RESUMO
Abstract Objective The aim of the present study was to analyze relapse rates and patterns in patients with endometrial cancer with the aim of evaluating the effectiveness of current follow-up procedures in terms of patient survival, as well as the convenience of modifying the surveillance strategy. Methods Retrospective descriptive study including all patients diagnosed with endometrial cancer relapse at the Department of Gynecology and Obstetrics of the Complejo Hospitalario Insular-Materno Infantil de Canarias, between 2005 and 2014. Results Recurrence was observed in 81 patients (10.04% of the sample); 66.7% of them suffered relapse within 2 years and 80.2% within 3 years after the termination of the primary treatment; 41.9% showed distant metastases while the rest corresponded to local-regional (40.7%) or ganglionar (17.4%) relapse; 42% of these were symptomatic; 14 patients showed more than 1 site of relapse. Relapse was detected mainly through symptoms and physical examination findings (54.3%), followed by elevated serummarker levels (29.6%), computed tomography (CT) images (9.9%) and abnormal vaginal cytology findings (6.2%). No differences in global survival were found between patients with symptomatic or asymptomatic relapse. Conclusion Taking into account that the recurrence rate of endometrial cancer is low, that relapse occurs mainly within the first 3 years post-treatment and that symptom evaluation and physical examination are the most effective follow-up methods, we postulate that a modification of the current model of hospital follow-up should be considered.
Assuntos
Humanos , Feminino , Protocolos Clínicos/normas , Neoplasias do Endométrio/mortalidade , Carcinoma Endometrioide/mortalidade , Recidiva Local de Neoplasia/mortalidade , Espanha , Serviços de Saúde da Mulher , Tomografia Computadorizada por Raios X , Estudos Retrospectivos , Avaliação de Resultados em Cuidados de Saúde , Neoplasias do Endométrio/cirurgia , Neoplasias do Endométrio/patologia , Neoplasias do Endométrio/diagnóstico por imagem , Carcinoma Endometrioide/cirurgia , Carcinoma Endometrioide/patologia , Carcinoma Endometrioide/diagnóstico por imagem , Intervalo Livre de Doença , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/cirurgia , Recidiva Local de Neoplasia/patologia , Recidiva Local de Neoplasia/diagnóstico por imagem , Estadiamento de NeoplasiasRESUMO
El íleo biliar se define como una obstrucción intestinal mecánica secundaria a la impactación de un cálculo biliar en el tracto gastrointestinal. Es responsable, aproximadamente, del 1% al 4% de las obstrucciones intestinales de origen mecánico y se asocia con alta morbimortalidad (1). La tomografía computarizada es en la actualidad considerada como el patrón de oro para el diagnóstico de esta patología, la cual se manifiesta con neumobilia, neumocolecisto, visualización directa de la fístula bilio-entérica, niveles hidroaéreos, líquido libre en cavidad peritoneal y localización ectópica de un cálculo.