Manejo y Pronóstico de Pacientes con Cáncer de Cabeza y Cuello durante la Pandemia de COVID-19
DOI:
https://doi.org/10.32635/2176-9745.RBC.2025v71n2.5046Palabras clave:
COVID-19, SARS-CoV-2, Neoplasias de Cabeza y Cuello, Carcinoma de Células Escamosas, SobrevidaResumen
Introducción: La pandemia de COVID-19 trajo consigo la necesidad de implementar medidas para el manejo de pacientes con carcinoma de células escamosas (CCE) de cabeza y cuello. Objetivo: Evaluar las medidas adoptadas para un centro oncológico durante la pandemia de COVID-19 e investigar si la infección por SARS-CoV-2 y la carga viral cambian los resultados de los pacientes con cáncer de cabeza y cuello. Método: Se realizó una prueba de detección de SARS-CoV-2 a los pacientes mediante reacción en cadena de la polimerasa con transcripción inversa cuantitativa en tiempo real y prueba rápida de antígeno COVID-19 antes de la cirugía entre octubre de 2020 y noviembre de 2021. Los resultados clínicos se compararon según la presencia de infección por SARS-CoV-2, considerando factores pronósticos para pacientes con CCE de cabeza y cuello, como comorbilidades preexistentes y estadificación tumoral. Resultados: De 194 pacientes reclutados, 99 casos confirmaron diagnósticos de CCE de cabeza y cuello y se sometieron a tratamiento quirúrgico. Las comorbilidades más frecuentes fueron hipertensión arterial y diabetes mellitus. La cavidad oral y la laringe fueron los sitios anatómicos más afectados, con el 51% y 33%, respectivamente. Un total de 61,6% de los casos fue clasificado como T3/T4 y el 53,4% no presentó afectación ganglionar. La presencia de comorbilidades y metástasis ganglionares se asoció con una supervivencia reducida. De 99 pacientes, el 8,1% (8/99) estaba infectado con SARS-CoV-2, pero no se observa la diferencia en la supervivencia general según la infección por SARS-CoV-2 (p = 0,086) y la carga viral no se asoció con el estado vital (p = 0,456). Conclusión: La presencia de infección por SARS-CoV-2 no influyó en la supervivencia general en pacientes con CCE de cabeza y cuello. Este es el primer estudio que describe estos hallazgos en un centro de atención oncológica en el estado de Espírito Santo, Brasil.
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