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Abstract Background The oral cavity is a link between of external environment with gastrointestinal tract. Studies are controversial on the presence of Periodontal Disease (PD) and its association with Gastric Adenocarcinoma (GAC). Methods The authors performed a systematic review and meta-analysis to verify the association between PD and GAC. Six electronic databases were evaluated between 1961 and 2022. Titles and abstracts were reviewed independently according to the eligibility criteria, assessing full texts of selected studies. The quality of the included research was verified using the Newcastle-Ottawa Scale for case-control and cohort studies. Statistical analyses were performed based on fixed and/or random effects models to calculate the summarized Relative Risk (RR) and its 95 % Confidence Interval (95 % CI). Results There were 639 studies, of which nine articles were included (3 case-controls and 6 cohorts). Overall, the authors identified 1,253 cases of GAC 2,501 controls in case-control studies, and 1,631 patients with GAC enrolled in cohort studies. Patients presenting PD increased the risk of developing GAC by 17 % (RR=1.17; 95 % CI 1.03‒1.32), which remained regardless of the diagnostic method for PD, i.e., clinical examination (RR = 1.19; 95 % CI 1.14‒1.24) and self-report (RR = 1.34; 95 % CI 1.06‒1.69). Moreover, Asian patients (RR=1.17; 95 % CI 1.00‒1.36) with PD had a higher risk of having GAC than American and European patients (RR = 1.18; 95 % CI 0.84‒1.66). Conclusions The presence of PD the risk of GAC suggesting that its infectious-inflammatory process of PD may be related to GAC development. Further investigations on the oral-gastric microbiota and its role in the carcinogenesis of gastric cancer should be carried out, and the screening of patients with potential risk for GAC should be considered in the clinical practice of dentists.
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ABSTRACT 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.
RESUMO Objetivo: O objetivo deste estudo foi analisar o prognóstico de mulheres com câncer de mama de acordo com os subtipos moleculares, variáveis sociodemográficas, características clínicas e de tratamento. Métodos: Este foi um estudo de coorte retrospectivo de base hospitalar. Foram analisadas 1.654 mulheres maiores de 18 anos diagnosticadas com câncer de mama invasivo entre 2000 a 2018. Os dados foram extraídos da Fundação Oncocentro de São Paulo, Brasil. As variáveis analisadas foram idade, histologia, subtipo moleculares, estadiamento clínico, tipo de tratamento e tempo entre o diagnóstico e tratamento. A análise de regressão de Cox foi aplicada para estimar o risco de morte. Resultados: As mulheres que apresentaram os subtipos moleculares HER-2-positivo (não luminal) e triplo negativo tiveram risco de morte quase duas vezes maior respectivamente, com razão de risco ajustada — HRaj=2,30 (intervalo de confiança de 95% — 95%IC 1,34-3,94) e HRaj=2,51 (95%IC 1,61-3,92). O atraso no tratamento associado ao avanço do estadiamento clínico ao diagnóstico aumentou em quatro vezes o risco de morte (HRaj=4,20 (IC95% 2,36-7,49). Conclusão: Os fenótipos HER-2-positivo (não luminal) e triplo negativo, além da interação entre estágio clínico avançado e maior tempo entre o diagnóstico e o tratamento, associaram-se a pior prognóstico. Assim, ações para reduzir as barreiras no diagnóstico e tratamento podem proporcionar melhores resultados, mesmo em fenótipos agressivos.
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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
Assuntos
Humanos , Adulto , Pessoa de Meia-Idade , Idoso , Neoplasias Gástricas/epidemiologia , Brasil , Adenocarcinoma , ProjetosRESUMO
Objective: To evaluate the impact of physical therapy on the quality of life of patients after breast cancer surgery. Methods: We included 16 female patients who underwent breast cancer surgery in this clinical, longitudinal, prospective, and convenience sample study. The patients underwent a mastectomy or a quadrantectomy through an axillary approach and were evaluated before and after 20 sessions of physical therapy. Quality of life was assessed by the European Organization for Research and Quality of Life Questionnaire C-30 (EORTC QLQ C-30) and the Breast Cancer Module (EORTC QLQ BR-23) questionnaire. For the statistical analysis, we used the Shapiro-Wilk test to evaluate the distribution of quality of life data. The data from before and after physical therapy was compared through the Wilcoxon test. Results: After participating in physical therapy, there was a significant improvement in physical function (p=0.023), cognitive function (p=0.033), social function (p=0.013), pain (p=0.025), fatigue (p=0.001), financial difficulty (p=0.007), and body image (p<0.001). Conclusion: According to the data presented in this study, we suggest that a physiotherapeutic approach positively impacts the quality of life of patients after breast cancer surgery.
Objetivo: Avaliar a influência da fisioterapia na qualidade de vida de pacientes após o tratamento cirúrgico do câncer de mama. Metodologia: Neste estudo clínico, longitudinal, prospectivo e de amostra por conveniência foram incluídas 16 pacientes que realizaram tratamento cirúrgico do câncer de mama, submetidas à mastectomia ou quadrantectomia, associada à abordagem axilar. Elas foram avaliadas antes e depois de 20 sessões de fisioterapia. A qualidade de vida foi examinada pelos questionários European Organization for Research and Treatment of Cancer Quality of Life Questionnaire C-30 (EORTC QLQ C-30) e Breast Cancer Module (EORTC QLQ BR-23). Para análise estatística, foi utilizado o teste de Shapiro-Wilk, para avaliação da distribuição dos dados sobre a qualidade de vida, sendo estes comparados antes e depois da fisioterapia por meio do teste de Wilcoxon. Resultados: Após a intervenção fisioterapêutica, houve melhora significativa em relação à qualidade de vida na função física (p=0,023), função cognitiva (p=0,033), função social (p=0,013), dor (p=0,025), fadiga (p=0,001), dificuldade financeira (p=0,007) e imagem corporal (p<0,001). Conclusão: De acordo com os dados apresentados no estudo, pode-se sugerir que a abordagem fisioterapêutica influencia positivamente na qualidade de vida de pacientes após o tratamento cirúrgico do câncer de mama.