anátomo-clínica nodular foi a mais frequente (32,7%) seguido pela extensiva superficial (28,9%), as demais formas foram menos frequentes. Não foi possível alcançar a mediana de sobrevida global, sendo a taxa de SVG a 5 anos 68,5% e a 10 anos 54,5%. A mediana de SVG em EIV foi de 12 meses (IC 95% 8,5-21,5). Conclusões: os resultados da série estudada em sobrevida global são similares aos descritos internacionalmente, assim como a maioria das características clínico-epidemiológicas. Este é o primeiro trabalho que informa sobre a sobrevida em melanoma cutâneo no Uruguai.


Subject(s)
Skin Neoplasms/epidemiology , Melanoma/epidemiology , Survival
10.
Rev. bras. cancerol ; 66(3): 1-4, 2020.
Article in Portuguese | LILACS | ID: biblio-1120170

ABSTRACT

Introdução: O melanoma é a principal causa de morte entre as neoplasias malignas cutâneas primárias. Sua incidência mundial vem aumentando progressivamente, entretanto, existem escassas informações epidemiológicas nacionais. Objetivo: Analisar os perfis epidemiológico e histopatológico de melanomas cutâneos diagnosticados em hospital universitário nos últimos 16 anos. Método: Série histórica de casos de melanoma cutâneo realizada por meio da revisão de prontuários e laudos histopatológicos de 2001 a 2016. Resultados:A frequência manteve-se com média de 2,99 melanomas por mil novos atendimentos ambulatoriais. A casuística foi de 224 melanomas cutâneos em 211 pacientes, brancos (98,6%), mulheres (55,9%), com idade média de 57,3 anos. O tempo médio entre o aparecimento da lesão (desde surgimento da lesão ou desde que a lesão começou a se modificar, relatado pelo paciente) e o diagnóstico foi 4,8 anos. O tamanho predominante foi de 0,5 a 2 cm, acometendo principalmente a região cefálica em indivíduos maiores de 60 anos e troncular naqueles menores de 60 anos. "Outros melanomas" (34,8%) e melanoma extensivo superficial (31,7%) foram os subtipos mais frequentes. A maioria dos casos apresentou índice de Breslow ≤1mm (70%). Os subtipos mais finos (≤1 mm) foram extensivo superficial e lentigo maligno. Melanomas nodulares possuíam Breslow intermediário (1 a 4 mm) ou espesso (≥4 mm) com altas taxas de disseminação e metástase linfonodal. Conclusão: A frequência manteve-se estável. Houve prevalência em população maior de 60 anos. Os subtipos mais frequentes foram "outros melanomas" e extensivo superficial com localização cefálica e troncular em sua maioria.


Introduction: Melanoma is the main cause of death among primary skin neoplasms. The worldwide incidence has been increasing, however there is scarce national epidemiological information. Objective: Analyze the epidemiological and histopathological profile of cutaneous melanomas diagnosed at a university hospital in the last 16 years. Method: Historical series of cutaneous melanoma cases from review of charts and histopathological reports from 2001 to 2016. Results: The mean frequency over the years was 2.99 melanomas for every 1,000 new outpatient visits. The casuistry consisted of 224 cases of cutaneous melanomas in 211 patients, Caucasians (98.6%), women (55.9%), with mean age of 57.3 years. The mean time between onset of the lesion (time since the appearance of the lesion or since it began to change reported by the patient) and diagnosis was 4.8 years. The predominant tumor size was 0.5 to 2 cm, affecting the cephalic region in individuals older than 60 years and torso in those younger than 60 years. "Other melanomas" (34.8%) and superficial spreading melanoma (31.7%) were the predominant subtypes. Most of the cases had Breslow index ≤ 1 mm (70% of patients). The thinnest subtypes (≤ 1 mm) were superficial spreading melanoma and lentigo maligna. Nodular melanomas had intermediate Breslow (1 to 4 mm) or thick (≥ 4 mm) with high dissemination rate and lymph node metastasis. Conclusion: The frequency remained stable. Population below 60 years old had a higher prevalence. The most frequent subtypes were "other melanomas" and extensive superficial located mainly in the cephalic and torso regions.


Introdução: El melanoma es la principal causa de muerte entre las neoplasias malignas cutáneas primarias. Su incidencia mundial ha aumentado progresivamente, sin embargo, la información epidemiológica nacional es escasa. Objetivo: Analizar el perfil epidemiológico e histopatológico de los melanomas cutáneos diagnosticados en un hospital universitario en 16 años. Método: Serie histórica de casos de melanoma cutáneo obtenidos por la revisión de registros médicos e informes histopatológicos de 2001-2016. Resultados: La frecuencia se mantuvo con un promedio de 2,99 melanomas/mil nuevas consultas. La casuística consistió en 224 melanomas cutáneos en 211 pacientes, blancos (98,6%), mujeres (55,9%), con edad media de 57,3 años. El promedio entre la aparición de la lesión (desde la aparición o desde que comenzó a cambiar según informe del paciente) y diagnóstico fue 4,8 años. El tamaño predominante de 0,5 a 2 cm, afectando principalmente la región cefálica en mayores de 60 años y el tronco cuando menores de 60. "Otros melanomas" (34,8%) y melanoma extenso superficial (31,7%) fueron los subtipos más frecuentes. La mayoría de los casos tenía índice de Breslow ≤1 mm (70%). Los más delgados (≤1 mm) fueron lentigo extenso superficial y maligno. Los nodulares tenían Breslow intermedio (1 a 4 mm) o grueso (≥4 mm) con altas tasas de diseminación y metástasis para ganglios linfáticos. Conclusión: La frecuencia se mantuvo estable. Hubo mayor prevalencia en la población menor de 60 años. Los subtipos más frecuentes fueron "otros melanomas" y extensos superficiales con localización principalmente cefálica y del tronco.


Subject(s)
Humans , Male , Female , Skin Neoplasms/epidemiology , Melanoma/epidemiology , Brazil , Retrospective Studies
11.
Ciênc. Saúde Colet ; 24(4): 1551-1561, abr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001778

ABSTRACT

Abstract Melanoma is the main serious skin cancer, due to its high lethality. This study aimed to make projections and analyze melanoma mortality trends in Brazil. Mortality Information System data were utilized for the period 1998-2012, which were projected until 2032, using the age-period-cohort model, with software R. The analysis of trends was made by Joinpoint regression, with 95% confidence interval, estimating the annual percentage change. It was revealed higher amounts of deaths in men for all regions. Brazilian trends presented reductions in men (APC = -0.4; CI95% = -0.6; -0.1; p < 0.01) and in women (APC = -0.8; CI95% = -0.9; -0.7; p < 0.01). The Midwest region presented increases for both sexes, while the Southeast region presented reducing trends for both sexes. In the North, there was stability for men and increases followed by stability in women, while the South presented reductions in men and stability in women; finally, the Northeast revealed one joinpoint per sex, with an increase followed by stability in men, and stability followed by reducing trends in women. The highest rates of the country were found in the South and Southeast regions, however, with reducing trends throughout time. Higher mortality trends in men were associated with later diagnoses in this group.


Resumo O melanoma é o mais grave câncer de pele, devido à alta letalidade. Este estudo objetiva projetar e analisar tendências da mortalidade por melanoma no Brasil. Os dados são do Sistema de Informação sobre Mortalidade, no período de 1998 a 2012, os quais foram projetados até 2032, usando o modelo idade-período-coorte, no software R . A análise de tendências foi feita pela Regressão loglineal ( Joinpoint regression ), com intervalo de confiança de 95%, para estimar a porcentagem anual de mudança. Revelou-se maior quantitativo de mortes em homens em todas as regiões. As tendências no Brasil apontaram para redução em homens (APC = -0,4; IC95% = -0,6; -0,1; p < 0,01) e em mulheres (APC = -0,8; IC95% = -0,9; -0,7; p < 0,01). A região Centro-oeste teve aumento para os dois sexos, em oposição ao Sudeste, com redução em ambos. No Norte, houve estabilidade em homens, e aumento seguido de estabilidade em mulheres, enquanto o Sul teve redução em homens e estabilidade em mulheres; e, por fim, o Nordeste teve um joinpoint em cada sexo, com aumento seguido de estabilidade em homens; e estabilidade seguida de redução em mulheres. As maiores taxas do país foram no Sul e Sudeste, todavia, com tendência a redução ao longo do tempo. A maior mortalidade em homens foi associada ao diagnóstico mais tardio.


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Aged , Aged, 80 and over , Young Adult , Skin Neoplasms/epidemiology , Melanoma/epidemiology , Skin Neoplasms/mortality , Brazil/epidemiology , Information Systems , Mortality/trends , Sex Distribution , Age Distribution , Forecasting , Melanoma/mortality , Middle Aged
12.
An. bras. dermatol ; 94(2): 157-163, Mar.-Apr. 2019. tab, graf
Article in English | LILACS | ID: biblio-1001134

ABSTRACT

Abstract BACKGROUND: Skin cancer is common in Brazil and is related to sun exposure, among other risk factors. There are no data on the incidence of malignant skin neoplasm in rural workers in western Paraná. OBJECTIVE: To analyze the incidence and profile of rural workers who were diagnosed with skin cancer at a reference service in Cascavel, western Paraná, in the last five years (2011-2016). METHODS: This retrospective cross-sectional study was carried out through a review of the anatomopathological reports of rural workers diagnosed with skin cancer at Cascavel Oncology Center (CEONC), in Cascavel. The following variables were collected: year of diagnosis, age, gender, injury location and histological subtype. RESULTS: A total of 681 cases of malignant epithelial neoplasia were identified, with a higher frequency in the 61-70 age group. Data analysis showed an increase of about 210% in the occurrence of skin cancers in the last 5 years. The cephalic region was the most affected, and the most common histological subtype was nodular basal cell carcinoma. There was no association between gender and location. STUDY LIMITATIONS: This is a retrospective study and analysis of a secondary data bank. CONCLUSION: This study is a regional estimation of the incidence of cutaneous neoplasms and provides evidence of a considerable increase in the number of diagnoses in rural workers from western Paraná, Brazil. Moreover, it is possible to conclude that the sample group studied is at risk of developing skin cancer.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Melanoma/epidemiology , Rural Population/statistics & numerical data , Skin Neoplasms/etiology , Sunlight/adverse effects , Brazil/ethnology , Brazil/epidemiology , Carcinoma, Basal Cell/etiology , Carcinoma, Squamous Cell/etiology , Incidence , Cross-Sectional Studies , Retrospective Studies , Age Distribution , Face , Melanoma/etiology
13.
Arq. bras. oftalmol ; 82(2): 107-110, Mar.-Apr. 2019. graf
Article in English | LILACS | ID: biblio-989395

ABSTRACT

ABSTRACT Purpose: To evaluate the first three years of The Amazon Ocular Oncology Center, the first ocular cancer center in the North of Brazil. Methods: Here, we report patient information including patients' age, gender, diagnosis, treatment, and city of origin. Results: Two hundred and twenty-one patients were included on this study: 160 (72%) patients came from the city of Manaus, 52 (24%) from other cities in Amazonas, and 9 (4%) from other states. Of the 221 patients, 150 (68%) were afflicted with benign lesions and the remaining 71 (32%) had malignant lesions. Benign diagnosis included pterygium, chalazium, conjunctival nevus, and papilloma, cataract, and retinal detachment. Of the malignant cases, squamous cell carcinoma (SCC) of the conjunctiva was the most frequent with 43 cases (60%). Other diagnoses included choroidal melanoma (8 cases, 11%), retinoblastoma (7 cases, 9%), lymphomas (5 cases, 7%), basal cell carcinomas of the eyelid (4 cases, 5%), conjunctival melanoma (2 cases, 2%), and Kaposi sarcomas (1 case, 1%). Of the 43 patients with SCC, the mean age was 62 years old, and 30 (69%) were male; 29 patients (67%) were treated with an excisional biopsy, and 14 (33%) were treated with neoadjuvant topic chemotherapy, followed by surgery.


RESUMO Objetivo: Reportar sobre os primeiros três anos do Centro de Oncologia Ocular do Amazonas, primeiro centro de oncologia ocular na região Norte do Brasil. Métodos: Relatamos informações de diagnóstico, idade, sexo, tratamento e cidade de origem dos pacientes atendidos nos 3 primeiros anos. Resultados: Identificamos 221 pacientes, dos quais 160 (72%) eram da cidade de Manaus, 52 (24%) de outras cidades do Amazonas e 9 (4%) de outros estados. Dos 221 casos, 150 (68%) eram lesões benignas e 71 (32%) malignas. Lesões benignas incluíram pterígio, calázio, nevus e papiloma de conjuntiva, catarata e descolamento de retina. Das lesões malignas a mais comum foi o carcinoma escamoso de conjuntiva com 43 casos (60%). Outros diagnósticos incluíram melanoma de coróide (8 casos, 11%), retinoblastoma (7 casos, 9%), linfomas (5 casos, 7%), carcinoma da pálpebra (4 casos, 5%), melanoma da conjunctiva (2 casos, 2%) e sarcoma de Kaposi (1 caso, 1%). Dentre os CEC de conjuntiva, a idade media foi de 62 anos e 30 pacientes (69%) eram do sexo masculino. Vinte e nove casos (67%) foram tratados com biópsia excisional e 14 (33%) com quimioterapia tópica neoadjuvante seguida de cirurgia.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Aged, 80 and over , Young Adult , Carcinoma, Squamous Cell/epidemiology , Oncology Service, Hospital/statistics & numerical data , Eye Neoplasms/epidemiology , Retinoblastoma/epidemiology , Sarcoma, Kaposi/epidemiology , Brazil/epidemiology , Carcinoma/epidemiology , Retrospective Studies , Cities/epidemiology , Eye Diseases/epidemiology , Lymphoma/epidemiology , Melanoma/epidemiology
14.
An. bras. dermatol ; 94(1): 42-46, Jan.-Feb. 2019. graf
Article in English | LILACS | ID: biblio-983727

ABSTRACT

Abstract: Background: Skin cancer is a highly prevalent condition with a multifactorial etiology resulting from genetic alterations, environmental and lifestyle factors. In Brazil, among all malignant tumors, skin cancers have the highest incidences. Objective: To retrospectively evaluate the incidence, prevalence and profile of basal cell carcinoma, squamous cell carcinoma and cutaneous melanoma in Campos dos Goytacazes and region. Methods: In total, 2,207 histopathological reports of a local reference hospital were analyzed between January 2013 and December 2015, of which 306 corresponded to the neoplasms studied. Results: Of the 306 reports evaluated, 232 basal cell carcinomas (75.9%), 55 squamous cell carcinomas (18%) and 19 cutaneous melanomas (6.5%) were identified. The face was the most involved anatomical site (58.8%) and women (51%) were the most affected gender. The temporal analysis revealed a decrease in the overall incidence of 3.4% from 2013 to 2014 and 5.4% from 2014 to 2015. There was a 10.1% increase in basal cell carcinomas and 38% in melanomas in this period; however, there was a decrease in the number of squamous cell carcinomas of 14.8% during the studied years. Study limitations: Some samples of cutaneous fragments had no identification of the anatomical site of origin. Conclusion: Research that generates statistical data on cutaneous tumors produces epidemiological tools useful in the identification of risk groups and allows the adoption of more targeted and efficient future prevention measures.


Subject(s)
Humans , Male , Female , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/epidemiology , Carcinoma, Basal Cell/epidemiology , Carcinoma, Squamous Cell/epidemiology , Melanoma/epidemiology , Skin Neoplasms/pathology , Brazil/epidemiology , Carcinoma, Basal Cell/pathology , Carcinoma, Squamous Cell/pathology , Medical Records , Incidence , Prevalence , Cross-Sectional Studies , Retrospective Studies , Sex Distribution , Age Distribution , Hospitals, University/statistics & numerical data , Melanoma/pathology
15.
Rev. méd. Panamá ; 39(2): 66-73, 2019. ilus, tab
Article in Spanish | LILACS | ID: biblio-1102124

ABSTRACT

Introducción: A nivel mundial hay un incremento de la incidencia de melanoma, Panamá no escapa a esta realidad. Para todas las etapas hay riesgo de recurrencia inclusive luego de una cirugía adecuada y elevadas probabilidades de fallecer a causa de metástasis. Este trabajo busca conocer la experiencia del ION en el tratamiento de estos pacientes, la cual no ha sido publicada a la fecha. Objetivos: Descri­ bir las características de los pacientes con melanoma y determinar la Supervivencia Global (OS) y la Su­ pervivencia Libre de Recurrencia (RFS). Metodología: Estudio retrospectivo de los pacientes con melanoma referidos al ION en los años 2012 a 2017 y el análisis de OS y RFS por el método de Kaplan­ Meier. Resultados: Un total de 247 pacientes de melanoma fueron atendidos en el ION en el periodo del estudio; 51.8% eran masculinos con mediana de edad de 65 años. El sitio más común fue acral (31%). En total 46% de nuestros pacientes están en etapas III­IV. Un 65% del total fueron operados, de éstos 80% con resección amplia, 27% con evaluaciones de ganglio centinela y 25% linfadenectomías. Encon­tramos 39% ulcerados y la histología más frecuente fue nodular con 31.6%. Hubo 31.4% de recurren­cias, de los cuales 63.8% era a distancia. La mOS: 55.8 meses en no metastásicos vs 13.1 meses en metastásicos (p<0.0001). La mRFS para los operados fue 53.6 meses y los factores pronósticos fueron ulceración (p=0.007) y realización de linfadenectomía (p=0.000). Conclusión: El diagnóstico de melano­ ma en la población panameña se hace en etapas avanzadas, lo que influye en su pronóstico. Su tasa de supervivencia está muy por debajo de otros países tanto desarrollados como en vías de desarrollo. Estos resultados deben tomarse con cuidado, ya que los factores clásicos descritos en múltiples estu­ dios, no parecen influenciar a nuestra población (edad, sexo, sitio anatómico, subtipo, mitosis). Siendo una enfermedad tan letal hace falta realizar estudios prospectivos a nivel nacional, así como fortalecer la red de prevención y atención primaria.


Introduction: Worldwide there is an increase in the incidence of melanoma, Panama does not escape this reality. For all stages there is a risk of recurrence even after adequate surgery and high chances of death due to metastasis. This work seeks to know the experience of ION in the treatment of these pa­ tients, which has not been published to date. Objectives: To describe the characteristics of patients with melanoma and determine the Global Survival (OS) and the Free Survival of Recurrence (RFS). Metho­ dology: Retrospective study of patients with melanoma referred to the ION in the years 2012 to 2017 and the analysis of OS and RFS by the Kaplan­Meier method. Results: A total of 247 melanoma patients we­ re treated at the ION during the study period; 51.8% were male with a median age of 65 years. The most common site was acral (31%). In total 46% of our patients are in stages III­IV. 65% of the total were ope­ rated, of these 80% with wide resection, 27% with sentinel lymph node evaluations and 25% lymphade­ nectomy. We found 39% ulcerated and the most frequent histology was nodular with 31.6%. There were 31.4% of recurrences, of which 63.8% were distant. The mOS: 55.8 months in non­metastatic vs 13.1 months in metastatic (p <0.0001). The mRFS for the operated patients was 53.6 months and the prog­ nostic factors were ulceration (p = 0.007) and lymphadenectomy (p = 0.000). Conclusion: The diagnosis of melanoma in the Panamanian population is made in advanced stages, which influences its prognosis. Its survival rate is well below other developed and developing countries. These results should be taken with care, since the classical factors described in multiple studies do not seem to influence our population (age, sex, anatomical site, subtype, mitosis). Being such a lethal disease, it is necessary to carry out prospective studies at the national level, as well as to strengthen the prevention and primary care network


Subject(s)
Humans , Male , Female , Middle Aged , Melanoma/diagnosis , Melanoma/mortality , Melanoma/epidemiology , Lower Extremity/physiopathology , Kaplan-Meier Estimate , Immunotherapy/statistics & numerical data , Lymph Node Excision , Neoplasm Staging/methods
16.
Rev. chil. dermatol ; 35(4): 134-140, 2019. ilus, tab, graf
Article in Spanish | LILACS | ID: biblio-1120275

ABSTRACT

INTRODUCCIÓN: Las neoplasias spitzoides son tumores melanocíticos con un espectro biológico variable, que constituyen un desafío diagnóstico. Los estudios en población latinoamericana son muy escasos, no contando con series chilenas. OBJETIVO: Caracterizar clínica e histopatológicamente a los pacientes con neoplasias spitzoides en el Hospital Clínico de la Universidad de Chile. METODOLOGÍA: Estudio retrospectivo, basado en revisión de fichas clínicas y biopsias de pacientes con diagnóstico confirmado de nevo de Spitz (NS), tumor de Spitz atípico y melanoma spitzoide, entre 1995-2018. Se analizó: edad, sexo, características clínicas e histopatológicas. RESULTADOS: Se estudiaron 62 neoplasias spitzoides. 39 mujeres (62,9%). Edad promedio de 18,9 (+14,3) años. Localización de lesiones: 8 (12,9%) cabeza, 6 (9,7%) tronco, 17 (27,4%) extremidades superiores y 22 (35,5%) extremidades inferiores; en 9 (14,5%) no se registró. Tamaño promedio 5,5 mm. Respecto al diagnóstico clínico: 21 (33,9%) nevo melanocítico, 16 (25,8%) nevo atípico, 12 (19,4%) NS, 7 (11,3%) lesiones vasculares, 3 (4,8%) melanoma y 3 (4,8%) otro. En cuanto al diagnóstico histopatológico: NS clásico 38 (61,3%), Nevo de Reed 9 (14,5%), NS desmoplásico 2 (3,2%), NS atípico 8 (12,9%) y melanoma spitzoide 5 (8,1%). CONCLUSIÓN: El presente estudio constituye la primera serie chilena de neoplasias spitzoides, según la literatura revisada. Destaca el mayor número de lesiones en mujeres y en extremidades, lo que ya había sido informado en otras series similares. Considerando la dificultad en el diagnóstico clínico preoperatorio, destaca un número mayor de sospecha de neoplasias spitzoides comparado a otros estudios.


INTRODUCTION: Spitzoid neoplasms are melanocytic tumors with a variable biological spectrum, which are a diagnostic challenge. There are few studies in Latin American population, not finding chilean series. OBJECTIVE: Clinically and histopathologically characterize patients with spitzoid neoplasms in the Hospital Clínico Universidad de Chile. METHODOLOGY: Retrospective study, based on re-view of clinical records and biopsies of patients with confirmed diagnosis of Spitz nevus (SN), atypical Spitz tumors and spitzoid melanoma (SM), between 1995-2018. It is analyzed: age, sex, clinical and histopathological characteristics. RESULTS: 62 spitzoid neoplasms were studied. 39 women (62.9%). Average age of 18.9 (+14.3) years. Location of injuries: 8 (12.9%) head, 6 (9.7%) trunk, 17 (27.4%) upper extremities and 22 (35.5%) lower extremities; in 9 (14.5%) it is not identified. Average size 5.5 mm. Clinical diagnosis: 21 (33.9%) melanocytic nevus, 16 (25.8%) atypical nevus, 12 (19.4%) NS, 7 (11.3%) vascular lesions, 3 (4.8%) melanoma and 3 (4.8%) other. Histopathological diagnosis: classic NS 38 (61.3%), Reed Nevus 9 (14.5%), desmoplastic SN 2 (3.2%), atypical SN 8 (12.9%) and SM 5 (8.1%). CONCLUSION: The present study appears in the first chilean series of spitzoid neoplasms, according to the literature reviewed. It highlights the greatest number of injuries in women and in the extremities, which had already been reported in other similar series. In the preoperative clinical diagnosis, a greater number of suspicion of spitzoid neoplasms stands out compared to other studies.


Subject(s)
Humans , Male , Female , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Skin Neoplasms/diagnosis , Skin Neoplasms/pathology , Nevus, Epithelioid and Spindle Cell/diagnosis , Nevus, Epithelioid and Spindle Cell/pathology , Melanoma/diagnosis , Melanoma/pathology , Skin Neoplasms/epidemiology , Immunohistochemistry , Epidemiology, Descriptive , Retrospective Studies , Nevus, Epithelioid and Spindle Cell/epidemiology , Dermoscopy , Age and Sex Distribution , Hospitals, University , Melanoma/epidemiology
17.
Rev. chil. dermatol ; 35(4): 141-145, 2019. graf
Article in Spanish | LILACS | ID: biblio-1120277

ABSTRACT

El melanoma maligno ha aumentado su incidencia. En la provincia de Osorno, para el período 2016 ­ 2018, se registraron 55 casos nuevos de melanoma, con predominio en sexo femenino. Los subtipos extensivo superficial y nodular fueron los más frecuentes; no obstante el lentiginoso acral fue un grupo prevalente, siendo el sexo masculino el más afectado por esta variedad. Un 49,1% de los melanomas fueron detectados con Breslow mayor a 1 mm, siendo los hombres los más afectados por una pesquisa más tardía. Reforzar la cobertura de la atención primaria urbana y rural, como así la oferta de dermatólogos, impactarán en la mejora de estos índices.


The Malignant Melanoma has increased its incidence. In the province of Osorno, between 2016 ­ 2018 there were 55 new cases of melanoma, with predo-minance in the female sex. The superficial spreading and nodular subtypes were most common. However the acral lentiginous was a prevalent group, with the male sex being the most affected by this variety. A 49,1% of melanomas were detected with Breslow greater than 1mm, with men being the ones who presented later inquiries. The coverage of urban and rural primary care needs to be strengthened, just like supply of dermatologists, it will impact the improvement of these rates.


Subject(s)
Humans , Male , Female , Adult , Middle Aged , Aged , Aged, 80 and over , Skin Neoplasms/epidemiology , Melanoma/epidemiology , Skin Neoplasms/pathology , Chile/epidemiology , Retrospective Studies , Age and Sex Distribution
18.
Epidemiol. serv. saúde ; 28(2): e2018325, 2019. tab, graf
Article in English, Portuguese | LILACS | ID: biblio-1012074

ABSTRACT

Objetivo: estimar o impacto orçamentário incremental da terapia-alvo para tratamento de primeira linha do melanoma avançado não cirúrgico e metastático, em comparação à dacarbazina. Métodos: análise de impacto orçamentário na perspectiva do Sistema Único de Saúde (SUS) do Brasil; a partir de dados demográficos e estimativas da incidência, foi delimitada a população no horizonte temporal de três anos (2018-2020) e estimados os custos diretos médicos; foi considerado cenário de referência o tratamento com dacarbazina, e como cenários alternativos a terapia-alvo com vemurafenibe, dabrafenibe, vemurafenibe + cobimetinibe e dabrafenibe + trametinibe; a avaliação das incertezas foi conduzida mediante análise por cenários. Resultados: o impacto orçamentário incremental variou de R$ 451.867.881,00 a R$ 768.860.968,00, representando 0,70 a 1,53% dos gastos anuais totais com medicamentos ambulatoriais no SUS; no melhor e no pior cenário, os resultados variaram de R$ 289.160.835,00 a R$ 1.107.081.926,00. Conclusão: a terapia-alvo, comparada à dacarbazina, implica impacto excessivo no orçamento, desfavorecendo eventual incorporação.


Objetivo: estimar el impacto presupuestario incremental de la terapia dirigida para tratamiento de primera línea del melanoma avanzado no quirúrgico y metastásico comparado con la dacarbazina. Métodos: análisis de impacto presupuestario, en la perspectiva del Sistema Único de Salud (SUS) de Brasil; a partir de datos demográficos y estimaciones de incidencia se delimitó la población en un horizonte temporal de tres años (2018-2020) y se estimaron los costos directos médicos. El escenario de referencia fue el tratamiento con dacarbazina y los escenarios alternativos la terapia dirigida con vemurafenib, dabrafenib, vemurafenib + cobimetinib y dabrafenib + trametinib; la evaluación de incertidumbre se llevó a cabo mediante análisis por escenarios. Resultados: el impacto presupuestario incremental varió de R$ 451.867.881,00 a R$ 768.860.968,00, representando 0,70 a 1,53% de gastos anuales totales con medicamentos de ambulatorios en el SUS; en el mejor y el peor escenario los resultados variaron de R$ 289.160.835,00 a R$ 1.107.081.926,00. Conclusión: el uso de terapia dirigida comparado a la dacarbazina implica en impacto excesivo en el presupuesto, desfavoreciendo una eventual incorporación.


Objective: to estimate the incremental budget impact of target therapy for first-line treatment of advanced non-surgical and metastatic melanoma compared to dacarbazine treatment. Methods: budget impact analysis, from the Brazilian National Health System (SUS) perspective; based on demographic data and incidence estimates, the population over a three-year time horizon (2018-2020) was delimited and the direct medical costs were estimated; the reference scenario was treatment with dacarbazine, and the alternative scenarios were target therapy with vemurafenib, dabrafenib, vemurafenib + cobimetinib and dabrafenib + trametinib; uncertainty assessment was conducted through scenario analysis. Results: the incremental budget impact ranged from R$ 451,867,881.00 to R$ 768,860,968.00, representing 0.70 to 1.53% of total SUS annual outpatient drugs expenditure; in best and worst scenario, results ranged from R$ 289,160,835.00 to R$ 1,107,081,926.00. Conclusion: the use of target therapy compared to dacarbazine implies an excessive impact on the budget, this bring unfovorable to its possible incorporation.


Subject(s)
Humans , Costs and Cost Analysis/trends , Dacarbazine/administration & dosage , Dacarbazine/therapeutic use , Molecular Targeted Therapy/methods , Molecular Targeted Therapy/trends , Melanoma/drug therapy , Melanoma/epidemiology , Skin Neoplasms/drug therapy , Unified Health System , Public Health/trends , Health Care Costs/trends , Neoplasm Metastasis/drug therapy , Antineoplastic Agents/economics
19.
An. bras. dermatol ; 93(5): 665-670, Sept.-Oct. 2018. tab, graf
Article in English | LILACS | ID: biblio-949948

ABSTRACT

Abstract: Background: Pigmented lesions on acral sites are common; clinical differentiation of nevi and early melanoma can be challenging. In these cases, dermoscopy can provide a more accurate diagnosis. Most dermoscopic patterns on acral skin have been described in Asian and European populations, while there are few studies in Latin American populations. Objectives: To determine the frequency of pigmented lesions in volar skin and their dermoscopic patterns in a Mexican population. Methods: An observational, descriptive, cross-sectional study was performed in Hispanic patients with the presence of at least one pigmented lesion on acral skin. Clinical and dermoscopic images were obtained. These were subsequently evaluated independently by two dermatologists trained and experienced in dermoscopy. Results: A total of 582 pigmented lesions on volar skin were diagnosed in 321 patients. Overall, prevalence of acral pigmented lesions on volar skin was 6.8%. For both observers, parallel furrows were the most frequent pattern described, but for observer 2, a lattice-like pattern was prevalent on the toes and a homogeneous pattern on the sides of the feet. There was lower inter-observer agreement, with a kappa index of 0.144. Study limitations: The lesions were not biopsied, so clinical-histological correlation could not be performed. The study did not correlate dermoscopic patterns with age. Conclusions. As previously reported by other authors, parallel furrows were the most frequently found dermoscopic pattern on palmoplantar skin.


Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Aged , Young Adult , Skin Neoplasms/pathology , Dermoscopy , Melanoma/pathology , Nevus, Pigmented/pathology , Skin Neoplasms/epidemiology , Toes/pathology , Cross-Sectional Studies , Melanoma/epidemiology , Mexico/epidemiology , Nevus, Pigmented/epidemiology
20.
An. bras. dermatol ; 93(4): 507-512, July-Aug. 2018. tab
Article in English | LILACS | ID: biblio-949925

ABSTRACT

Abstract: Background: Cutaneous melanoma accounts for up to 80% of deaths caused by skin cancer. Diagnostic suspicion and access to medical care and early intervention in suspected cases is vital to the patient's prognosis. Objectives: To compare demographic and histopathological characteristics of primary cutaneous melanoma diagnosed in the public healthcare system (Sistema Único de Saúde SUS) and the private system in Joinville, Santa Catarina State, Brazil. Methods: This cross-sectional retrospective study analyzed primary cutaneous melanoma cases recorded from 2003 to 2014 in the resident population of Joinville. Ethical approval was obtained from the local Research Ethics Committee. Results: 893 cases of primary cutaneous melanoma were identified. Patients in the private system were mostly younger, while there were more elderly patients in the public healthcare system (p <0.001). There was no statistically significant association between type of care (public/private) and gender or presence of multiple primary cutaneous melanomas. Histological diagnosis of superficial spreading melanoma was more common in patients treated in private healthcare, while nodular melanoma was more frequent in patients in the public healthcare system (p <0.001). Mean Breslow depth in patients treated in private healthcare was 1.35mm, compared to 2.72mm in the public system (p <0.001). Study limitations: This was a retrospective study using secondary databases. Conclusions: thin cutaneous melanoma (in situ cutaneous melanoma and Breslow T1) showed the strongest association with the private healthcare system, while thick cutaneous melanoma was more frequent in the public system (Breslow category T3 and T4) (p <0.001).


Subject(s)
Humans , Male , Female , Infant, Newborn , Infant , Child, Preschool , Child , Adolescent , Adult , Middle Aged , Young Adult , Skin Neoplasms/diagnosis , Melanoma/diagnosis , Prognosis , Skin Neoplasms/pathology , Skin Neoplasms/therapy , Skin Neoplasms/epidemiology , Brazil/epidemiology , Cross-Sectional Studies , Retrospective Studies , Public Sector/statistics & numerical data , Private Sector/statistics & numerical data , Melanoma/pathology , Melanoma/therapy , Melanoma/epidemiology , Neoplasm Staging
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