Abstract:
INTRODUCTION:The purpose of postoperative surveillance programs after curative treatment for colorectal cancer is to detect asymptomatic recurrences with the premise that an important rate will be eligible for curative resection, improving overall survival. We have implemented a surveillance program for patients with colorectal cancer, stages II-III, with periodic clinical, carcinoembryonic antigen and cancer antigen-19-9 assessment, computed tomography and colonoscopy. The aim of this study was to assess the rate of curative treatment of recurrence, colorectal cancer mortality and clinical characteristics associated with non-resectable recurrence. MATERIAL AND METHODS:Open cohort study, single center. All patients on the intensive surveillance program between March 2008 and January 2015 were included. STATISTICS:chi-square, Wilcoxon rank sum test, logistic regression, Kaplan-Meier log-rank test (SPSS20®). RESULTS:We had a total 404 patients evaluated; 59.6% male; mean age of 65 ± 10 years; 50.7% rectal tumor; 56.2% stage III. The average time of follow-up was 37 months and the recurrence rate was 12.9% (n = 52), mostly detected in the first three years (88.4%). The pattern of recurrence was associated with the site of the primary tumor (p < 0.001). Twenty-one patients underwent curative resection. Factors associated with non-resectable recurrence were aged ≥ 70 years (p = 0.022), disease location in the colon (p = 0.033) and cancer antigen-19-9-9 elevation (p = 0.024). The overall rate of cancer-specific mortality was 2.2% (n = 9). DISCUSSION:The association between colon cancer and non-resectable recurrence is explained by the higher rate of disseminated disease in these patients. Cancer antigen-19-9 added no benefit to the surveillance program. CONCLUSION:This intensive real-world postoperative surveillance program allowed performing curative surgery to 40.3% of patients with recurrence. :Introdução: A vigilância intensiva pós-operatória do carcinoma colo-retal permite a deteção da recorrência em fase assintomática, aumentando o número de doentes que podem beneficiar de nova cirurgia. Implementámos um programa de vigilância de doentes com carcinoma colo-retal estádios II-III, operados com intenção curativa, com avaliação clínica, tomografia computorizada e colonoscopia. O presente estudo teve como objectivos avaliar a taxa de cirurgia de intenção curativa, a taxa de mortalidade por cancro e identificar características clínicas associadas à irresecabilidade da recidiva. Material e Métodos: Estudo de coorte, unicêntrico. Foram incluídos todos os doentes com carcinoma colo-retal integrados em programa de vigilância entre março de 2008 e janeiro de 2015. Análise estatística: qui-quadrado, Wilcoxon, regressão logística, Kaplan-Meier (SPSS20®). Resultados: Avaliámos 404 doentes; idade média: 65 ± 10 anos, 59,6% sexo masculino, 50,7% reto, 56,2% estádio III. O tempo médio de vigilância foi 37 meses e a taxa de recidiva foi 12,9% (n = 52), a maioria detetada nos primeiros três anos (88,4%). O padrão de recidiva associou-se à localização do tumor primário (p < 0,001). Vinte e um doentes foram submetidos a cirurgia curativa. Os fatores associados a recidiva irressecável foram: idade ≥ 70 anos (p = 0,022), carcinoma colo-retal localizado no cólon (p = 0,033) e elevação de antigénio carboidrato 19-9 (p = 0,024). A taxa global de mortalidade específica por cancro foi 2,2% (n = 9). Discussão: A associação entre neoplasia do cólon e recidiva irressecável deve-se à taxa mais elevada de doença disseminada nestes doentes. O antigénio carboidrato 19-9 não trouxe benefício acrescido ao programa de vigilância. Conclusão: Este estudo confirma o interesse clínico da vigilância intensiva na deteção de recidiva assintomática, permitindo alcançar cirurgia curativa em 40,3% dos doentes com recidiva.
journal_name
Acta Med Portjournal_title
Acta medica portuguesaauthors
Rodrigues RV,Pereira da Silva J,Rosa I,Santos I,Pereira N,Soares C,Pereira ADdoi
10.20344/amp.7889subject
Has Abstractpub_date
2017-09-29 00:00:00pages
633-641issue
9eissn
0870-399Xissn
1646-0758journal_volume
30pub_type
杂志文章abstract:UNLABELLED:In Portugal, there have been many studies on the prevalence of overweight and obesity in children and adolescents. However, because many of the studies are not submitted to publication in scientific journals, these results remain unknown. OBJECTIVE:To obtain recent data on the prevalence of overweight and o...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:2011-03-01 00:00:00
abstract::The interaction between HPV E6 and p53 protein is known as the most important event in HPV-associated carcinogenesis. Some in vitro studies suggested that p53 genetic variants are targeted for ubiquitin-proteasome degradation induced by E6 with different abilities. A common p53 variant at position 72 (R72P) has leaded...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:2011-01-01 00:00:00
abstract::Malignant spinal cord compression occurs in 2.5% - 5% cancer patients. Early diagnosis and therapeutic intervention are critical for pain control and improvement of any neurological deficit. Treatment should be directed to the underlying disease together with appropriate symptom management. The case of a man with tetr...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2012-11-01 00:00:00
abstract::On page 761, in the first sentence of the Introduction, where it reads: "Cardiovascular Botulinum toxin A (BoNT-A) has beenapproved for spasticity management."It should read: "Botulinum toxin A (BoNT-A) has been approved for spasticity management."Article published with errors: https://www.actamedicaportuguesa.com/rev...
journal_title:Acta medica portuguesa
pub_type: 已发布勘误
doi:10.20344/amp.15226
更新日期:2020-12-02 00:00:00
abstract::The pathogenesis of cholestasis, bilirubin encephalopathy, and Alzheimer's disease appears to result from accumulation of diverse cytotoxic agents, which in turn may cause apoptotic cell death. In addition, mitochondria has lately been considered as a central executioner of programmed cell death, through the release o...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2002-07-01 00:00:00
abstract::Several infectious, neoplastic or inflammatory skin diseases, may be early manifestations of HIV infection. We reviewed the clinical data of 226 HIV seropositive male patients with cutaneous disease, from a total of 337 inpatients at the Infectious Diseases Unit--Department of Medicine 1--Curry Cabral Hospital, from 1...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1994-03-01 00:00:00
abstract:INTRODUCTION:Respiratory tract infections represent the most frequent conditions in pediatric clinical practice that motivate antibiotic prescribing. The objective was to identify the frequency and pattern of antibacterial prescribing in respiratory diseases. MATERIAL AND METHODS:Over a period of two years (divided by...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.11111
更新日期:2019-02-28 00:00:00
abstract::Differential diagnosis concerning Crohn's Disease and intestinal tuberculosis is often difficult. The authors present an illustrative case with ileal tuberculosis and secondary amyloidosis. Diagnostic tools and therapeutic measures are described. Literature review and theoretical discussion of both pathologies are inc...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1993-08-01 00:00:00
abstract::Among others complications due central venous catheters (CVCs), the blood infection (BI) deserves particular attention. The purposes of this study were to analyze the clinical and epidemiological characteristics of adult patients using CVC; to know the yeast colonization index; and to link it to risk factors for BI. Y...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2011-12-01 00:00:00
abstract:INTRODUCTION:Metals are a common cause of allergic contact dermatitis. After the introduction of the EU Nickel Directive (1994/27/CE; 2004/96/EC) and, more recently, the Cement Directive (2003/53/EC) there has been a significant decrease in sensitization to metals mainly in the Nordic countries. The applicability of th...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2014-05-01 00:00:00
abstract::Pleural effusions can be a manifestation of several nosological entities. Etiologic diagnosis involves a good clinical history, followed by thoracocentesis with pleural biopsy and eventually bronchoscopy or thoracoscopy. The differentiation between transudates and exudates, by the biochemical characteristics of the pl...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:1995-10-01 00:00:00
abstract::This article briefly reviews the impact of regularly promoted alternative therapies within portuguese society. The origins, attractions and acceptance of alternative therapies, homeopathic included, are discussed. Recent homeopathic studies published in renowned scientific journals provoked comments and reports claimi...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1990-09-01 00:00:00
abstract:INTRODUCTION:Accurate recognition of omental infarction has resulted in increasing supporters of non-operative approach. In order to assess the efficacy and safety of conservative management, we surveyed the cases of omental infarction treated at a single institution. MATERIAL AND METHODS:Primary omental infarction tr...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.4996
更新日期:2014-07-01 00:00:00
abstract:INTRODUCTION:Biological and biosimilar medicinal products have specific characteristics that call for a closer monitoring of their safety profile. Since the current legal framework stems from both European and national regulations, some gaps in the operational field may be expected. The goal of this paper is to identif...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.8079
更新日期:2017-03-31 00:00:00
abstract::Essencial Thrombocytemia is a rare chronic myeloproliferative disease of unknown etiology, characterized by markedly elevated platelet production (> 600,000/ml). It is more frequent among women above 50 years of age and may be associated with hemorrhagic or thrombotic tendencies. The authors report a case of Essencial...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2003-03-01 00:00:00
abstract::The accurate treatment of a dyslipidaemia is based on correct diagnosis. Together with the laboratory values. A good clinical interview, focusing on the family history, is the bases for a good diagnosis strategy. The author schematze the rules of etiological diagnosis of inherited defects of lipid metabolism. ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1995-02-01 00:00:00
abstract::The diagnosis of cerebral cardioembolism requires, apart from evidence of an embolic cardiopathy, a cause-effect relation to be established between the potential cardioembolic source and the occurrence of ischemic stroke. There are several arguments in favour of this reaction, namely the neurologic aspects put forward...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:1997-08-01 00:00:00
abstract::Twelve cases of extreme umbilical blood flow impairement (8 cases with loss of end-diastolic blood flow and 4 cases with reversed flow) found among 658 pregnancies studied by continuous Doppler between April 1st 1989 and March 31st 1990, are reported. The findings were associated to intra-uterine growth retardation (9...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1991-05-01 00:00:00
abstract:INTRODUCTION:Outpatient antimicrobial therapy programs have been in place for more than four decades. They provide safe and effective treatment for a selected group of patients while reducing costs. In Europe in general, and in Portugal in particular, these programs are still a relatively new phenomenon. The aim of thi...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.11730
更新日期:2019-09-02 00:00:00
abstract::Thyroid associated ophthalmopathy is an uncommon disease, characterized by a diffuse inflammation of the orbit in a bilateral and asymmetric pattern, causing proptosis and swelling of the eyelids and conjuntiva. In 90% of the patients it is associated with Graves' disease, however it may occur with hipothyroidism or e...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2004-07-01 00:00:00
abstract::As far as we know, there is no experience of quality management in mental health care in Portugal. This study fills a gap in the area of consultation-liaison psychiatry. Due to its multidisciplinarity and to the complexity of the problems it deals with, consultation-liaison psychiatry seems a privileged field for the ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1997-12-01 00:00:00
abstract:INTRODUCTION:Medically assisted reproduction in natural cycle has been investigated, especially in women with poor response to conventional ovarian stimulation, with endometrial receptivity improvement, lower cost and possibility of successive cycles. The disadvantages are: lower profitability per treatment cycle and h...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.10195
更新日期:2019-02-01 00:00:00
abstract::From 1984 until 1994 there were 7 cases of newborn with esophageal atresia without fistulae, five of which were treated through primary anastomosis and two of these presented exceptional long gaps. This article is an analysis of these 7 newborns, their post-operative complications and the therapeutics used. Two deaths...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1997-02-01 00:00:00
abstract::The effects of immunodepression on several disease states have constituted an important area of research, leading to the identification of relevant associations between immunodepression and a vast set of comorbidities, including infectious diseases, cardiovascular diseases and cancer. Research on the effects of immuno...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:10.20344/amp.7997
更新日期:2017-01-31 00:00:00
abstract::Our study included 42 patients with obstructive sleep apnea (OSAS) confirmed by polysomnography. In these patients we investigated the clinical manifestations, the results of the laboratory examinations, including polysomnography, ORL observations and tests of pulmonary function, as well as the therapeutic results. Ou...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1994-12-01 00:00:00
abstract:INTRODUCTION:The use of adequate assessment tools in health care is crucial for the management of care. The lack of specific tools in Portugal for assessing the performance of children who use cochlear implants motivated the translation and adaptation of the EARS (Evaluation of Auditory Responses to Speech) test batter...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2014-01-01 00:00:00
abstract::The circumstances preceding the future revision of the medical curriculum are analysed, main internal and external stimuli are described, and sources of resistance to changes in medical training require new educational philosophy, privileging oriented training during undergraduation, as a preliminary phase of medical ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:1993-10-01 00:00:00
abstract::Hidradenocarcinoma is a rare neoplasm of the eccrine cells of the sweat glands, usually asymptomatic with slow growing and higher incidence between 50 and 80 years, occurring in both sexes and preferentially located in the palmar, plantar, frontal, axillary and nuchal regions. It has an aggressive behavior, with high ...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:10.20344/amp.9017
更新日期:2018-03-29 00:00:00
abstract:INTRODUCTION/OBJECTIVES:The authors make the balance of the first five years of teaching Anatomy to the Licensure in Health Sciences, of Lisbon University. MATERIALS AND METHODS:Were studied 408 students, enrolled in the Curricular Unit of Anatomy (mandatory subject of the 1st semester) and 29 in the Curricular Unit o...
journal_title:Acta medica portuguesa
pub_type: 杂志文章
doi:
更新日期:2013-05-01 00:00:00
abstract::Literature analysis has been controversial about pre-eclampsia. It is known that not pregnant patients should be treated due cardiovascular benefits. However, the real benefits of antihypertensive treatment in pre-eclampsia were not demonstrated. Yet, there are many drugs that can be used for antihypertensive treatmen...
journal_title:Acta medica portuguesa
pub_type: 杂志文章,评审
doi:
更新日期:2008-07-01 00:00:00