ABSTRACT
BACKGROUND: Low socioeconomic status, increasing age, and poor lifestyle behaviors are associated with poor survival in patients with oral cavity squamous cell carcinoma (OCSCC). To determine the overall survival (OS) and the risk of OCSCC death by tumor subsite. MATERIAL AND METHODS: A retrospective cohort study of OCSCC patients diagnosed from 2007 to 2009 and treated at a single cancer center in Rio de Janeiro, Brazil. Patient information was obtained from the Hospital Cancer Registry (HCR) database and complemented by individual search of physical and electronic medical records. Descriptive statistics of population characteristics were computed. OS was estimated using the Kaplan-Meier method. Univariate and multivariate Cox proportional hazards regression analyses were used to estimate the risk of death by tumor subsite. RESULTS: Seven hundred and three patients with OCSCC were identified. Most patients were men (77.4%) with low levels of education (67.5%), who drank (73.9%) and smoked (79.7%). The most prevalent tumor site was the tongue (45.4%), 73.4% of patients had advanced (clinical stage III or IV) OCSCC at diagnosis and 74.1% died during follow-up. For the entire cohort, the OS was 39.1% at two years and 27.9% at five years. The median survival time was 1.4 years (95% CI: 1.2-1.5). Non-operative treatment (HR: 3.11; 95% CI: 2.26-4.29; p < 0.001), advanced stage (HR 2.14; 95% CI 1.68-2.74; p < 0.001), and age > 60 years at diagnosis (HR: 1.37; 95% CI: 1.15-1.64; p < 0.001) were independently associated with the risk of death. However, these factors varied by tumour subsite.CONCLUSION: Analysis of specific subsites of the oral cavity revealed substantial differences in prognostic factors associated with poor survival in OCSCC
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Subject(s)
Humans , Male , Female , Middle Aged , Aged , Carcinoma, Squamous Cell/mortality , Mouth Neoplasms/mortality , Retrospective Studies , Carcinoma, Squamous Cell/pathology , Mouth Neoplasms/pathology , Kaplan-Meier Estimate , Risk Factors , Prognosis , Socioeconomic Factors , Proportional Hazards Models , Brazil/epidemiologyABSTRACT
AIM: Estimate the incidence of bone metastases (BM) and skeletal-related events according to the histological subtype of lung cancer and its impact on patient survival. PATIENTS & METHODS: Retrospective cohort study was carried out with patients diagnosed with lung cancer. Cumulative incidence, Kaplan-Meier survival analysis and the risk of death were estimated. RESULTS: In non-small-cell lung cancer (NSCLC), the cumulative incidence of BM during follow-up was 23.8% at 24 months; in small-cell lung cancer, it was 18.5%. The presence of BM in patients with NSCLC was associated with an increased risk of death (hazard ratio: 1.25; 95% CI: 1.04-1.49; p = 0.013). CONCLUSION: This study revealed a high incidence of BM and skeletal-related events. BM was associated with a poor prognosis in NSCLC patients.
Subject(s)
Bone Diseases/epidemiology , Bone Diseases/etiology , Bone Neoplasms/epidemiology , Bone Neoplasms/secondary , Lung Neoplasms/epidemiology , Lung Neoplasms/pathology , Adult , Aged , Bone Diseases/mortality , Bone Neoplasms/mortality , Brazil/epidemiology , Combined Modality Therapy , Female , Humans , Incidence , Lung Neoplasms/mortality , Lung Neoplasms/therapy , Male , Middle Aged , Neoplasm Grading , Neoplasm Staging , Prognosis , Retrospective Studies , Risk FactorsABSTRACT
Translation, cross-cultural adaptation and validation of the DYMUS questionnaire for the assessment of dysphagia in multiple sclerosis. The original English version of the DYMUS was translated using the forward-backward technique, cross-culturally adaptated, pilot-tested in 40 patients, and then applied to 100 multiple sclerosis patients to assess the reliability and construct validity. Construct validity was assessed by Mann-Whitney test and Spearman's correlation coefficient (rs). The internal consistency of the questionnaire was evaluated using Cronbach's alpha coefficient and inter-item correlation. DYMUS-BR internal consistency was high (Cronbach's alpha= 0.72); Cronbach's alpha was 0.65 for the 'dysphagia for solids' subscale and 0.67 for the 'dysphagia for liquids' subscale and positive inter-item correlations was found between all items, except for weight loss question. Significant association (p<0.001) and correlation (rs = 0,357; p = 0.01) was found between DYMUS-BR and dysphagia self-assessment. The DYMUS-BR questionnaire maintained the characteristics of that originally described, demonstrating to be a reliable, valid, easy and consistent tool to be used by health professionals for preliminary selection of Brazilian MS patients who need more specific instrumental analyses of swallowing.
