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Título

Epidemiological Analysis of Patients with Diffuse Gliomas Treated in Paraíba

RESUMO

Introduction: Diffuse glioma (DG) is the most frequent and aggressive type of malignant tumor of the Central Nervous System with high morbidity and mortality. Epidemiological data on patients with diffuse gliomas in Brazil are scarce. Objective: To characterize the epidemiological profile of patients with gliomas in Paraíba. Method: This is a cross-sectional, retrospective observational study that included participants of both genders, over 18 years of age, with DG diagnosed and treated in João Pessoa. Results: The sample consisted of 28 patients, with a mean age of 59 years. The most relevant symptom at diagnosis was seizure (46.15%), followed by headache (23%), progressive forgetfulness (23%), aphasia (12%), progressive visual loss (8%), and hemiparesis (8%). Astrocytomas were the most prevalent type of umor (16 patients), with grade 4 being the most prevalent of them. There were 5 glioblastomas multiform (GBM) diagnosed, all in males, while in astrocytomas, only 37.5% were males. The mean KPS scale was 81.15 with only 19.2% (5 patients) having KPS below 70, and the mean overall survival was 41 months. Patients with KPS greater than 85 had better overall survival (57.8 months) than patients with KPS less than 85 (36.4 months). When we associated age and overall survival, we noticed that patients younger than 45 years had a mean overall survival of 105 months, while patients aged 45 years or older had a mean overall survival of 30.9 months. None of the five patients with GBM survived after 5 years (mean overall survival of 10 months). As for Astrocytomas, 37.5% of patients were alive after 5 years (6 patients, with a mean overall survival of 46.9 months). As for the other gliomas, 2 of the 5 patients were alive after 5 years (median overall survival 74.7 months). Discussion: Current literature highlights that patients with older ages (>45 years) have a worse prognosis than younger patients. In addition, KPS <85 is also an important predictor of unfavorable outcomes, and may increase mortality. In contrast, low-grade gliomas (1 and 2) reduce mortality by up to 22%. In GBMs, the 5-year survival after diagnosis is less than 5%. Conclusion: The data brought by this study corroborate the current literature, in addition to reinforcing the influence of age, KPS at diagnosis and histological type as prognostic factors, assisting in decision making by health professionals.

Palavras Chave

Epidemiology; Gliomas; Neurooncology; Oncology; Neurosurgery.