Perfil epidemiológico de pacientes com metástase na coluna vertebral em Salvador, Bahia, Brasil

Resumo

Objetivo Analisar o perfil epidemiológico dos pacientes com suspeita de doença metastática na coluna vertebral em hospital de referência.

Métodos Estudo observacional, descritivo e retrospectivo, realizado em hospital de referência neurocirúrgica do estado da Bahia, a partir de dados coletados em prontuários de pacientes submetidos à biópsia percutânea da coluna vertebral por suspeita de patologia metastática no período de março de 2013 a fevereiro de 2014.

Resultados Foram incluídos 46 pacientes, sendo 25 (54,3%) do sexo masculino, com idade média de 54,3 anos (desvio padrão: 15). Mais da metade dos pacientes (56,2%) possuíam diagnóstico de neoplasia anterior à biópsia vertebral, sendo os tipos mais comuns o adenocarcinoma de mama e próstata, seguidos pela neoplasia pulmonar. A coluna lombar foi a mais frequentemente acometida (n = 31; 67,4%), seguida pela torácica (n = 14; 30,4%) e sacral (n = 11; 23,9%). Nenhum paciente apresentou acometimento cervical em nossa amostra. O número de vértebras acometidas variou de 1 a 4, sendo que 8 pacientes (17,4%) apresentavam lesões múltiplas (≥ 3 lesões). O mieloma múltiplo foi a neoplasia mais comumente encontrada na análise do material de biópsia vertebral, correspondendo a 12 casos (26,1%), seguido pela metástase de carcinoma de mama, 9 (19,6%); de próstata, 5 (10,9%); e pulmonar, 5 (10,9%). Sete pacientes (15,2%) não apresentaram alterações neoplásicas.

Conclusões Foram encontrados dados epidemiológicos compatíveis com a literatura, exceto pelo tipo histológico das metástases vertebrais, sendo mieloma múltiplo o de maior prevalência em nosso estudo. Este estudo torna-se relevante por ser o primeiro a avaliar metástases vertebrais no Norte-Nordeste brasileiro.

Abstract

Objective To analyze the epidemiological profile of patients with suspected spine metastases in a referral hospital.

Methods An observational, descriptive and retrospective study, conducted in neurosurgical referral hospital in the state of Bahia with data collected from medical records of patients undergoing percutaneous spinal biopsy for suspected metastatic disease from March 2013 to February 2014.

Results 46 were included, which 25 (54.3%) were male. The mean age was 54.3 years (SD: 15). More than half of patients (56.2%) had a previous diagnosis of cancer; the most common types were breast and prostate adenocarcinoma, followed by lung cancer. The lumbar spine was the most frequently affected (n = 31, 67.4%), followed by the thoracic spine (n = 14, 30.4%) and sacral (n = 11, 23.9%). No patient had cervical involvement in our sample. The number of affected vertebrae ranged from 1 to 4, and 8 (17.4%) cases had multiple lesions (lesions ≥ 3). Multiple myeloma was the most common neoplasm found in the analysis of vertebral biopsy, corresponding to 12 patients (26.1%), followed by metastatic breast carcinoma, 9 (19.6%), prostate cancer, 5 (10.9%), and lung cancer, 5 (10.9%). Seven patients (15.2%) showed no neoplastic lesions.

Conclusions Epidemiological data was consistent with the literature data, except by histological type of the vertebral metastases, which multiple myeloma was the most prevalent in our study. This study is relevant because it is the first to assess vertebral metastases in the Brazilian North-Northeast.

Palavras-Chave

coluna vertebral - neoplasias - metástase neoplásica - neoplasias da coluna vertebral - biópsia por agulha

Keywords

spine - neoplasms - neoplasm metastasis - spinal neoplasms - biopsy - needle

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