EPIDEMIOLOGICAL PROFILE OF PATIENTS WITH ESOPHAGEAL CANCER TREATED AT THE ONCOLOGY OUTPATIENT CLINIC IN THE PUBLIC HEALTH SYSTEM OF THE SÃO LUCAS HOSPITAL OF THE PONTIFICAL CATHOLIC UNIVERSITY OF RIO GRANDE DO SUL (HSL-PUCRS)

Introduction: Esophageal cancer is the fifth cause of death due to malignant neoplasm in men in Brazil. Late diagnosis is a poor prognostic factor and the difficulty of access to specialist consultation contributes to the therapeutic delay, worsening of the patient's clinical condition and can result in a lower overall survival. GOAL To describe the epidemiological profile of esophageal cancer patients treated at HSL-PUCRS Brazilian public health system and evaluate clinical, radiological and laboratory changes that can be identified as prognostic factors for overall survival. Method: A retrospective observational study that collected data from medical records of all patients seen at the Oncology Outpatient Clinic of the HSL-PUCRS with diagnosis of esophageal malignancy in the period from 2012 to 2019. The Neutrophils/Lymphocytes ratio and sarcopenia (on chest tomography) will be correlated with overall survival. RESULTS One hundred eight patients with esophageal cancer were identified within 7 years. The mean follow-up was 382 days, and 14 patients (12.9%) only had one visit and did not start treatment. The mean time between the diagnosis and the first consultation with Oncologist was 80 days. In the initial evaluation 65 patients had performance status (PS) ECOG 0 or 1 and 43 PS ECOG ≥ 2. The clinical stage of the disease was II and III in 56.4%, stage IV 27.8% and 17 patients (15.7%) were not staged. The mean survival was 13.8 months (m), being 7.1m in stage IV, 12.1m in stage III and 25.6m in the EC II. Of the 61 patients with stage II and III, 39 underwent concomitant chemotherapy and radiotherapy (58.9% neoadjuvant). Five patients discontinued treatment for toxicity (including 2 per death) and 11 patients for lack of compliance. In the 23 neoadjuvant treatments, 4 patients were not submitted to surgery due to clinical worsening and nine (47.3%) achieved complete pathological response. The remaining 22 patients with locally advanced disease underwent isolated radiotherapy or exclusive palliative care. Overall Survival will be correlated with complete pathologic response, sarcopenia, and lymphocyte/ lymphocyte ratio. Conclusion: This study is an overview of the profile of patients diagnosed with esophageal cancer treated in a Brazilian public health service. Epidemiological data demonstrate a predominance of advanced stage and most patients did not undergo ideal treatment due to unfavorable status performance and/or poor adherence to treatment.

Publication History

Article published online:
23 October 2019