Sobrevida e fatores prognóstico do Carcinoma Epidermóide de Boca e Orofaríngeo: análise de 1776 casos

Abstract

The most common type of cancer in the head and neck region is the squamous cell carcinoma (SCC), which is more frequent in the mouth (SCCM) and oropharyngeal (SCCO), with a presentation of more than 90% in these regions, representing 6% of all carcinomas. Epidemiological evaluation of this population-based pathology is still scarce and this neoplasm is a public health problem in Brazil and in the world. Faced with these facts, this study aims to describe and analyze survival, highlighting the main factors associated with its prognosis. For this, a retrospective prognostic study was carried out in databases and medical records, where all the cases diagnosed with SCCM and SCCO of the North League Riograndense Against Cancer of the last 11 years were selected. Survival were calculated with Kaplan-Meier and comparison of functions with Log-Rank. The risks calculated in univariate Cox models and predictive models in the multivariate analysis of Cox. For SCCM's Disease Free Survival (DFS) the poor prognostic factors, the histopathological gradation system of malignancy (HGSM) of the World Health Organization (WHO) in little differentiated, location in the retromolar region, not having conjugal companion, advanced staging and more complex treatments. These characteristics were repeated in the Global Survival (GS) for SCCM, with the exception of the current marital status. In the GS of the SCCO, localization in basis of language and alcohol consumption obtained the worst prognoses. Already for DFS of SCCO, the HGSM in little differentiated, smoking and having no marital partner, obtained the worst prognoses. The HGSM appears to be an effective prognostic factor for SCCM. Not having a partner can compromise DFS (SCCM and SCCO), with repercussion on patient's quality of life, adherence and maintenance of treatment. Wellestablished risk factors, such as alcohol and smoking, seem to be important prognostic factors in SCCO, but should be approached with caution, especially when the type, time, and quantity used are not checked. Even with the improvement in the SCCM's and SCCO's survival through advances in treatment, she is still worrisome, as the difficulty of diagnosis increases (Lip> Oral> Oropharynx). Both SCCM and SCCO were considered median, reaffirming already well established prognostic factors, such as clinical staging and localization, others still controversial, such as HGSM, smoking and drinking habits, gained strength as independent prognostic factors and an unexpected coadjutant, the current marital status.