Nonsmall cell lung cancer: evaluation of 737 consecutive patients in a single institution

OBJECTIVE: To analyze surgical and pathological parameters and outcome and prognostic factors of patients with nonsmall cell lung cancer (NSCLC) who were admitted to a single institution, as well as to correlate these findings to the current staging system. METHOD: Seven hundred and thirty seven patients were diagnosed with NSCLC and admitted to Hospital do Cancer A. C. Camargo from 1990 to 2000. All patients were included in a continuous prospective database, and their data was analyzed. Following staging, a multidisciplinary team decision on adequate management was established. Variables included in this analysis were age, gender, histology, Karnofsky index, weight loss, clinical stage, surgical stage, chemotherapy, radiotherapy, and survival rates. RESULTS: 75.5% of patients were males. The distribution of histologic type was squamous cell carcinoma 51.8%, adenocarcinoma 43.1%, and undifferentiated large cell carcinoma 5.1%. Most patients (73%) presented significant weight loss and a Karnofsky index of 80%. Clinical staging was IA 3.8%, IB 9.2%, IIA 1.4%, IIB 8.1%, IIIA 20.9%, IIIB 22.4%, IV 30.9%. Complete tumor resection was performed in 24.6% of all patients. Surgical stage distribution was IA 25.3%, IB 1.4%, IIB 17.1%, IIIA 16.1%, IIIB 20.3%, IV 11.5%. Chemotherapy and radiotherapy were considered therapeutic options in 43% and 72%, respectively. The overall 5-year survival rate of nonsmall cell lung cancer patients in our study was 28%. Median survival was 18.9 months. CONCLUSIONS: Patients with NSCLC who were admitted to our institution presented with histopathologic and clinical characteristics that were similar to previously published series in cancer hospitals. The best prognosis was associated with complete tumor resection with lymph node dissection, which is only achievable in earlier clinical stages.

Umbilical mass as the sole presenting symptom of pancreatic cancer: a case report

Umbilical nodes are rare. The metastatic involvement of the region was first described in 1846. Sister Mary Joseph was the first observer to establish the correlation between carcinomas and umbilical nodes. The umbilical node may be the sole presenting sign of cancer and is usually associated with advanced disease and poor prognosis. A 64-year-old woman, previously healthy, presented vague abdominal discomfort and a hard umbilical nodule for 1 week, which was first diagnosed as an incarcerated umbilical hernia. She underwent a new clinical assessment and biopsy. After immunohistochemical analysis and computerized tomography, she was diagnosed with pancreatic cancer. The clinical staging showed advanced disease with distant metastasis. She received palliative chemotherapy. After 8 months, she was alive in poor clinical condition. Clinical suspicion should lead to a careful additional evaluation whenever an umbilical nodule presents with malignant signs.

Educação e colonização no Brasil: as escolas étnicas alemãs

Este artigo apresenta dados de pesquisa sobre a organização escolar e curricular de escolas primárias na colônia catarinense Hansa, fundada em 1897. Foi baseado na análise de documentos da Companhia Colonizadora Hamburguesa. Os resultados mostram peculiaridades como o ensino em alemão e o currículo focalizado no Cálculo e na aprendizagem da língua e cultura alemãs nas disciplinas de Leitura, Escrita, Poesia, Canto, Religião e Latim. Porém, havia matérias como Português e História, que abordavam questões brasileiras. Nos seus primeiros anos, as instituições mantiveram aspectos pedagógicos que as caracterizam como típicas expressões do fenômeno das escolas étnicas: as escolas alemãs [Deutsch Schulen]. Elas atenderam a necessidade de escola, embasadas por um conjunto de práticas educativas de cunho étnico que mesclaram aspectos culturais estrangeiros àqueles do contexto brasileiro. O uso da língua alemã constituiu um indicador étnico essencial. A compreensão dessas instituições escolares na história da educação brasileira é parametrizada pelas relações entre currículo e cultura, considerando a questão étnica como fator central na análise dos processos sociais.