ORIGINAL

Brain Tumors Epidemiology in a Low-Income Health Region of Brazil

Epidemiologia de Tumores Cerebrais em uma Região de Saúde de Baixa Renda do Brasil

  • Bruno Bastos Godoi (1)
  • Silvio Pereira Ramos Junior (2)
  • Guaracy de Macedo Machado Filho (2)
  • Luísa Figueiredo Moreira Gomes (3)
  • Caroline Ferraz Correa Martins (3)
  • Henrique Silveira Costa (4)
  • Pedro Henrique Scheidt Figueiredo (4)
  • Sebastião Nataniel Silva Gusmão (2)
  Views: 200
  Downloads: 19

Resumo

Introdução: Segundo a Organização Mundial da Saúde, os Tumores Cerebrais (TC), malignos e benignos, têm incidência crescente em todo o mundo, principalmente naqueles países de baixa e média renda. Objetivo: De acordo com esses dados crescentes em regiões de saúde de baixa renda, este estudo teve como objetivo descrever a epidemiologia dos TC neurocirúrgicos em uma região de saúde de baixa renda no Brasil. Métodos: Trata-se de um estudo de coorte retrospectivo, sendo descritos pacientes que realizaram intervenção neurocirúrgica em um centro de referência em neurocirurgia de alta complexidade no período de 2010 a 2018, com coleta de dados de seus prontuários (idade, sexo, tipo de TC e distúrbio neurológico, pré e pós-operatório). Resultados: Foram avaliados 197 pacientes submetidos a procedimento neurocirúrgico por TC malignos do sistema nervoso central. A média de idade foi de 52,0 anos (±16,9), sendo 53,8% do sexo feminino e 41,5% desses pacientes apresentavam tumor cerebral maligno. Os tumores meníngeos e mesenquimais foram o tipo de tumor cerebral não maligno mais frequente e o astrocitoma foi o tumor maligno mais frequente. Antes da neurocirurgia, 85,8% dos pacientes apresentavam algum distúrbio neurológico. Após isso, o número de pacientes com algum déficit reduziu para 42,6%. Conclusão: Apesar de serem fornecidos dados de uma das regiões mais pobres do Brasil, pode-se concluir que a assistência neurocirúrgica se compara aos países desenvolvidos. Em nossos resultados encontramos uma incidência mundial semelhante de TC, e também uma incidência semelhante de distúrbios neurológicos antes e após a neurocirurgia.

Palavras-chave

Neoplasias cerebrais; Neurocirurgia; Epidemiologia; Doenças do sistema nervoso; Status socioeconômico

Abstract

Introduction: According to the World Health Organization, Brain Tumor (BT), malignant and benign, have an increasing incidence worldwide, mainly in those low and middle-income countries. Objective: According to these growing data in low-income health regions, this study aimed to describe the epidemiology of Neurosurgical BT in a low-income health region in Brazil. Methods: This is a retrospective cohort study. patients who underwent neurosurgery intervention in a high-complexity neurosurgery reference center from 2010 to 2018, with data collect from its medical records (age, gender, type of BT and neurological disorder, pre- and postoperative) were described. Results: A total of 197 patients who underwent a neurosurgical procedure due to Central Nervous System malignant BT was assessed. The mean age was 52.0 years (±16.9), in which 53.8% were female and 41.5% of those patients had a malignant brain tumor. Meningeal and mesenchymal tumors were the most frequent type of non-malignant brain tumor and astrocytoma was the most frequent malignant tumor. Before neurosurgical procedure, 85.8% of patients had some neurological disorder. After this, the number of patients with any deficit reduced to 42.6%. Conclusion: Despite being given data from one of the poorest regions of Brazil, it can be concluded that neurosurgical assistance is compared to that in developed countries. In our results a similar worldwide incidence of BT, and also a similar incidence of neurological disorders before and after neurosurgery were found.

Keywords

Brain neoplasms; Neurosurgery; Epidemiology; Nervous system diseases; Socioeconomic status

References

1. 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.

2. 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.

3. Bell JS, Koffie RM, Rattani A, et al. Global incidence of brain and spinal tumors by geographic region and income level based on cancer registry data. J Clin Neurosci. 2019;66:121-7. http://dx.doi.org/10.1016/j. jocn.2019.05.003. PMid:31133367.

4. Bondy ML, Scheurer ME, Malmer B, et al. Brain tumor epidemiology: consensus from the Brain Tumor Epidemiology Consortium (BTEC). Cancer. 2008;113(7, Suppl):1953-68. http://dx.doi.org/10.1002/ cncr.23741. PMid:18798534.

5. Santos MO. Estimativa 2018: incidência de Câncer no Brasil. Rev Bras Cancerol. 2018;64(1):119-20. http://dx.doi.org/10.32635/2176- 9745.RBC.2018v64n1.115.

6. Ostrom QT, Gittleman H, Truitt G, Boscia A, Kruchko C, Barnholtz- Sloan JS. CBTRUS statistical report: primary brain and other central nervous system tumors diagnosed in the United States in 2011-2015. Neuro-oncol. 2018;20(suppl_4):iv1-86. http://dx.doi.org/10.1093/ neuonc/noy131. PMid:30445539.

7. McNeill KA. Epidemiology of brain tumors. Neurol Clin. 2016;34(4):981-98. http://dx.doi.org/10.1016/j.ncl.2016.06.014. PMid:27720005.

8. Bauchet L, Ostrom QT. Epidemiology and molecular epidemiology. Neurosurg Clin N Am. 2019;30(1):1-16. http://dx.doi.org/10.1016/j. nec.2018.08.010. PMid:30470396.

9. Mendes GA, Ongaratti BR, Semmelmann Pereira-Lima JF. Epidemiologia de uma série de tumores primários do sistema nervoso central. Arq Bras Neurocir Brazilian Neurosurg. 2014;33(04):279-83. http://dx.doi.org/10.1055/s-0038-1626227.

10. Helal AE, Abouzahra H, Fayed AA, Rayan T, Abbassy M. Socioeconomic restraints and brain tumor surgery in low-income countries. Neurosurg Focus. 2018;45(4):E11. http://dx.doi. org/10.3171/2018.7.FOCUS18258. PMid:30269590.

11. Johnson KJ, Schwartzbaum J, Kruchko C, et al. Brain tumor epidemiology in the era of precision medicine: The 2017 Brain Tumor Epidemiology Consortium meeting report. Clin Neuropathol. 2017;36(6):255-63. http://dx.doi.org/10.5414/NP301066. PMid:29035190.

12. Fuentes-Raspall R, Solans M, Roca-Barceló A, et al. Descriptive epidemiology of primary malignant and non-malignant central nervous tumors in Spain: results from the Girona Cancer Registry (1994–2013). Cancer Epidemiol. 2017;50(Pt A):1-8. http://dx.doi.org/10.1016/j. canep.2017.07.005. PMid:28738268.

13. Pignatti F, Van Den Bent M, Curran D, et al. Prognostic factors for survival in adult patients with cerebral low-grade glioma. J Clin Oncol. 2002;20(8):2076-84. http://dx.doi.org/10.1200/JCO.2002.08.121. PMid:11956268.

14. Ostrom QT, Wright CH, Barnholtz-Sloan JS. Brain metastases: epidemiology. Handb Clin Neurol. 2018;149:27-42. http://dx.doi. org/10.1016/B978-0-12-811161-1.00002-5. PMid:29307358.

15. Nilsson J, Holgersson G, Järås J, Bergström S, Bergqvist M. The role of income in brain tumor patients: a descriptive register-based study: no correlation between patients’ income and development of brain cancer. Med Oncol. 2018;35(4):52. http://dx.doi.org/10.1007/ s12032-018-1108-5. PMid:29532282.

16. Mwita CC, Rowland T, Gwer S. Burden of brain tumors in low- and middle-income countries: a systematic review protocol. JBI Database Syst Rev Implement Rep. 2018;16(3):609-14. http://dx.doi.org/10.11124/ JBISRIR-2017-003424. PMid:29521859.

17. 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.

18. Șuteu P, Todor N, Ignat RM, Nagy V. Clinical prognostic factors associated with survival and a survival score for patients with brain metastases. Future Oncol. 2019;15(22):2619-34. http://dx.doi. org/10.2217/fon-2019-0119. PMid:31290342.

19. Liu Z, Lei B, Zheng M, Li Z, Huang S, Deng Y. Prognostic factors in patients treated with surgery for brain metastases: a single-center retrospective analysis of 125 patients. Int J Surg. 2017;44:204-9. http:// dx.doi.org/10.1016/j.ijsu.2017.05.033. PMid:28528216.

20. Kavouridis VK, Harary M, Hulsbergen AFC, et al. Survival and prognostic factors in surgically treated brain metastases. J Neurooncol. 2019;143(2):359- 67. http://dx.doi.org/10.1007/s11060-019-03171-6. PMid:30989623.

21. Gittleman H, Boscia A, Ostrom QT, et al. Survivorship in adults with malignant brain and other central nervous system tumor from 2000-2014. Neuro-oncol. 2018;20(suppl_7):VII6-16. http://dx.doi. org/10.1093/neuonc/noy090. PMid:29850889.


(1) MD, MR, Medical Residency in Neurology, Faculty of Medicine, Federal University of Jequitinhonha’s Valley and Mucuri – UFVJM, Diamantina, MG, Brazil.

(2) MD, Neurosurgeon, Faculty of Medicine, Federal University of Jequitinhonha’s Valley and Mucuri – UFVJM, Diamantina, MG, Brazil.

(3) Medical student, Faculty of Medicine, Federal University of Jequitinhonha’s Valley and Mucuri – UFVJM, Diamantina, MG, Brazil.

(4) Physical therapist, Postgraduate Program in Rehabilitation and Functional Performance, Physical Therapy School, Federal University of Jequitinhonha’s Valley and Mucuri – UFVJM, Diamantina, MG, Brazil.

 

Received Mar 6, 2021
Corrected May 2, 2022
Accepted May 12, 2022


JBNC  Brazilian Journal of Neurosurgery

  •   ISSN (print version): 0103-5118
  •   e-ISSN (online version): 2446-6786

Contact

Social Media

   

ABNc  Academia Brasileira de Neurocirurgia

  •   Rua da Quitanda 159 – 10º andar - Centro - CEP 20091-005 - Rio de Janeiro - RJ
  •   +55 21 2233.0323
  •    abnc@abnc.org.br