PRELIMINARY ANALYSIS OF RECTAL ADENOCARCINOMA PATIENTS TREATED WITH NEOADJUVANT CHEMORADIOTHERAPY IN A HOSPITAL IN THE INTERIOR OF THE STATE OF MINAS GERAIS

Introduction: Colorectal cancer has high prevalence, morbidity and mortality rates worldwide. In Brazil, according to INCA data, it was the third most prevalent cancer in men and the second in women in 2018. In locally advanced diseases, treatment is based on the German study - Sauer NEJM- published in 2004 and revised in 2012., which showed gains in local recurrence, sphincter preservation and lower toxicity with neoadjuvant chemoradiotherapy compared to adjuvant treatment. Objective: To analyze the characteristics of rectal adenocarcinoma patients treated with neoadjuvant chemoradiotherapy in a hospital in the interior of the state of Minas Gerais. Method: We retrospectively analyzed the medical records of patients with middle and low rectum adenocarcinoma who underwent neoadjuvant chemo-irradiation treatment in our hospital from 2010 to 2015. We made a preliminary quantitative descriptive analysis of the data obtained. Results: of the 103 patients analyzed, 40% were women and 60% men; average age of 70 years (37 - 94 years): 94% SUS, 5% health insurance and 1% private; 52% had some type of comorbidity, the most frequent being cardiovascular and endocrinometabolic; In terms of location, 52% were middle rectum and 48% low rectum; only 10% had staged pelvic magnetic resonance imaging (MRI), 5% stage I, 79% IIA, 3% IIB, 2% IIC, 1% IIIA, 9% IIIB, 1% IIIC; 98% completed RT and 2% did not; 99% completed chemotherapy and 1% did not; 69% had surgery, 28% did not and 3% without information; median time between end of radiotherapy and surgery was 102 days (49 - 282 days); complete pathological response was observed in 10% of the patients who underwent surgery; after surgery 10% stage 0, 25% I, 23% IIA, 1% IIB, 1% IIC, 13% IIIA, 10% IIIB, 4% IIIC, 3% IVA, 1% IVB; 9% without information; relapse in operated was 35% and 57% in non-operated; overall survival at 3 years was 54% (36% deceased and 10% lost follow-up). Conclusion: The epidemiological profile of the individuals treated at this institution is characterized by mostly male patients, with high average age and mostly from SUS. The low rate of MRI observed may be explained by the limitations of the public health system, which hinders accurate staging of the disease.

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Artikel online veröffentlicht:
23. Oktober 2019