Resumen de Diagnósticos de câncer de endométrio em tempos de pandemia de covid-19

Maria Ingrid Barbosa Passamani, Jacob Henrique da Silva Klippel, Lavínya Araujo Callegari, Maryane Leal Lopes, Neide Aparecida Tosato Boldrini

• português

  Introdução: O câncer endometrial (CE) é o sexto mais frequente entre mulheres. No cenário da pandemia COVID-19, houve grave comprometimento do sistema de saúde, contribuindo para diagnósticos mais tardios de CE e interferindo diretamente no prognóstico. Objetivos: Avaliar a prevalência de CE durante a pandemia no serviço de Ginecologia do Hospital Universitário Cassiano Antonio Moraes (Hucam-Ufes). Métodos: Foram incluídas pacientes com diagnóstico histológico de CE de janeiro de 2020 a dezembro de 2022. Pacientes com sangramento uterino anormal (SUA) e espessura endometrial (EE) maior ou igual a 12mm foram submetidas a Cureta de Novak (CN); pacientes sem sucesso com a CN, EE abaixo de 12mm ou resultado inconclusivo realizava-se histeroscopia. Resultados: De 25 pacientes diagnosticadas com CE, 22 (88%) possuíam SUA e 20 (80%) estavam na pós menopausa. O diagnóstico de CE foi realizado por CN em 12 pacientes (48%), 8 (32%) por histeroscopia e 5 pacientes foram diagnosticadas por achado acidental. A prevalência foi de 21,55% de CE. A média etária, IMC e EE foi, respectivamente, 59,6 anos, 30,5 e 20,9mm. O tempo médio entre o primeiro sintoma e o tratamento foi 12,4 meses, o tempo médio para diagnóstico com CN de 8 meses e histeroscopia, 16,5 meses. O subtipo histológico mais prevalente foi adenocarcinoma endometrióide (32%). Conclusão: O SUA, principalmente após a menopausa, deve ser investigado. É provável que o contexto de pandemia pela COVID-19 tenha prejudicado o diagnóstico e tratamento de CE. É importante otimizar as vias de diagnóstico e tratamento do CE visando maior sucesso terapêutico.

• English

  Introduction: Endometrial cancer (EC) is the sixth most frequent among women. During the COVID-19 pandemic, there was a severe compromise of the health system, contributing to later diagnoses of EC and directly interfering with the prognosis. Objectives: To evaluate the prevalence of EC in pandemic years among patients at the Gynecology Department of the University Hospital. Methods: Patients with histological diagnosis of EC from January 2020 to December 2022. Patients with abnormal uterine bleeding (AUB) and endometrial thickness (EE) greater than or equal to 12mm underwent Novak Curettage (NC); unsuccessful patients with NC or EE greater than 12mm or inconclusive results on NC underwent hysteroscopy. Results: 25 patients were diagnosed with EC. Among them, 22 (88%) had SUA as their main symptom and 20 (80%) were post-menopausal. CN was diagnosed in 12 patients (48%), and 8 (32%) were diagnosed by hysteroscopy. Ten patients had the diagnosis by incidental finding. The mean age, BMI, and EE were 59.6 years, 30.5, and 20.9 mm, respectively. The mean waiting time from first symptom and treatment was 12.4 months, the mean time to diagnosis with CN was eight months, and with hysteroscopy was 16.5 months. The most prevalent histological subtype was endometrioid adenocarcinoma (32%). Conclusion: SUA is a symptom that should be investigated. The pandemic context has hampered the diagnosis and treatment of EC cases. Optimizing the avenues of suspicion, diagnosis, and treatment of endometrial cancer as early as possible is crucial, aiming at its more significant therapeutic and possibly curative success.