Análise de sobrevida e avaliação de estratégias de enfrentamento em pacientes com carcinoma espinocelular oral

Abstract

Oral cancer is a global public health problem. In 2021, approximately 170,000 people died due to the disease. Although advances in diagnosis and treatment have occurred in recent decades, the 5-year survival rate of oral cancer patients has not significantly increased. The high incidence of patients with oral squamous cell carcinoma (OSCC) diagnosed in advanced stages highlights the need for studies on the factors related to late diagnosis and survival. This study, divided into two articles, evaluated factors related to survival and delays in patient diagnosis. The first article is a cross-sectional and retrospective study that evaluated factors associated with the survival of patients with OSCC treated at the Oncology Specialist Center (OSC) in Governador Valadares. A total of 600 patients diagnosed between 2009 and 2021 were included. The overall survival, disease-related survival, and disease-free survival rates were 41.2%, 40.4%, and 77.1%, respectively. In the multivariate analysis, smoking, being a former smoker, presence of lymph node invasion, and more than 2 months between the first consultation and treatment were identified as independent prognostic factors. The second article is a qualitative study that analyzed the knowledge associated with the diagnosis of OSCC and the coping strategies of patients facing the disease's manifestations. The sample consisted of 15 patients, aged between 52 and 80 years (mean of 64.5, SD ± 7.5). The results showed four coping strategies that cause delays in seeking help: 1) self-medication, 2) seeking medical consultations, 3) abandoning consultations, and 4) consulting general dentists. Additionally, participants believed that the disease could heal spontaneously and did not immediately seek medical help. In conclusion, the studies provide a greater understanding of the mechanisms involved in diagnostic delays and outline the survival panorama of OSCC in an inland region of Brazil.