Caracterización de pacientes con cáncer de pulmón en un servicio de neumología / Characterization of patients with lung cancer in a pneumology service i: en

Introducción: El cáncer de pulmón es un problema de salud pública a escala mundial y Cuba no está exenta de este. Objetivo: Caracterizar a los pacientes diagnosticados con cáncer de pulmón según variables clínicas, epidemiológicas y morfológicas. Métodos: Se realizó un estudio transversal, descriptivo y retrospectivo de los 145 adultos diagnosticados con cáncer de pulmón en el Servicio de Neumología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde enero del 2018 hasta diciembre del 2019. A tal efecto, en el procesamiento estadístico se emplearon como medidas de resumen el porcentaje y la media para variables cualitativas y cuantitativas, respectivamente; asimismo, se aplicaron el coeficiente kappa para establecer el grado de concordancia entre datos y la prueba de independencia de la Χ2 para identificar asociación significativa entre los criterios de interés seleccionados (con p<0,05). Resultados: Se obtuvo un predominio del sexo masculino (62,1 %) y el grupo etario de 65-75 años (37,9 %). Respecto a la variedad histológica, resultó más frecuente el carcinoma epidermoide (42,7 %). El pulmón derecho fue el más afectado, específicamente su lóbulo superior (33,8 %); del mismo modo, existieron alteraciones morfológicas, como la infiltración bronquial (100,0 %), la irregularidad y el edema de la mucosa (con 98,5 % en cada caso) y la inflamación con engrosamiento de la pared bronquial (90,3 %). Conclusiones: La determinación de las características clínicas, epidemiológicas y morfológicas relacionadas con el cáncer de pulmón permite efectuar el correcto seguimiento de los pacientes y aplicar un adecuado protocolo terapéutico.

Introduction: Lung cancer is a public health problem worldwide and Cuba is not exempt from it. Objective: Characterize patients diagnosed with lung cancer according to clinical, epidemiological and morphological variables. Methods: A cross-sectional, descriptive and retrospective study was carried out on 145 adults diagnosed with lung cancer in the Pneumology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from January, 2018 to December, 2019. For this purpose, in the statistical processing, the percentage and mean were used as summary measures for qualitative and quantitative variables, respectively; Likewise, there were applied the kappa coefficient to establish the degree of agreement between data and the Χ2 independence test to identify a significant association between the selected criteria of interest (with p<0.05). Results: There was a predominance of the male sex (62.1%) and the age group of 65-75 years (37.9%). Regarding the histological type, squamous cell carcinoma was more common (42.7%). The right lung was the most affected, specifically its upper lobe (33.8%); also, there were morphological alterations, such as bronchial infiltration (100.0%), mucosal irregularity and edema (with 98.5% in each case), and inflammation with bronchial wall thickening (90.3%). Conclusions: The determination of the clinical, epidemiological and morphological characteristics related to lung cancer makes it possible to carry out the correct follow-up of the patients and apply an appropriate therapeutic protocol.

Uso del músculo temporal en reconstrucción periorbitaria post exéresis de carcinoma epidermoide cutáneo del globo ocular izquierdo / Use of the temporal muscle in post exeresis periorbital reconstruction of cutaneous epidermoid carcinoma of the left eyeball

Introducción. El carcinoma epidermoide cutáneo (CEC) es la segunda neoplasia cutánea más frecuente después del carcinoma basocelular. La incidencia del CEC ha aumentado de forma considerable durante los últimos 20 años y predicen un incremento en la próxima década. La mayoría de los CEC están localizados y se resuelven habitualmente mediante la extirpación quirúrgica u otros procedimientos locales. El uso del músculo temporal es una alternativa quirúrgica para corregir el defecto periorbitario tras la extirpación del CEC. Objetivo. Evaluar el resultado de la cobertura del músculo temporal en la corrección del defecto periorbitario. Material y métodos. Se presenta un caso quirúrgico de un paciente masculino, 62 años, que presenta una gran lesión tumoral que compromete el globo ocular, región orbitaria y periorbitaria izquierda, acompañado de dolor, anemia, astenia y pérdida ponderal de aproximadamente 20 libras. Con una evolución de 6 años. Conclusión. El uso del músculo temporal es una alternativa eficaz en la reconstrucción de lesiones craneofaciales, que ha sido utilizado por más de 100 años.

Introduction. Skin epidermoid carcinoma (SEC) is the second most common skin neoplasm after basal cell carcinoma. The incidence of SEC has increased considerably over the past 20 years and predicts an increase over the next decade. Most SECs are located and usually resolved by surgical removal or other local procedures. The use of the temporal muscle is a surgical alternative to correct the peri-orbital defect after removal of the SEC. Objective. To evaluate the result of temporal muscle coverage in the correction of the peri-orbital defect. Material and methods. There is a surgical case of a male patient, 62 years old who has a large tumor injury that compromises the eyeball, orbital region and left periorbital. Accompanied by pain, anemia, asthenia, and weight loss approximately 20 pounds. With an evolution of 6 years. Conclusion. The use of the temporalis muscle is an effective alternative in the reconstruction of craniofacial lesions that has been used for more than 100 years

Utilização da morfometria celular no microambiente neoplásico e sua relação com a imunoexpressão da interleucina-4 / Use of cellular morphometry in the neoplastic microenvironment and its relationship with the immunoexpression of interleukin-4

A morfometria celular é um tipo de análise quantitativa que utiliza as medidas geométricas para obter informações acerca da morfologia nuclear, citoplasmática e outras medidas gerais das células, sendo que estes parâmetros podem estar alterados devido a processos fisiológicos e patológicos que modificam a morfologia celular normal, sendo uma análise relevante no prognóstico de diversas lesões. Os ceratinócitos possuem morfologia poliédrica com núcleos ovoides, mas podem sofrer alterações com eventos patológicos e fisiológicos, por exemplo, no núcleo. Essas alterações podem estar presentes em neoplasias malignas, como, no carcinoma epidermoide. A interleucina-4 (IL-4) é uma citocina secretada por diversos tipos de células, estando envolvida no desenvolvimento e diferenciação de células Th2, atuando na resposta antiinflamatória e sua expressão parece estar relacionada com o desenvolvimento de algumas neoplasias, incluindo o câncer oral. O objetivo da pesquisa foi realizar análise morfométrica celular (compartimentos nuclear e citoplasmático), identificação de irregularidades nucleares de ceratinócitos malignos e comparar com a imunoexpressão da IL-4 e profundidade de invasão nos casos de Carcinoma Epidermoide de Lábio Inferior (CELI) e Língua Oral (CELO). Foram analisados 30 casos de cada lesão. Para morfometria celular foram analisados 16 ceratinócitos malignos por caso; a imunoexpressão de IL-4 foi analisada no parênquima e estroma das lesões, utilizando softwares de análises de imagens. Foram aplicados os testes estatísticos de Análise de Variância, Kruskal-Wallis e Correlação de Spearman. A imunoexpressão de IL-4 no parênquima foi maior nos casos de CELI em todos os campos analisados (p<0,05); Houve correlação positiva entre área celular total e profundidade de invasão (p=0,038) e negativa entre imunoexpressão da IL-4 no parênquima superficial e perímetro nuclear superficial (p=0,007). Portanto, sugere-se que exista uma relação protetora da imunoexpressão IL-4 com as lesões analisadas, bem como alterações morfométricas dos ceratinócitos malignos com a imunoexpressão da IL-4 nessas lesões (AU).

Cell morphometry is a type of quantitative analysis that uses geometric measurements of cells to obtain information about the nuclear, cytoplasmic and general morphology of cells. Such parameters may be altered due to physiological and pathological processes that modify normal cell morphology, being a relevant analysis in the prognosis of several injuries. Keratinocytes have a polyhedral morphology with ovoid nuclei, but may undergo changes with pathological and physiological events, for example, in the nucleus. These changes may be present in malignant neoplasms, such as squamous cell carcinoma. Interleukin-4 (IL-4) is a cytokine secreted by several types of cells, being involved in the development and differentiation of Th2 cells, acting in the anti-inflammatory response and its expression seems to be related to the development of some neoplasms, including the oral cancer. The objective of the research was to perform cellular morphometric analysis (nuclear and cytoplasmic compartments), identification of nuclear irregularities of malignant keratinocytes and compare with the immunoexpression of IL-4 and depth of invasion in cases of Epidermoid Carcinoma of the Lower Lip (CELI) and Oral Tongue. (CELLO). Thirty cases of each lesion were analyzed. For cell morphometry, 16 malignant keratinocytes were analyzed per case; IL-4 immunoexpression was analyzed in the parenchyma and stroma of the lesions, using image analysis software. The statistical tests of Analysis of Variance, Kruskal-Wallis and Spearman's Correlation were applied. The immunoexpression of IL-4 in the parenchyma was higher in cases of CELI in all analyzed fields (p<0,05); There was a positive correlation between total cell area and depth of invasion (p=0.038) and a negative correlation between IL-4 immunoexpression in the superficial parenchyma and superficial nuclear perimeter (p=0.007). Therefore, it is suggested that there is a protective relationship between IL-4 immunoexpression and the lesions analyzed, as well as morphometric alterations of malignant keratinocytes with IL-4 immunoexpression in these lesions (AU).

El pH salival como marcador biológico en pacientes diagnosticados con carcinoma epidermoide oral de Guantánamo / Salivary pH as diagnostic biomarker in patients diagnosed with oral squamous cells carcinoma in Guantanamo / pH salivar como marcador biológico em pacientes diagnosticados com carcinoma epidermóide oral de Guantánamo

RESUMEN Introducción: El cáncer bucal constituye un problema de salud de connotación mundial. Objetivo: Comparar las variaciones del pH salival entre pacientes con carcinoma epidermoide recién diagnosticados, después del tratamiento oncoespecífico y sujetos aparentemente sanos de la provincia Guantánamo, Cuba, en el período noviembre 2019- enero 2022. Método: Se realizó un estudio descriptivo, comparativo, transversal, en pacientes ambulatorios de la consulta de Cirugía Maxilofacial del Hospital General Docente "Dr. Agostinho Neto". El grupo de estudio estuvo conformado por 200 pacientes divididos en 3 subgrupos: subgrupo I (50 pacientes recién diagnosticados con carcinoma epidermoide oral, con diagnóstico concomitante de caries dental y periodontitis crónica del adulto); subgrupo II (50 pacientes con la referida patología después de tratamiento oncoespecífico, tratados por las enfermedades bucales antes citadas) y subgrupo III (100 pacientes controles aparentemente sanos). Se estudiaron las variables: edad, sexo, tipo de dieta y pH salival. Resultados: La edad media fue de 59,8 años, 70 % fueron hombres. Se asoció la dieta consumida y cada subgrupo (p=0,001). El pH salival de los pacientes con carcinoma epidermoide recién diagnosticados afectados por ambas enfermedades bucales fue ácido (6,25±0,37) en comparación a los otros subgrupos. El 98,6 % de los pacientes con pH salival ácido presentaron una dieta usual a base de carbohidratos y grasas (p=0,000). Conclusiones: Se evidenció que el pH salival de los pacientes con carcinoma epidermoide recién diagnosticados fue ácido en comparación a los otros subgrupos, por lo que este parámetro puede usarse como un marcador biológico de la enfermedad.

ABSTRACT Introduction: Oral cancer is a common health problem worldwide. Objective: Compare the salivary pH range changes among patients diagnosed recently with oral squamous cells carcinoma after receiving oncospecific treatment and subjects apparently healthy, Guantanamo, Cuba, period time November 2019 -January 2022. Method: A descriptive, comparative, cross-sectional study was carried out in outpatients of the Maxillofacial Surgery Consultation room at the Hospital General Docente "Dr. Agostinho Neto". The study group consisted of 200 patients divided into 3 subgroups: subgroup I (50 newly diagnosed patients with oral squamous cell carcinoma, with concomitant diagnosis of dental caries and chronic adult periodontitis); subgroup II (50 patients with the aforementioned pathology after oncospecific treatment, treated for the aforementioned oral diseases) and subgroup III (100 apparently healthy control patients). The following variables were studied: age, sex, type of diet and salivary pH. Results: Average age was 59.8 years, 70% were men. There was an association between the diet consumed and each subgroup (p= 0.001). The salivary pH of newly diagnosed squamous cell carcinoma patients affected by both oral diseases was acidic (6.25±0.37) compared to the other subgroups. The 98.6% of patients with acid salivary pH presented a usual diet based on carbohydrates and fats (p=0.000). Conclusions: It was shown that the salivary pH of newly diagnosed patients with squamous cell carcinoma was acidic compared to the other subgroups. Therefore, this parameter can be used as a biological marker of the disease.

RESUMO Introdução: O câncer bucal é um problema de saúde global. Objetivo: Comparar as variações do pH salivar entre pacientes com carcinoma espinocelular recém-diagnosticado, após tratamento oncoespecífico, e indivíduos aparentemente saudáveis da província de Guantánamo, Cuba, no período de novembro de 2019 a janeiro de 2022. Método: Estudo descritivo, comparativo, cruzado seccional, em pacientes ambulatoriais da consulta de Cirurgia Bucomaxilofacial do Hospital General Docente "Dr. Agostinho Neto". O grupo de estudo foi composto por 200 pacientes divididos em 3 subgrupos: subgrupo I (50 pacientes recém-diagnosticados com carcinoma espinocelular oral, com diagnóstico concomitante de cárie dentária e periodontite crônica do adulto); subgrupo II (50 pacientes com a patologia supracitada após tratamento oncoespecífico, tratados para as doenças bucais supracitadas) e subgrupo III (100 pacientes controles aparentemente saudáveis). As variáveis estudadas foram: idade, sexo, tipo de dieta e pH salivar. Resultados: A média de idade foi de 59,8 anos, 70% eram homens. A dieta consumida e cada subgrupo foram associados (p=0,001). O pH salivar de pacientes recém-diagnosticados com carcinoma espinocelular afetados por ambas as doenças bucais foi ácido (6,25±0,37) em comparação com os outros subgrupos. 98,6% dos pacientes com pH salivar ácido apresentaram dieta habitual baseada em carboidratos e gorduras (p=0,000). Conclusões: Evidenciou-se que o pH salivar dos pacientes com carcinoma espinocelular recém-diagnosticado foi ácido em relação aos demais subgrupos. Portanto, esse parâmetro pode ser utilizado como marcador biológico da doença.

Caracterización de pacientes con cáncer ocular en un hospital de Santiago de Cuba / Characterization of patients with eye cancer in a hospital from Santiago de Cuba i: en

Introducción: La neoplasia ocular puede afectar el ojo, los anexos y la órbita. El tratamiento eficaz depende de un diagnóstico precoz, presuntivo y certero. Objetivo: Caracterizar a los pacientes con cáncer ocular según variables de interés. Método: Se realizó un estudio observacional, descriptivo y retrospectivo de 58 pacientes con tumor maligno ocular, confirmado mediante biopsia, atendidos en el Servicio de Cirugía Plástica Ocular del Centro Oftalmológico del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba, desde octubre del 2015 hasta igual periodo del 2020. Se utilizó la media para las variables cuantitativas. Resultados: En la serie la edad media fue de 62,49 años; primaron el sexo masculino (51,7 %) y el color de la piel mestizo (53,4 %). La localización más frecuente de las lesiones tumorales en los anexos fue en los párpados (53,4 %) y la conjuntiva (41,4 %). Los tipos histológicos predominantes fueron carcinoma basocelular palpebral (44,8 %) y carcinoma epidermoide de la conjuntiva (41,4 %). La estadificación del tumor se estableció: T1 en 47 pacientes, T2 y T3 en 4, así como T4 en 3. Conclusiones: El control del cáncer ocular es de suma importancia, pues permite trazar estrategias para el diagnóstico precoz y el tratamiento adecuado de los pacientes.

Introduction: The ocular neoplasm can affect the eye, annexes and orbit. The effective treatment depends on an early, presumptive and accurate diagnosis. Objective: To characterize patients with eye cancer according to variables of interest. Method: An observational, descriptive and retrospective study of 58 patients with eye malignancy confirmed by means of biopsy was carried out. They were assisted in the Ocular Plastic Surgery Service of the Ophthalmologic Center at Dr. Juan Bruno Zayas Alfonso Teaching General Hospital in Santiago de Cuba, from October, 2015 to the same period in 2020. The mean was used for the quantitative variables. Results: In the series the mean age was of 62.49 years; there was a prevalence of the male sex (51.7 %) and the mixed race color of the skin (53.4 %). The most frequent localization of the tumoral lesions in the annexes was in the lids (53.4 %) and the conjunctive (41.4 %). The predominant histologic types were palpebral basal cell carcinoma (44.8 %) and squamous cell carcinoma of the conjunctive (41.4 %). The estadification of the tumor was established: T1 en 47 patients, T2 and T3 in 4, as well as T4 in 3. Conclusions: The control of the eye cancer is very important, because it allows to trace strategies for the early diagnosis and the appropriate treatment of patients.

Carcinoma epidermoide de piel tratado con HeberFERON®

RESUMEN Introducción: en la literatura biomédica son escasos los reportes sobre el uso de los interferones como tratamiento en el carcinoma epidermoide. En una unidad de atención primaria, en Colón, Matanzas, se implementó el HeberFERON® en este tipo de tumor, con experiencias favorables. Objetivo: describir la efectividad del HeberFERON® en el carcinoma epidermoide. Materiales y métodos: se realizó un estudio observacional, descriptivo en 33 lesiones de carcinoma epidermoide en 29 pacientes. La dosis fue de 7,0 y 10,5 MUI de actividad antiviral, infiltrada de forma perilesional tres veces por semana durante tres semanas. Se realizó el seguimiento clínico de los pacientes antes del tratamiento y a las 16 semanas del inicio del mismo. Las variables fueron: edad, sexo, fototipo de piel, procedencia, localización, tipo clínico, estadio y respuesta clínica al tratamiento. Se consideraron cuatro categorías de respuesta: completa, parcial, enfermedad estable y progresiva. Se incluyó la respuesta objetiva (completa más parcial). Se recogieron los datos en una historia clínica. Se utilizaron los programas Microsoft Excel y SPSS para el procesamiento estadístico. Resultados: el 65,5 % de los pacientes correspondió al sexo masculino. Un 58,6 % son fototipo II y de procedencia urbana. Predominaron las edades entre 61 y 80 años (55,2 %). Hubo respuesta objetiva en 57,6 % (cinco completas y 14 parciales). Las mejores respuestas la mostraron el carcinoma epidermoide queratósico superficial y el noduloulceroso. Conclusiones: la mezcla de interferones fue efectiva en el carcinoma epidermoide en todos los subtipos clínicos, aunque los autores sugieren un segundo ciclo de HeberFERON® o asociarlo con quimioterapia cuando la respuesta no sea completa.

ABSTRACT Introduction: there are few reports in the literature on the use of interferon in the treatment of the squamous cell carcinoma. In a primary care unit in Colon, Matanzas, HeberFERON® was implemented in this type of tumor with favorable experiences. Objective: to describe the effectiveness of HeberFERON® in epidermoid carcinoma. Materials and methods: an observational, descriptive study was conducted in 33 epidermoid carcinoma lesions in 29 patients. The doses were 7.0 and 10.5 MUI of antiviral activity, perilesionally infiltrated three times a week for three weeks. Clinical follow-up of patients was performed before the treatment and at 16 weeks from the beginning of the treatment. The variables were: age, sex, skin phototype, origin; location, clinical type, stage and clinical response to treatment. Four categories of response were considered: complete, partial, stable and progressive disease. The objective response (complete plus partial) was included. Data were collected in a clinical record. The Microsoft Excel and SPSS programs were used for statistical processing. Results: 65.5 % of patients were male. 58.6 % are phototype II and of urban origin. Ages ranging from 61 to 80 years (55.2 %) predominated. There was objective response in 57.6 % (five complete and 14 partials). The superficial keratotic squamous cell carcinoma and the nodular ulcerative one showed the best responses. Conclusions: interferon mixing was effective in all clinical subtypes of epidermoid carcinoma, although the authors suggest a second cycle of HeberFERON® or to associate it with chemotherapy when the response is not complete.

Reconstrucción mandibular mediante colgajo miocutáneo de pectoral mayor en carcinoma epidermoide, reporte de caso clínico y revisión de la literatura / Mandibular reconstruction using pectoralis major myocutaneous flap in squamous cell carcinoma, clinical case report and literature review

RESUMEN El carcinoma epidermoide surge del epitelio de la mucosa oral, es frecuente en la quinta y sexta décadas de la vida y está típicamente asociado con factores de riesgo como tabaquismo y el consumo de alcohol. En todo el mundo, la incidencia de cáncer oral es más alta en hombres que en mujeres. El incremento en la incidencia del cáncer en México requiere de un manejo adecuado, como colgajos vascularizados para reparar defectos generados por una hemimandibulectomía con márgenes de seguridad. A pesar de la llegada de injertos de tejido libres vascularizados, el colgajo pectoral mayor miocutáneo sigue siendo un colgajo pediculado ampliamente utilizado para la reconstrucción de defectos de tejidos blandos en la región oral y maxilofacial. Se muestra el protocolo quirúrgico realizado en el Hospital Regional "General Ignacio Zaragoza" ISSSTE para el tratamiento de un carcinoma epidermoide mandibular.

ABSTRACT Squamous cell carcinoma arises from the epithelium of the oral mucosa, common in the fifth and sixth decades of life and is typically associated with risk factors such as smoking and alcohol consumption. Worldwide, the incidence of oral cancer is higher among men than women. The increase in the incidence of cancer in Mexico requires proper management and the use of vascularized flaps to repair defects generated by a hemimandibulectomy with safety margins. Despite the advent of vascularized free tissue grafts, the myocutaneous pectoralis major flap remains a pedunculated flap widely used for the reconstruction of soft tissue defects in the oral and maxillofacial region. The surgical protocol carried out at the ISSSTE "General Ignacio Zaragoza" Regional Hospital for the treatment of mandibular squamous cell carcinoma is shown.

Desenvolvimento de metodologia para identificação de fungos através de metabarcoding aplicada em amostras humanas de adenocarcinoma gástrico e carcinoma epidermoide de pênis / Development of methodology for fungi identification through metabarcoding applied in gastric adenocarcinoma and penile epidermoid carcinoma of human sample

O microbioma humano compreende material genético da microbiota de um local do corpo e tem influência direta ou indireta na manutenção da homeostase. O distúrbio da microbiota pode estar relacionado ao desenvolvimento de doenças. A população fúngica ainda é muito pouco estudada no contexto do microbioma. No presente estudo, foi desenvolvida uma metodologia para identificação de fungos por metabarcoding. A metodologia desenvolvida foi aplicada em mostras de pacientes portadores de adenocarcinoma gástrico ou carcinoma epidermoide de pênis. De modo geral, em ambos os tumores foi verificada a redução de diversidade fúngica conforme a evolução do estadiamento patológico. Também foram verificados resultados não concordantes ao analisar espécies diferencialmente abundantes em dados de sequenciamento da região ITS2 e de WGS nas amostras de lavado gástrico. Este trabalho reforça a importância em se estudar os fungos e sua associação com doenças como o câncer e incentiva próximos estudos através do desenvolvimento de uma metodologia específica para o micobioma.

The human microbiome comprises genetic material from the microbiota of a body site and has a direct or indirect influence on the maintenance of homeostasis. The disturbance of the microbiota may be related to the development of diseases. The fungal population is still very little studied in the context of the microbiome. In this study, a methodology was developed to identify fungi by metabarcoding. The methodology developed was applied to samples from patients with gastric adenocarcinoma or squamous cell carcinoma of the penis. In general, in both tumors, a reduction in fungal diversity was observed according to the evolution of the pathological staging. Discordant results were also found when analyzing differentially abundant species in sequencing data from the ITS2 region and WGS in gastric lavage samples. This work reinforces the importance of studying fungi and their association with diseases such as cancer and encourages further studies through the development of a specific methodology for the mycobiome

Caracterización clínico-patológica de pacientes con cáncer esofágico avanzado en el Hospital Princess Marina, Botsuana / Clinicopathological characterization of patients with advanced esophageal cancer at Princess Marina Hospital, Botswana / Caracterização clínico-patológica de pacientes com câncer de esôfago avançado no Hospital Princess Marina, Botswana

RESUMEN Introducción: El cáncer de esófago avanzado es una de las neoplasias más agresivas con una elevada morbilidad y mortalidad. Botsuana ocupa el duodécimo cuarto puesto mundial con respecto a las muertes ocasionadas por esta enfermedad. Objetivo: Determinar las características clínico-patológicas de los pacientes con cáncer esofágico avanzado en el Hospital Princess Marina de Gaborone, Botsuana. Método: Se realizó un estudio prospectivo-descriptivo donde se caracterizó clínica y patológicamente a 45 pacientes con el diagnóstico endoscópico e histológico de cáncer de esófago avanzado en el periodo de enero a septiembre de 2019. Resultados: Predominó el sexo masculino (86,7 %) y los pacientes mayores de 60 años (60,0 %). La disfagia, la anorexia y la pérdida de peso fueron los síntomas más frecuentes y prevalecieron los pacientes con un tiempo entre la aparición de los síntomas y el diagnóstico-endoscópico entre tres y seis meses; la dieta inadecuada, el etilismo crónico y el hábito de fumar fueron los factores de riesgo predominantes. La localización anatómica más frecuente fue el tercio medio (51,1 %), el tipo endoscópico predominante fue el vegetante (46,7 %) y la mayoría de los pacientes presentó el tipo histológico carcinoma epidermoide (95,6 %) bien diferenciado (84,4 %). Conclusiones: El estudio de las características clínico-patológicas de los pacientes con cáncer esofágico avanzado permite su correcta estadificación, siendo una herramienta útil en la valoración multidisciplinaria del tratamiento debido a su complejo manejo clínico e institucional.

ABSTRACT Introduction: Advanced esophageal cancer is one of the most aggressive neoplasms with high morbidity and mortality. Botswana ranks 14th in the world for deaths from this disease. Objective: To determine the clinicopathological characteristics of patients with advanced esophageal cancer at the Princess Marina Hospital in Gaborone, Botswana. Method: A prospective-descriptive study was carried out, where 45 patients with endoscopic and histological diagnosis of advanced esophageal cancer were characterized clinically and pathologically, from January to September 2019. Results: Males predominated (86.7%), and also patients older than 60 years (60.0%). Dysphagia, anorexia and weight loss were the most frequent symptoms, and prevailed patients with three to six months between the appearance of symptoms and endoscopic diagnosis; inadequate diet, chronic alcoholism, and smoking were the predominant risk factors. The most frequent anatomical location was the middle third (51.1%), the predominant endoscopic type was the vegetative (46.7%) and most of the patients presented the histological type squamous cell carcinoma (95.6%) well differentiated (84.4%). Conclusions: The study of the clinical-pathological characteristics of patients with advanced esophageal cancer allows its correct staging, being a useful tool in the multidisciplinary assessment of treatment due to its complex clinical and institutional management.

RESUMO Introdução: O câncer de esôfago avançado é uma das neoplasias mais agressivas com alta morbimortalidade. Botswana ocupa o 14º lugar no mundo em mortes por esta doença. Objetivo: determinar as características clínico-patológicas de pacientes com câncer de esôfago avançado no Hospital Princesa Marina em Gaborone, Botsuana. Método: Foi realizado estudo prospectivo-descritivo em que 45 pacientes com diagnóstico endoscópico e histológico de câncer de esôfago avançado foram caracterizados clínica e patologicamente de janeiro a setembro de 2019. Resultados: Predominou o sexo masculino (86,7%) e pacientes com mais de 60 anos ( 60,0%). Disfagia, anorexia e perda de peso foram os sintomas mais frequentes e prevaleceram os pacientes com tempo entre o aparecimento dos sintomas e o diagnóstico endoscópico entre três e seis meses; dieta inadequada, alcoolismo crônico e tabagismo foram os fatores de risco predominantes. A localização anatômica mais frequente foi o terço médio (51,1%), o tipo endoscópico predominante foi o vegetativo (46,7%) e a maioria dos pacientes apresentou o tipo histológico carcinoma espinocelular (95,6%) bem diferenciado (84,4%). Conclusões: O estudo das características clínico-patológicas dos pacientes com câncer de esôfago avançado permite seu correto estadiamento, sendo uma ferramenta útil na avaliação multidisciplinar do tratamento devido ao seu complexo manejo clínico e institucional.

Exérese tumoral seguida de blefaroplastia no tratamento de carcinoma de células escamosas em pálpebra inferior de equino / Tumoral resection followed by blepharoplasty in squamous cell carcinoma treatment in the lower eyelid of a horse

Background: Equines are routinely subjected to enucleation due to palpebral tumors. Blepharoplasties in horses, especially in the lower eyelid, are rarely performed due to the difficulty of sliding once the tissue around the eyes presents low mobility. Defects involving more than 50% of the lower eyelid is considered challenging after tumor removal. Squamous cell carcinoma (SCC) is the second most reported neoplasm in horses, being very common in regions of the lower eyelid, third eyelid, sclera and or cornea. The aim of this study is to present the Destro VY skin advancement flap as a blepharoplasty technique performed after surgical excision of a SCC, with total commitment of the lower eyelid, completely covering the right eye of a mare. Case: A 8-year-old mare Paint Horse, weighing 420 kg, was referred for evaluation of tumor tissue of 6.0 x 4.0 x 2.0 cm, with nodular and ulcerated appearance, involving the right lower eyelid, in its total extension and completely covering the eye, without adhering to it. Considering the initial suspicion of SCC, the treatment strategy performed was surgical eyelid excision and maintenance of the eye, followed by blepharoplasty as an attempt to reconstruct the eyelid. Under general inhalation anesthesia, the animal was placed in left lateral recumbency, when the surgical region was prepared and local anesthetic block was performed. After antisepsis, a skin incision was made circumscribing the tumor, respecting a margin of 10 mm apart and excision of all visible tumor tissue was performed followed by intralesional ozone therapy. Blepharoplasty was performed to cover the portions of the exposed lacrimal and zygomatic bones, as well as correction of the eyelid aesthetics. For this, Destro VY skin advancement flap was performed for reconstruction of the lower eyelid. An incision of approximately 7 cm in Vshaped skin was performed, and the subcutaneous tissue under the V was dissected, maintaining a central pedicle, responsible for the vascularization of the flap, which was slid, approximately 20 mm, towards the eye. After obtaining the desired skin approximation, Y-suture was performed, covering the exposed bone and reconstructing the lower eyelid. In the postoperative period, local instillation of mitomycin eye drops and systemic meloxicam administration were instituted. The mare had her vision restored, presenting satisfactory morpho functional and aesthetic results and no tumor recurrence during 1-year of follow-up. Discussion: The repair of lower eyelid imperfections is challenging, especially when they have large defects, and there are no reports of performing the Destro VY skin advancement flap technique in horses for lower eyelid reconstruction. In this case, the importance of the blepharoplasty technique is emphasized, avoiding enucleation, preserving horse's vision and aesthetics. In addition, aiming to avoid tumor recurrence, especially if surgical safety margins can not be achieved, other complementary treatments should be associated, including intralesional ozone therapy, mitomycin, an antineoplastic chemotherapy drug, and meloxicam, a COX-2 selective, non-steroidal anti-inflammatory drug, as performed in this study. It is concluded that the use of the Destro VY skin advancement flap technique for reconstruction of the external lamella in cases of SCC in the lower eyelid of horses is a feasible technique, which preserves the animal's vision, as well as aesthetics. The safety margin in the surgical excision of the SCC and the association of complementary therapies in the resolution of the condition are important points also to be considered.

Carcinoma epidermoide córneo-conjuntival. Presentación de un caso / Squamous cell, corneal-conjunctival carcinoma of. Case report

RESUMEN Se presentó el caso de un paciente masculino de 60 años, blanco, que fue atendido en la Consulta de Oftalmología, del Hospital "Dr. Mario Muñoz", del municipio de Colón, provincia de Matanzas. Refirió que llevaba aproximadamente 20 días, con sensación de cuerpo extraño en el ojo izquierdo, enrojecimiento, secreción constante, fotofobia y una lesión que le había aumentado de tamaño durante este período; la que se tornaba dolorosa durante el parpadeo. Se decidió realizar este trabajo con el objetivo de mostrar los beneficios obtenidos al concluir el tratamiento aplicado a este tipo de tumor (AU).

ABSTRACT The authors present the case of a white male patient, aged 60 years, who assisted the Consultation of Ophthalmology of the Hospital "Dr. Mario Muñoz", of the municipality of Colon. He referred feeling a foreign body in the left eye for already 20 days, presence of redness, constant secretion, photophobia and a lesion that had grown during that period, painful when blinking. The authors decided to write this article with the objective of showing the benefits obtained with the applied treatment in this kind of tumor (AU).

Aspectos broncoscópicos e histológicos en pacientes con cáncer de pulmón / Bronchoscopic and histologic aspects in patients with lung cancer

Introducción: Se denomina como cáncer de pulmón a un conjunto de enfermedades resultantes del crecimiento aberrante de células del tracto respiratorio, en particular del tejido pulmonar. Objetivo: Determinar los aspectos broncoscópicos e histológicos útiles en la confirmación del diagnóstico de dichas neoplasias malignas. Métodos: Se realizó una investigación descriptiva y transversal de los 346 pacientes atendidos por cáncer de pulmón en el Servicio de Neumología del Hospital General Docente Dr. Juan Bruno Zayas Alfonso de Santiago de Cuba durante los años 2016 y 2017, en quienes se realizó broncoscopia. Para ello se utilizaron las variables edad, sexo, técnica diagnóstica empleada, diagnóstico histopatológico, localización más frecuente. Resultados: Predominaron los pacientes en las edades entre los 56 y 75 años (66,1 %), así como el sexo masculino (65,0 %). La biopsia bronquial fue el procedimiento que mayormente reveló la presencia del cáncer (61,3 %) y el tipo histológico más frecuente fue el carcinoma epidermoide (67,8 %). Conclusiones: Se demostró la importancia de la broncoscopia y sus procedimientos diagnósticos para confirmar la existencia del proceso morboso.

Introduction: It is denominated as lung cancer to a group of diseases resulting from the abnormal growth of cells of the breathing tract, in particular of the lung tissue. Objective: To determine the useful bronchoscopic and histologic aspects in the confirmation of the diagnosis of these neoplasms. Methods: A descriptive and cross-sectional investigation of the 346 patients assisted due to lung cancer in the Pulmonology Service of Dr. Juan Bruno Zayas Alfonso Teaching General Hospital was carried out in Santiago de Cuba during 2016 and 2017 to whom a bronchoscopy was carried out. The variables used were age, sex, diagnostic technique used, histopatologic diagnosis and more frequent localization. Results: The patients aged 56 and 75 (66.1 %), as well as the male sex (65.0 %) prevailed. The bronchial biopsy was the procedure that mostly revealed the presence of cancer (61.3 %) and the most frequent histologic type was the squamous cell carcinoma (67.8 %). Conclusions: The importance of bronchoscopy and its diagnostic procedures to confirm the existence of the morbid process was demonstrated.

Carcinoma epidermoide primitivo de mama en hombre. Presentación de un caso / Primitive Epidermoid Breast Carcinoma in Men. Case Presentation

RESUMEN El carcinoma epidermoide primitivo está considerado el tumor más raro de la mama, con una incidencia que representa solo del 0,04 al 0,075 % de todos los tumores malignos de esta localización. Es una variedad de carcinoma metaplásico constituido por células pavimentosas queratinizantes. Se presenta el caso de un paciente de sexo masculino, de 65 años, de color de piel blanca, residente en el municipio Abreus, provincia Cienfuegos, que acudió a la consulta de mastología de la provincia por presentar una tumoración de 5 cms. en el cuadrante superior externo de la mama derecha, de dos meses de evolución. Se realizó exéresis de la tumoración y se recibió informe de la biopsia con el resultado de carcinoma epidermoide poco diferenciado. Actualmente el paciente se sigue en consulta y está libre de metástasis. Por lo inusual del caso se decide su publicación. Se presenta este reporte por ser el primer paciente de sexo masculino, operado de carcinoma epidermoide de mama en la provincia Cienfuegos.

ABSTRACT Primitive epidermoid carcinoma is considered the rarest breast tumor, with an incidence that represents only 0.04 to 0.05 % of all malignant tumors of this location. It is a variety of metaplastic carcinoma made up of keratinizing pavement cells. The case presented is a 65-year-old white male patient, resident in the Abreus municipality, Cienfuegos province who attended the province's mastology clinic for presenting a 5 cm tumor in the upper external quadrant of the right breast, two months in evolution. Exeresis of the tumor was performed and a report of the biopsy was received with the result of poorly differentiated squamous cell carcinoma. Currently the patient is followed in consultation and is free of metastases. Due to the unusual nature of the case, its publication is decided. This report is presented as the first male patient to undergo surgery for squamous cell carcinoma of the breast in the Cienfuegos province.

Cáncer de piel no melanoma en adultos mayores de hogares de ancianos, Guantánamo 2017-2019 / Nonmelanoma skin cancer in elderly at nursing homes of Guantanamo from 2017 to 2019

RESUMEN Introducción: En Guantánamo no se ha caracterizado el cáncer de piel en los adultos mayores. Objetivo: Caracterizar a los pacientes ingresados en los hogares de ancianos "Caridad Jaca" y "San José" de la ciudad de Guantánamo con diagnóstico de cáncer de piel en el periodo 2017-2019. Método: Se realizó un estudio observacional, prospectivo y transversal con todos los ancianos (n=256) con cáncer de piel (n=15). Se estudiaron las siguientes variables: edad, sexo, lugar de nacimiento y donde vivió, antecedentes patológicos personales, fototipo cutáneo, características de la lesión, diagnóstico clínico, dermatoscópico e histopatológico. Resultados: En el 5,9 % de los ancianos se diagnosticó un cáncer de piel. Fue más común en hombres (53,4 %), con 60 a 79 años (53,4 %), nacidos o que vivieron en áreas urbanas y fototipo cutáneo III (40,0 %). El 100,0 % se expuso a la luz solar, el 86,7 % sin medios de fotoprotección. El cáncer se localizó más en la cara (66,7 %), tenían entre 3 y 4 años de evolución (60,0 %) y el carcinoma basocelular (46,6 %) fue el más frecuente. En el 80,0 % de los casos se apreció correlación diagnóstico clínico, dermatoscópico e histopatológico. Conclusiones: Es baja la frecuencia del cáncer de piel en los ancianos, sin embargo, se requiere prestar más atención al aseguramiento del diagnóstico precoz de esta enfermedad.

ABSTRACT Introduction: Skin cancer in elderly has not been characterized in Guantanamo. Objective: Characterize the patients admitted to the nursing homes "Caridad Jaca" and "San José" in the city of Guantánamo with a diagnosis of skin cancer in the period 2017-2019. Method: It was conducted an observational, prospective and cross-sectional study with all the elderly (n=256) with skin cancer (n=15). Studied variables: age, sex, place of birth and lived, personal pathological history, skin phototype, characteristics of the lesion, clinical dermatoscopic and histopathological diagnosis. Results: 5.9% of the elderly were diagnosed with skin cancer. It was more common in men (53.4%), range age from 60 to 79 (53.4%), were born or lived in urban areas and with skin phototype III (40.0%). 100.0% of the patients were exposed to sunlight, 86.7% without photo-protection means. The cancer was more localized in the face area (66.7%), had between 3 and 4 years of evolution (60.0%) and basal cell carcinoma (46.6%) was the most frequent. Clinical, dermatoscopic and histopathological diagnosis correlation was observed in 80.0 % of the cases. Conclusions: The rate of skin cancers in erderly is low, however, more attention is needed to ensure early diagnosis of this disease.

Cáncer de cabeza y cuello. Su impacto en la historia de la humanidad / Head & neck cancer. Its impact on the history of mankind

Resumen El cáncer epidermoide es el más frecuente en cabeza y cuello y sus primeras descripciones datan de la época faraónica. Ha impactado en la humanidad al afectar la productividad laboral, científica y cultural y, en ocasiones, ha influido en el derrotero de la historia. El cáncer de cabeza y cuello es más frecuente en países e individuos depauperados económicamente, sin embargo, puede afectar cualquier estrato socioeconómico; lo han padecido personajes conocidos, famosos, económicamente poderosos, intelectuales y artistas. El tratamiento del cáncer de cabeza y cuello ha sido motivo de controversia desde su descripción inicial hasta la actualidad. En la decisión terapéutica ha influido no solo el estadio del cáncer sino el entorno del paciente; en ocasiones, en un afán de disminuir la morbilidad derivada de los diversos tratamientos oncológicos, se han tomado decisiones erróneas que han implicado la pérdida de la vida del enfermo. Infortunadamente, en la actualidad seguimos viendo estas conductas. Se presenta una síntesis de casos de connotados personajes que presentaron este cáncer y se describe el impacto que ello implicó en la sociedad de ese momento.

Abstract Squamous cell carcinoma is the most common head and neck malignancy, and its first descriptions date from the pharaonic era. It has impacted humanity by affecting labor, scientific and cultural productivity and, sometimes, it has influenced the course of history. Head and neck cancer is common in economically impoverished countries and individuals; however, it can affect any socioeconomic stratum; it has been suffered by known, famous, economically powerful celebrities, intellectuals and artists. Head and neck cancer treatment has been controversial since its initial description up to the present day. Therapeutic decisions have been influenced not only by the stage but by the patient's environment and, sometimes, in an effort to reduce the morbidity resulting from the various oncological treatments, erroneous decisions have been made that have implied the loss of the patient's life; unfortunately, currently we continue to see these behaviors. A synthesis of cases of renowned celebrities that suffered from this cancer is presented, and the impact this implied in the society of their times is described.

Carcinoma epidermoide metastásico asociado a epidermólisis ampollosa distrófica / Metastasic squamous cell carcinoma in dystrophic epidermolysis bullosa

Caso clínico: femenino de 18 años con diagnóstico de epidermolisis ampollosa distrófica (EAD) quién desarrolló una neoformación nodular sobre una úlcera crónica. Se diagnosticó carcinoma epidermoide (CE) invasor al que se realizó resección. Sin embargo, 5 meses después del tratamiento quirúrgico presentó metástasis a ganglios, pulmón e hígado con desenlace fatal. Comentarios: el CE es la causa más importante de muerte en pacientes con EAD. Suele ser agresivo y metastásico. Se recomienda una vigilancia cada 3 a 6 meses para realizar diagnóstico y tratamiento oportunos (AU)

Case report: 18-year-old female patient with dystrophic epidermolysis bullosa (DEB) who developed a tumor over a chronic ulcer. She was diagnosed with invasive squamous cell carcinoma (SCC) and underwent surgical resection. However, 5 months later she presented metastases to the lymph nodes, lung and liver with a fatal outcome. Comments: SCC is the most important cause of death in patients with DEB. It is usually aggressive and metastatic. Surveillance every 3 to 6 months is recommended for prompt diagnosis and treatment (AU)

Carcinoma de células escamosas corneal em equino / Corneal squamous cell carcinoma in an equine

O carcinoma de células escamosas é uma neoplasia maligna das células epidérmicas, considerado a segunda neoplasia mais comum nos olhos e anexos oculares de equinos. A ocorrência intensifica-se, principalmente, nos animais com regiões despigmentadas e desprovidas de pelos e sujeitas à radiação solar. As lesões podem se apresentar isoladas ou múltiplas, com tamanhos variados e ulceradas. O tratamento depende do tamanho, grau de invasão, equipamento disponível e condição financeira do proprietário. Como tratamento, tem sido utilisados a excisão cirúrgica, quimioterápicos de uso tópico e intralesional. O objetivo deste trabalho foi relatar um carcinoma de células escamosas na córnea de um equino. Foi encaminhado para a Clínica do Rancho um equino, macho, não castrado, 11 anos de idade, apresentando uma massa rósea na córnea do olho direito com evolução de quatro meses. Mediante suspeita clínica de carcinoma de células escamosas, foi indicada exérese cirúrgica da massa, seguida de avaliação histopatológica. O resultado do exame confirmou o diagnóstico da neoplasia. A terapia pós-cirúrgica consistiu na administração de colírios antibiótico, anti-inflamatório e atropina, além do anti-inflamatório flunixin meglumine. Como tratamento adjuvante foi feito o quimioterápico 5-Fluorouracil tópico durante 12 dias. Após dois meses do procedimento cirúrgico, o paciente não apresentava qualquer sinal de neoplasia no local, nem possíveis metástases em outras regiões. Diante do exposto, conclui se que o exame histopatológico é essencial para o diagnóstico definitivo da neoplasia e que a exérese cirúrgica associada com tratamento adjuvante a base do quimioterápico 5- fluorouracil foi eficaz para a erradicação do carcinoma de células escamosas.(AU)

Squamous cell carcinoma is a malignant neoplasm of the epidermal cells, being considered the second most common neoplasm in the eyes and ocular annexes of horses. The occurrence of the tumor intensifies mainly in animals that have depigmented and hairless regions subjected to solar radiation. Lesions may be isolated or multiple, with varying sizes and ulcerated. The treatment depends on the size, degree of invasion, equipment available and financial condition of the owner. As a treatment, besides surgical excision, topical and intralesional chemotherapeutic agents have been considered. The aim of this study was to report squamous cell carcinoma in the cornea of an equine. An 11-year-old, stallion horse, with a rosy mass in the right eye cornea that evolved for four months, was referred to the Rancho Clinic. Upon clinical suspicion of squamous cell carcinoma, surgical excision of the mass was indicated, followed by histopathological evaluation. The test result confirmed the diagnosis of the neoplasm. Postoperative therapy consisted of administration of antibiotic, anti-inflammatory and atropine eye drops, in addition to the anti-inflammatory flunixin meglumine. As adjuvant treatment was the topical 5-Fluorouracil chemotherapy for 12 days. Two months after the surgical procedure, the patient showed no signs of neoplasia at the site, nor possible metastases in other regions. Given the above, it is concluded that the histopathological examination is essential for the definitive diagnosis of the neoplasia and that surgical exeresis associated with adjuvant treatment based on 5-fluorouracil chemotherapy was effective for the eradication of squamous cell carcinoma.(AU)

Carcinoma de células escamosas corneal em equino / Corneal squamous cell carcinoma in an equine

O carcinoma de células escamosas é uma neoplasia maligna das células epidérmicas, considerado a segunda neoplasia mais comum nos olhos e anexos oculares de equinos. A ocorrência intensifica-se, principalmente, nos animais com regiões despigmentadas e desprovidas de pelos e sujeitas à radiação solar. As lesões podem se apresentar isoladas ou múltiplas, com tamanhos variados e ulceradas. O tratamento depende do tamanho, grau de invasão, equipamento disponível e condição financeira do proprietário. Como tratamento, tem sido utilisados a excisão cirúrgica, quimioterápicos de uso tópico e intralesional. O objetivo deste trabalho foi relatar um carcinoma de células escamosas na córnea de um equino. Foi encaminhado para a Clínica do Rancho um equino, macho, não castrado, 11 anos de idade, apresentando uma massa rósea na córnea do olho direito com evolução de quatro meses. Mediante suspeita clínica de carcinoma de células escamosas, foi indicada exérese cirúrgica da massa, seguida de avaliação histopatológica. O resultado do exame confirmou o diagnóstico da neoplasia. A terapia pós-cirúrgica consistiu na administração de colírios antibiótico, anti-inflamatório e atropina, além do anti-inflamatório flunixin meglumine. Como tratamento adjuvante foi feito o quimioterápico 5-Fluorouracil tópico durante 12 dias. Após dois meses do procedimento cirúrgico, o paciente não apresentava qualquer sinal de neoplasia no local, nem possíveis metástases em outras regiões. Diante do exposto, conclui se que o exame histopatológico é essencial para o diagnóstico definitivo da neoplasia e que a exérese cirúrgica associada com tratamento adjuvante a base do quimioterápico 5- fluorouracil foi eficaz para a erradicação do carcinoma de células escamosas.

Squamous cell carcinoma is a malignant neoplasm of the epidermal cells, being considered the second most common neoplasm in the eyes and ocular annexes of horses. The occurrence of the tumor intensifies mainly in animals that have depigmented and hairless regions subjected to solar radiation. Lesions may be isolated or multiple, with varying sizes and ulcerated. The treatment depends on the size, degree of invasion, equipment available and financial condition of the owner. As a treatment, besides surgical excision, topical and intralesional chemotherapeutic agents have been considered. The aim of this study was to report squamous cell carcinoma in the cornea of an equine. An 11-year-old, stallion horse, with a rosy mass in the right eye cornea that evolved for four months, was referred to the Rancho Clinic. Upon clinical suspicion of squamous cell carcinoma, surgical excision of the mass was indicated, followed by histopathological evaluation. The test result confirmed the diagnosis of the neoplasm. Postoperative therapy consisted of administration of antibiotic, anti-inflammatory and atropine eye drops, in addition to the anti-inflammatory flunixin meglumine. As adjuvant treatment was the topical 5-Fluorouracil chemotherapy for 12 days. Two months after the surgical procedure, the patient showed no signs of neoplasia at the site, nor possible metastases in other regions. Given the above, it is concluded that the histopathological examination is essential for the definitive diagnosis of the neoplasia and that surgical exeresis associated with adjuvant treatment based on 5-fluorouracil chemotherapy was effective for the eradication of squamous cell carcinoma.

Supervivencia de pacientes con cáncer de pulmón sometidos a cirugía de resección con linfoadenectomía por muestreo / Survival of patients with lung cancer undergoing resection surgery with lymphadenectomy by sampling

RESUMEN Fundamentación: En la provincia Sancti Spíritus no se reportan estudios sobre la supervivencia de pacientes con cáncer de pulmón sometidos a cirugía de resección con linfoadenectomía por muestreo. Objetivo: Evaluar la supervivencia de los pacientes con cáncer de pulmón sometidos a cirugía de resección pulmonar y linfadenectomía por muestreo. Metodología: Se realizó una investigación retrospectiva en el Hospital Provincial General Camilo Cienfuegos de Sancti Spíritus, desde el 1 de enero del 1996 al 31 de diciembre del 2007. Fueron incluidos 48 pacientes a los que se les realizó cirugía de resección pulmonar con linfadenectomía por muestreo. Como variable principal fue considerada la supervivencia global a los 5 y 10 años. Otras variables fueron: edad, sexo, clasificación histológica y estadio patológico del tumor primario. Resultados: Predominaron los pacientes del sexo masculino, los mayores de 50 años y con estadio patológico IB. La estirpe histológica predominante fue el carcinoma epidermoide. La mediana de supervivencia fue superior para los estadios tempranos. La mayor supervivencia a los 5 años correspondió a los estadios IA y IIA. A los 10 años no hubo diferencias en la supervivencia de los pacientes. Conclusiones: La mayor supervivencia a los 5 años de los pacientes sometidos a cirugía de resección pulmonar y linfadenectomía por muestreo correspondió a los que se encontraban en estadios con menor extensión de la enfermedad. Entre los 5 y 10 años después de la cirugía hubo una estabilización en la sobrevida de todos los pacientes, indistintamente del estadio patológico inicial.

ABSTRACT Background: In Sancti Spiritus province there are no reports on the survival of patients with lung cancer undergoing resection surgery with lymphadenectomy by sampling. Objective: To evaluate the survival of patients with lung cancer undergoing lung resection surgery and lymphadenectomy by sampling. Methodology: A retrospective investigation was conducted at Camilo Cienfuegos General Provincial Hospital of Sancti Spíritus, from January 1, 1996 to December 31, 2007. They were included 48 patients who underwent lung resection surgery with lymphadenectomy by sampling. The main variable was considered overall survival at 5 and 10 years. Other variables were: age, sex, histological classification and pathological stage of the primary tumor. Results: Male patients, those older than 50 years and with pathological stage IB predominated. The predominant histological line was squamous cell carcinoma. The median survival was higher for the early stages. The greatest survival at 5 years corresponded to stages IA and IIA. At 10 years there were no differences in patient survival. Conclusions: The greatest survival at 5 years of patients undergoing lung resection surgery and lymphadenectomy by sampling corresponded to those who were in stages with less extension of the disease. Between 5 and 10 years after surgery there was stabilization in the survival of all patients, regardless of the initial pathological stage.