Tratamento e sobrevida do câncer de pulmão de pequenas células: um estudo de coorte retrospectivo baseado em dados do registro hospitalar de câncer de um centro público de referência em oncologia brasileiro
a retrospective study at a brazilian public cancer referral center
DOI:
https://doi.org/10.15448/1980-6108.2025.1.47468Palavras-chave:
carcinoma pulmonar de células não pequenas, análise de sobrevida, prognóstico, estudos retrospectivos.Resumo
Objetivo: Avaliar características, tratamento recebido, sobrevida e fatores prognósticos de pacientes com câncer de pulmão de pequenas células.
Métodos: Estudo de coorte retrospectivo conduzido em um centro público de referência em oncologia no Rio de Janeiro, Brasil. Participaram 866 pacientes com câncer de pulmão de pequenas células admitidos no período 2000-2020. A comparação entre as curvas de sobrevida foi realizada pelo teste log-rank; as variáveis cujo p < 0,10 foram inseridas nos modelos de regressão de Cox que estimaram hazard ratios (HR) e intervalos de confiança de 95%. A associação entre receber o melhor tratamento de suporte (nenhum tratamento) e o período de admissão foi avaliada por meio de regressão logística.
Resultados: A mediana e a probabilidade de sobrevida em 12 meses foram de, respectivamente, 6,2 meses e 23,7%. Na regressão multivariada de Cox ajustada por tratamento, performance status ruim (HR: 1,99; 1,57-2,51) e desconhecido (HR: 2,79; 2,22-3,49), cor da pele não branca (HR: 1,25; 1,07-1,46), estadiamento avançado (HR: 1,62; 1,29-2,04) e desconhecido (HR: 1,33; 1,07-1,65) permaneceram associados à sobrevida em 12 meses. Pacientes admitidos nos últimos três períodos de admissão mostraram probabilidade quase quatro vezes maior de receber os melhores cuidados de suporte em comparação ao primeiro período.
Conclusão: O prognóstico do câncer de pulmão de pequenas células é ruim e a perspectiva para aumentar sua sobrevida é melhorar o acesso oportuno a diagnóstico e tratamento.
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Copyright (c) 2025 Gelcio Luiz Quintella Mendes, Luiz Henrique de Lima Araújo, Aureliano Mota Cavalcanti de Sousa, Debora Santos da Silva, Rafael Tavares Jomar
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