ORIGINAL
Introdução: os tumores do sistema nervoso central (SNC) e calota craniana estão sendo mais frequentes tanto em homens quanto em mulheres, justificado pelo aumento da expectativa de vida humana e exposição a fatores de risco. Objetivo: estudar a incidência de tumores do SNC computados no único hospital regional do planalto norte de Santa Catarina, uma região com mais de 380 mil habitantes. Métodos: o presente estudo analisou epidemiologicamente pacientes que foram submetidos a ressecção neurocirúrgica para remoção de tumor no SNC e/ou calota craniana, entre os anos de 2017 a 2022, no único hospital regional referência para Neurocirurgia, do planalto norte catarinense. Resultados: A amostra foi composta por 155 indivíduos, com média etária de 54,4±15,1 anos, maioria do sexo feminino. A maior taxa de mortalidade (TM) intra-hospitalar foi para o sexo masculino. Quanto às características gerais da população, teve-se: maioria eram munícipes da região de referência do serviço; majoritariamente assistida pelo SUS; ocupação laboral prevalente foi agricultura; sinais sintomas prevalentes foram cefaleia e convulsão; tumor não maligno prevalente foi meningioma; tumor maligno prevalente foi glioblastoma; localização anatômica prevalente em lobo frontal; sendo que a TM foi maior para pacientes com glioma. Conclusão: De forma pioneira o presente estudo caracteriza então o cenário neurocirúrgico e neurooncológico de pacientes atendidos e assistidos na região do Planalto Norte Catarinense, apresentando a possível correlação positiva entre fatores de risco ocupacionais e tumores do SNC e calota craniana. Estudo futuros devem completar a presente análise, assim como, subsidiar medidas e estratégias em saúde e doença para a região.
Introduction: Central nervous system (CNS) and skullcap tumors are becoming more frequent in both men and women, justified by the increase in human life expectancy and exposure to risk factors. Objective: to study the incidence of CNS tumors in a sole regional hospital of Northern Plateau of Santa Catarina, region counting with more than 380,000 habs. Methods: Patients who underwent neurosurgical resection to remove a tumor in the CNS and/or cranial vault were epidemiologically analyzed, from 2017 to 2022, in the sole regional reference hospital for neurosurgery in the northern plateau of Santa Catarina, Brazil. Results: The sample consisted of 155 individuals, with a mean age of 54.4±15.1 years, mostly female. The highest in-hospital mortality rate (MR) was in males. As for the general characteristics of the population most were living in the reference region of the service; mostly assisted by the Brazilian health system; prevalent labor occupation was agriculture; prevalent symptom and signs were headache and seizure; prevalent non-malignant tumor was meningioma; prevalent malignant tumor was glioblastoma; prevalent anatomical location in the frontal lobe; and the MR was higher for patients with glioma. Conclusion: In a pioneering way, the present study characterizes the neurosurgical and neurooncological scenario of patients assisted in the Northern Plateau region of Santa Catarina, presenting the possible positive correlation between occupational risk factors and tumors of the CNS and cranial vault. Future studies should complete the present analysis, as well as subsidize health and disease measures and strategies for the region.
1. Instituto Nacional de Câncer José Alencar Gomes da Silva. Câncer do sistema nervoso central. Rio de Janeiro: INCA; 2020. Available from: https://www.gov.br/inca/pt-br/assuntos/cancer/tipos/sistema-nervoso-central. Accessed: 12/08/2022.
2. Sandes VA, Dantas RL, Porto RLS, et al. A ocorrência de tumores do sistema nervoso central no estado de Sergipe no período de 2008 a 2017. Res Soc Dev. 2020;9(11):e3439119673. http://dx.doi.org/10.33448/ rsd-v9i11.9673.
3. Goldman SA. Considerações gerais sobre tumores cerebrais. Manual MSD; 2021. Available from: https://www.msdmanuals.com/pt-br/ casa/dist%C3%Barbios-cerebrais,-da-medula-espinal-e-dos-nervos/ tumores-do-sistema-nervoso/considera%C3%A7%C3%B5es-gerais-sobre-tumores-cerebrais. Accessed: 10/08/2022.
4. Ostrom QT, Francis SS, Barnholtz-Sloan JS. Epidemiology of brain and other CNS tumors. Curr Neurol Neurosci Rep. 2021;21(12):68. http://dx.doi.org/10.1007/s11910-021-01152-9. PMid:34817716.
5. Baldi I, De Graaf L, Bouvier G, et al. Occupational exposure to pesticides and central nervous system tumors: results from the CERENAT case-control study. Cancer Causes Control. 2021;32(7):773-82. http:// dx.doi.org/10.1007/s10552-021-01429-x. PMid:33876308.
6. Instituto Brasileiro de Geografia Estatística. População. Rio de Janeiro: IBGE; 2021.
7. Gritsch S, Batchelor TT, Gonzalez Castro LN. Diagnostic, therapeutic, and prognostic implications of the 2021 World Health Organization classification of tumors of the central nervous system. Cancer. 2022;128(1):47-58. http://dx.doi.org/10.1002/cncr.33918. PMid:34633681.
8. Louis DN, Perry A, Wesseling P, et al. The 2021 WHO Classification of Tumors of the Central Nervous System: a summary. Neuro-oncol. 2021;23(8):1231-51. http://dx.doi.org/10.1093/neuonc/noab106. PMid:34185076.
9. Strowd RE 3rd, Plotkin SR. Familial nervous system tumor syndromes. Continuum. 2020;26(6):1523-52. http://dx.doi.org/10.1212/ CON.0000000000000950. PMid:33273171.
10. Instituto Brasileiro de Geografia Estatística. População. Rio de Janeiro: IBGE; 2021.
11. Instituto Brasileiro de Geografia Estatística. População. Rio de Janeiro: IBGE; 2022.
12. Instituto Nacional de Câncer José Alencar Gomes da Silva. Câncer do sistema nervoso central. Rio de Janeiro: INCA; 2020. Available from: https://www.gov.br/inca/pt-br/assuntos/cancer/tipos/sistema-nervoso-central. Accessed: 12/08/2022.
13. Instituto Nacional de Câncer José Alencar Gomes da Silva. Tipos de câncer. Rio de Janeiro: INCA; 2019. Available from: https://www. inca.gov.br/tipos-de-cancer. Accessed: 12/08/2021.
14. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: globocan estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin. 2018;68(6):394-424. http://dx.doi.org/10.3322/caac.21492. PMid:30207593.
15. Zhang J, Walsh MF, Wu G, et al. Germline mutations in predisposition genes in pediatric cancer. N Engl J Med. 2015;373(24):2336-46. http:// dx.doi.org/10.1056/NEJMoa1508054. PMid:26580448.
16. Stoyanov GS, Sarraf JS, Matev BK, et al. A comparative review of demographics, incidence, and epidemiology of histologically confirmed intracranial tumors in Brazil and Bulgaria. Cureus. 2018;10(2):e2203. http://dx.doi.org/10.7759/cureus.2203. PMid:29682433.
17. Pouchieu C, Baldi I, Gruber A, Berteaud E, Carles C, Loiseau H. Descriptive epidemiology and risk factors of primary central nervous system tumors: current knowledge. Rev Neurol. 2016;172(1):46-55. http://dx.doi.org/10.1016/j.neurol.2015.10.007. PMid:26708326.
18. McFaline-Figueroa JR, Lee EQ. Brain Tumors. Am J Med. 2018;131(8):874-82. http://dx.doi.org/10.1016/j.amjmed.2017.12.039. PMid:29371158.
19. Daniels JL, Olshan AF, Savitz DA. Pesticidas e câncer infantil. Environ Health Perspect. 1997;105(10):1068-77. http://dx.doi.org/10.1289/ ehp.971051068. PMid:9349828.
20. Picano E, Vano E, Domenici L, Bottai M, Thierry-Chef I. Efeitos do câncer e não-câncer no cérebro e nos olhos da exposição crônica à radiação ionizante de baixa dose. Câncer BMC. 2012;12(1):157. http:// dx.doi.org/10.1186/1471-2407-12-157.
21. de Graaf L, Boulanger M, Bureau M, et al. Exposição ocupacional a pesticidas, câncer e distúrbios neurológicos crônicos: uma revisão sistemática de estudos epidemiológicos em trabalhadores de espaços verdes. Res. Ambiente. 2022;203:111822.
22. Liu R, Page M, Solheim K, Fox S, Chang S. Qualidade de vida em adultos com tumores cerebrais: conhecimento atual e direções futuras. Neuro-oncol. 2009;11(3):330-9. http://dx.doi.org/10.1215/15228517- 2008-093. PMid:19001097.
23. Hadidchi S, Surento W, Lerner A, et al. Headache and brain tumor. Neuroimaging Clin N Am. 2019;29(2):291-300. http://dx.doi. org/10.1016/j.nic.2019.01.008. PMid:30926118.
24. Yang S, Chu S, Gao Y, et al. A narrative review of Cancer-Related Fatigue (CRF) and its possible pathogenesis. Cells. 2019;8(7):738. http:// dx.doi.org/10.3390/cells8070738. PMid:31323874.
25. Miller KD, Ostrom QT, Kruchko C, et al. Brain and other central nervous system tumor statistics, 2021. CA Cancer J Clin. 2021;71(5):381- 406. http://dx.doi.org/10.3322/caac.21693. PMid:34427324.
26. Venkatasubba Rao CP, Suarez JI, Martin RH, et al. Global survey of outcomes of neurocritical care patients: analysis of the PRINCE study part 2. Neurocrit Care. 2020;32(1):88-103. http://dx.doi.org/10.1007/ s12028-019-00835-z. PMid:31486027.
27. Steinberger J, Bronheim RS, Vempati P, et al. Morbidity and Mortality of Meningioma Resection Increases in Octogenarians. World Neurosurg. 2018;109:e16-23. http://dx.doi.org/10.1016/j.wneu.2017.09.021. PMid:28919230.
28. Rafiq R, Katiyar V, Garg K, Kasliwal M, Chandra PS, Kale SS. Comparison of outcomes of surgery for intracranial meningioma in elderly and young patients: a systematic review and meta-analysis. Clin Neurol Neurosurg. 2021;207:106772. http://dx.doi.org/10.1016/j. clineuro.2021.106772. PMid:34245986.
29. Jimenez AE, Cicalese KV, Chakravarti S, et al. Social determinants of health and the prediction of 90-day mortality among brain tumor patients. J Neurosurg. 2022. In press. http://dx.doi.org/10.3171/2022.11. JNS222033. PMid:35353473.
30. Dicpinigaitis AJ, Hanft S, Cooper JB, et al. Comparative associations of baseline frailty status and age with postoperative mortality and duration of hospital stay following metastatic brain tumor resection. Clin Exp Metastasis. 2022;39(2):303-10. http://dx.doi.org/10.1007/ s10585-021-10138-3. PMid:35023030.
31. Dasenbrock HH, Liu KX, Devine CA, et al. Length of hospital stay after craniotomy for tumor: a National Surgical Quality Improvement Program analysis. Neurosurg Focus. 2015;39(6):E12. http://dx.doi. org/10.3171/2015.10.FOCUS15386. PMid:26621410.
32. Neville IS, Ureña FM, Quadros DG, et al. Safety and costs analysis of early hospital discharge after brain tumour surgery: a pilot study. BMC Surg. 2020;20(1):105. http://dx.doi.org/10.1186/s12893-020-00767-y. PMid:32410602.
33. Siqueira EMP, Diccini S. Complicações pós-operatórias em neurocirurgia eletiva e não eletiva. Acta Paul Enferm. 2017;30(1):101-8. http://dx.doi.org/10.1590/1982-0194201700015.
34. Gupta T, Achari R, Chatterjee A, et al. Comparison of epidemiology and outcomes in neuro-oncology between the east and the west: challenges and opportunities. Clin Oncol. 2019;31(8):539-48. http:// dx.doi.org/10.1016/j.clon.2019.05.018. PMid:31182288.
35. Barić H, Trkulja V, Peterković V, Mrak G. Mortality and morbidity in surgically treated patients with petroclival meningiomas: a systematic review and meta-analysis of case series. Br J Neurosurg. 2022;36(4):501- 10. http://dx.doi.org/10.1080/02688697.2022.2033700. PMid:35109722.
36. Tan AC, Ashley DM, López GY, Malinzak M, Friedman HS, Khasraw M. Management of glioblastoma: state of the art and future directions. CA Cancer J Clin. 2020;70(4):299-312. http://dx.doi.org/10.3322/ caac.21613. PMid:32478924.
37. Hermans G, van den Berghe G. Clinical review: intensive care unit acquired weakness. Crit Care. 2015;19(1):274. http://dx.doi.org/10.1186/ s13054-015-0993-7. PMid:26242743.
38. Tyler PD, Du H, Feng M, et al. Assessment of intensive care unit laboratory values that differ from reference ranges and association with patient mortality and length of stay. JAMA Netw Open. 2018;1(7):e184521. http://dx.doi.org/10.1001/jamanetworkopen.2018.4521. PMid:30646358.
39. Shah V, Kochar P. Brain cancer: implication to disease, therapeutic strategies and tumor targeted drug delivery approaches. Recent Patents Anticancer Drug Discov. 2018;13(1):70-85. http://dx.doi.org/10.2174/ 1574892812666171129142023. PMid:29189177.
40. Barnholtz-Sloan JS, Ostrom QT, Cote D. Epidemiology of brain tumors. Neurol Clin. 2018;36(3):395-419. http://dx.doi.org/10.1016/j. ncl.2018.04.001. PMid:30072062.
41. Ostrom QT, Fahmideh MA, Cote DJ, et al. Risk factors for childhood and adult primary brain tumors. Neuro-oncol. 2019;21(11):1357-75. http://dx.doi.org/10.1093/neuonc/noz123. PMid:31301133.
42. Costa AR, Lança de Oliveira M, Cruz I, Gonçalves I, Cascalheira JF, Santos CRA. The sex bias of cancer. Trends Endocrinol Metab. 2020;31(10):785-99. http://dx.doi.org/10.1016/j.tem.2020.07.002. PMid:32900596.
1 Medical student, Mafra Campus, University of Contestado, Mafra, SC, Brazil.
2 Veterinary Medicine student, Mafra Campus, University of Contestado, Mafra, SC, Brazil.
3 MD, Neurology, Hospital São Vicente de Paulo and Neuromax Group, Mafra, SC, Brazil.
4 MD, Neurosurgeon, São Vicente de Paulo Hospital and Neuromax Group, Mafra, SC, Brazil.
5 MD, Neurosurgeon, Santa Terezinha University Hospital and Neuromax Group, Mafra, SC, Brazil.
6 MD, Neurosurgeon, Beatriz Ramos Hospital and Neuromax Group, Mafra, SC, Brazil.
7 PhD, Cell and Molecular Biologist, Professor, Medicine School, Mafra Campus, University of Contestado, Mafra, SC, Brazil.
8 Researcher, NUPESC and Neuromax Group, Mafra, SC, Brazil.
9 MD, Neurosurgeon, São Vicente de Paulo Hospital and Neuromax Group, Mafra, SC, Brazil.
10 Professor, Medicine School, Mafra Campus, University of Contestado, Mafra, SC, Brazil.
11 Researcher, NUPESC, Mafra, SC, Brazil.
Received Dec 9, 2022
Corrected Jan 25, 2023
Accepted Feb 20, 2023
