Serviço de Oncologia
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- Non-Small Cell Lung Cancer: Screening, Diagnosis, and StagingPublication . Ferreira, J. P.; Magalhães, M.; Rocha, E.; Marques, F.Lung cancer is the leading cause of cancer deaths worldwide. Tobacco consumption is the primary cause of lung cancer, accounting for more than 85% 90% of all lung cancer deaths. Non-small cell lung cancer accounts for about 85% of all lung cancers. Several studies have shown that low-dose helical CT of the lung detects more nodules and lung cancers, including early-stage cancers, than does chest radiography. The National Lung Cancer Screening Trial results show that three annual rounds of low-dose CT screening reduce mortality from lung cancer. Despite the great debate around lung cancer screening, recently the National Comprehensive Cancer Network has come out in favor of lung cancer screening in an updated set of guidelines. All patients who present with suspect lung cancer should have a complete and meticulous history and physical examination performed to identify symptoms or physical findings suggestive of locally extensive or metastatic disease, assess pulmonary health status, identify significant comorbidities, and assess overall health status. Tissue sampling is required to confirm a diagnosis in all patients with suspected lung cancer. Non-surgical approaches, surgical approaches, or both may be used to obtain a tissue sample. Evaluation of the mediastinal lymph nodes is a key step in the further staging of the patient. The best way of evaluating mediastinal lymph nodes is still a matter of debate. The tumor node metastasis (TNM) International Staging System provides useful prognostic information and is used to stage all patients with non-small cell lung cancer. Recent trials added new data on screening and diagnostic approach. Those data will be reviewed in this paper.
- Metastatic Testicular Germ Cell Tumor or a Chemoresponsive Liver Hemangioma?Publication . Ferreira, J.; Magalhães, M.; Esteves, D.; Marques, F.Testicular germ cell tumors are the most common solid organ malignancy in young adult men. The presence of non-pulmonary visceral metastasis is an independent factor that places such patients into the higher risk group. Hepatic hemangiomas are the most common tumors of the liver and are entirely benign. Overlap between these entities may occur, particularly when metastases are hypervascular. We describe a case of a 27-year-old man with a testicular germ cell tumor and a nodule in the right hepatic lobe suggestive of hemangioma. After three cycles of chemotherapy, a size reduction in the hepatic nodule was confirmed, and this lesion was removed. Pathology revealed a fibrosing hemangioma. In this case report, the authors discuss the possible mechanisms for the hemangioma chemotherapy response.
- HIV and HPV infections and ocular surface squamous neoplasia: systematic review and meta-analysisPublication . Carreira, H.; Coutinho, F.; Carrilho, C.; Lunet, N.BACKGROUND: The frequency of ocular surface squamous neoplasias (OSSNs) has been increasing in populations with a high prevalence of infection with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/AIDS) and infection with human papillomavirus (HPV). We aimed to quantify the association between HIV/AIDS and HPV infection and OSSN, through systematic review and meta-analysis. METHODS: The articles providing data on the association between HIV/AIDS and/or HPV infection and OSSN were identified in MEDLINE, SCOPUS and EMBASE searched up to May 2013, and through backward citation tracking. The DerSimonian and Laird method was used to compute summary relative risk (RR) estimates and 95% confidence intervals (95% CI). Heterogeneity was quantified with the I(2) statistic. RESULTS: HIV/AIDS was strongly associated with an increased risk of OSSN (summary RR=8.06, 95% CI: 5.29-12.30, I(2)=56.0%, 12 studies). The summary RR estimate for the infection with mucosal HPV subtypes was 3.13 (95% CI: 1.72-5.71, I(2)=45.6%, 16 studies). Four studies addressed the association between both cutaneous and mucosal HPV subtypes and OSSN; the summary RR estimates were 3.52 (95% CI: 1.23-10.08, I(2)=21.8%) and 1.08 (95% CI: 0.57-2.05, I(2)=0.0%), respectively. CONCLUSION: Human immunodeficiency virus infection increases the risk of OSSN by nearly eight-fold. Regarding HPV infection, only the cutaneous subtypes seem to be a risk factor.
- Terapêutica após progressão do carcinoma do pulmão de não pequenas células precoce ou localmente avançado tratado com quimioterapiaPublication . Araujo, A.; Magalhães, M.; Febra, J.; Coutinho, F.; Rosendo, E.; Castro, A.; Araujo, A.; Ferreira, G.; Marinho, C.; Rocha, E.O carcinoma do pulmão de não pequenas células continua tendo um prognóstico sombrio. Nos estádios IB a alguns IIIB, o tratamento recomendado passará por cirurgia e quimioterapia (QT), radioterapia e QT ou pelas três modalidades em conjunto. Infelizmente, a maioria destes doentes apresenta progressão da sua doença ao fim de alguns meses. Se a progressão envolver múltiplos locais, terá que ser considerada uma nova terapia oncológica sistémica e esta deverá ter em consideração o doente, o tumor, a QT prévia realizada e o tempo que decorreu entre o fim da QT e a progressão. Para a escolha dos fármacos que se poderão utilizar, deverá ter -se em consideração, ainda, as características e a toxicidade próprias de cada um deles. Sublinha -se que não havendo uma dose limitadora da sua administração, é o desenvolvimento dos efeitos laterais que limita a sua utilização
- O cancro no concelho de Santa Maria da FeiraPublication . Araujo, A.
- New modalities and new drugs in the NSCLC treatmentPublication . Araujo, A.
- Diagnóstico e Tratamento do Cancro do Pulmão: Estado da ArtePublication . Araujo, A.
- Immuno-oncology in lung cancerPublication . Araujo, A.
- Clinical practice: approaching the reality of individual patientsPublication . Araujo, A.
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