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Lung cancer is the principal cause of cancer-related deaths worldwide; however, there has been controversy as to whether there is a difference in survival rate according to gender in Brazil. The aim of the present study, therefore, was to compare the epidemiologic and clinical profile and the overall survival of patients with lung cancer according to gender.A retrospective cohort study was performed involving 1283 patients diagnosed with lung cancer between 2006 and 2014 at a single cancer center. Survival analysis was conducted using Kaplan-Meier statistics. A log-rank test was used to assess differences between survival curves, and Cox proportional hazards regression analysis was performed to quantitate the relationship between gender and overall survival.Compared with men, women were more frequently younger (P .001), nonsmokers (P = .007), diagnosed with adenocarcinoma (P .001), had early stage disease (P .001), received surgery or surgery in combination with chemotherapy (P .001), and had a better survival rate (P .001). The median overall survival rate was higher in women (14.2 vs. 10.5 months in men; P .001). Cox regression-adjusted analysis shows that women were 16% less likely to die than men (hazard ratio, 0.84; 95% confidence interval, 0.72-0.98; P = .03).A higher overall survival rate was found in women with lung cancer as compared with men with lung cancer in Brazil.

Background: The immune system is recognized to have therapeutic potential to destroy cancer cells. T-cell immunoglobulin mucin domain-3 (sTIM-3) and its ligand galectin 9 (GAL9) cause suppression of cytokine production, cell cycle arrest, and cell death. Then, soluble levels of TIM-3 and GAL-9 may have prognostic implications in non-small-cell lung cancer (NSCLC) in non-smoker patients. Methods: This prospective cohort study, including 49 NSCLC patients with an age median of 65 years, evaluated the soluble levels of sTIM-3 and sGAL9 by enzyme-linked immunosorbent assay. Results: Low levels of sGAL9 in smokers compared to non-smoker NSCLC patients (P

BACKGROUND Coronavirus disease 2019 (COVID‐19) and cancer are serious public health problems worldwide. However, little is known about the risk factors of in‐hospital mortality among COVID‐19 patients with and without cancer in Brazil. The objective of this study was to evaluate the risk factors of in‐hospital mortality among COVID‐19 patients with and without cancer and to compare mortality according to gender and topography during the year 2020 in Brazil. METHODS This was a secondary data study of hospitalized adult patients with a diagnosis of COVID‐19 by real‐time polymerase chain reaction testing in Brazil. The data were collected from the Influenza Epidemiological Surveillance Information System. RESULTS This study analyzed data from 322,817 patients. The prevalence of cancer in patients with COVID‐19 was 2.3%. COVID‐19 patients with neurological diseases and cancer had the most lethal comorbidities in both sexes. COVID‐19 patients with cancer were more likely to be older (median age, 67 vs 62 years; P < .001), to have a longer hospital stay (13.1 vs 11.5 days; P < .001), to be admitted to the intensive care unit (45.3% vs 39.6%; P < .001), to receive more invasive mechanical ventilation (27.1% vs 21.9%), and to have a higher risk of death (adjusted odds ratio [aOR], 1.94; 95% confidence interval [CI], 1.83‐2.06; P < .001) than those without cancer. Patients with hematological neoplasia (aOR, 2.85; 95% CI, 2.41‐3.38; P < .001) had a higher risk of mortality than those with solid tumors (aOR, 1.83; 95% CI, 1.72‐1.95; P < .001) in both sexes. CONCLUSIONS Brazilian COVID‐19 patients with cancer have higher disease severity and a higher risk of mortality than those without cancer., Patients with hematological neoplasia (adjusted odds ratio [aOR], 2.85; 95% confidence interval [CI], 2.41‐3.38; P < .001) have a higher risk of mortality than those with solid tumors (aOR, 1.83; 95% CI, 1.72‐1.95; P < .001) in both sexes.

Patients with cancer need to receive their proper treatment and often cannot wait for their treatment, despite delays due to the COVID-19 pandemic. As a result, many cancer centers have had challenges maintaining their oncological activities.To compare the average hospital management data and indicators in two different periods, with and without the peak of COVID-19 cases, from an important tertiary cancer center in the northeast region of Brazil.A retrospective and observational study was performed comparing average hospital administrative data and indicators, between January to March v April to June, 2020 exclusively at the Hospital de Câncer de Pernambuco, Brazil.There were on average a 13% reduction in the chemotherapy administered (P = .131), 17% fewer radiotherapy treatments carried out (P = .043) and 41% as many oncologic surgeries undertaken (P = .002). There was a reduction in the number of sessions of out-patient chemotherapy of 8•6% (P = .271) and chemotherapy inpatients of 33% (P = .038). Admission of new cases of patients with cancer was reduced by 44% (P = .007) during the period analyzed. Ambulatory appointments also decreased by 55% (P = .004) and emergency room appointments fell by 7•9% (P = .495). The number of hospitalizations was reduced by 36% (P = .005) and the occupancy rate decreased by 23•6% (P = .003), while the length of individual hospital stays (in days) increased 10•5% (P = .116).We report a reduction in the number of radiotherapy treatments and surgeries performed cancer carried out, ambulatory and emergency appointments, hospitalization and admission of new cases of cancer during peak of COVID-19 in an important public tertiary cancer center in the northeast region of Brazil.

e20597 Background: malignant mesothelioma is a rare tumor with about 31,000 new cases diagnosed annually worldwide. Malignant pleural mesothelioma (MPM) is recognized as an occupational cancer, and past exposure to asbestos represents its main risk factor. Little is known about the epidemiological and clinicopathological profile in developing countries. Methods: this is a cross-sectional study that analyzed the incidence and mortality rates and the clinicopathological profile of MPM in Brazil, from Brazilian public databases: Population-Based Cancer Registries (PBCRs - for incidence), Hospital Cancer Registry (HCR - for clinicopathological profile) and National Mortality Information System (SIM - for mortality). Results: In thirty PBCRs, from 23 of 26 states (average covered of 17% of the Brazilian population), 310 new MPM cases were reported, from 2000 to 2015. The mean age at diagnosis was 62.8 years. Incidence crude rate reached its maximum of 8.96 per 1.000.000 men in the 75-79 age group, and of 3.34 per 1.000.000 women in the 80+ age group. The clinicopathological profile registered in the HCR, from 2000 to 2017, showed a majority of men (70.2%), smoker/former smoker (62.7%) and alcohol users (58.2%). Regarding histology, 59% were described as mesothelioma, NOS (not otherwise specified), 30.6% as epithelioid, 7% as fibrous mesothelioma and 3.4% as biphasic. 54.4% were stage IV at diagnosis, 27.5% stage III and 18.1% stages I or II. A quarter of the patients received neither local nor systemic treatment. From 2000 to 2017 512 deaths related to MPM were registered in SIM database, an average of 28 deaths per year (mean age of death 63.7 years). The age-adjusted mortality rate remained statistically stable over all analyzed period. Conclusions: According to our study, most MPM patients in Brazil are elderly men, stage IV at diagnosis, with mesothelioma NOS. A considerable percentage do not receive any specific treatment for the disesase. Understanding the scenario of MPM in Brazil is important to design prevention, diagnosis and treatment strategies.

Objectives Regarding the fatality rates stemming from various existing forms of cancers worldwide, lung cancer (LC) is ranked as the main cause of death amongst those who suffer from cancer. Although the epidemiological, clinical, and histological profile of patients with this type of cancer is largely unknown, Brazil has made tremendous efforts to generate data for supporting healthcare policies concerning lung cancer. Taking these factors into account, this study aims to analyse the epidemiological, clinical, and histological profiles of patients with non-small-cell lung cancer (NSCLC) in Brazil. Material and methods For this study, a cross-sectional epidemiological study was conducted to nationally analyse patient’s data within the cancer hospital registries found in the National Cancer Institute (INCA) and the Sao Paulo Cancer Foundation (FOSP) between 2000 and 2011. Results A total of 35,018 patients diagnosed with NSCLC in Brazil between 2000 and 2011 were analysed. The analysis demonstrated the occurrence of an epidemiological shift, related to the most prevalent histological type of NSCLC in the study population from 2003. The shift resulted in a higher percentage of adenocarcinoma (43.3%) over squamous cell carcinoma (36.5%). Additionally, there was a significant increase in both the number of cases of LC in women and in the rates of patients diagnosed with metastatic disease. Conclusion The use of filtered cigarettes since the 60’s and the increase in the number of LC cases in women, were one of the causes for the switch in the histological profile of NSCLC in Brazil. Consequently, adenocarcinoma is now the predominant type of cancer detected. Late diagnosis is a hallmark sign.

e21508 Background: Non-small cell lung cancer (NSCLC) accounts for approximately 85% of all cases of lung cancer. The immune system is now recognized to have the potential to destroy cancer cells. TIM-3 binds to Galectin-9 (GAL9) causing suppression of cytokine production, cell cycle arrest and cell death. Soluble CD40L (sCD40L) that is released by activated T lymphocytes and platelets. Therefore, we hypothesized that soluble forms immune checkpoint receptors and their ligands, such as TIM-3, GAL9 and CD40L may also prognostic implications of NSCLC. Objectives: Evaluate the soluble levels of CD40L, TIM-3 and GAL9 in patients with NSCLC in III and IV stages of disease. Methods: Samples of blood were collected from a cohort prospective involving 32 patients between 50 and 80 years old (65 + 8,6 years). Enzyme-linked immunosorbent assay was used to quantify expression these receptors. A non-parametric test was used to compare all groups (Mann-Whitney U-test). Statistical significance was defined as p

e13597 Background: Lung cancer is the principal cause of death from cancer worldwide. However, little is known of the clinic and histological profile from former smokers patients with lung cancer. Objectives: To characterize the clinical and histological profile and to identify independent factors associated with smoking status (former versus current) in patients with lung cancer in Brazil between 2010 and 2016. Methods: An ecological study was conducted using data from Brazilian hospital-based cancer registries between 2010 and 2016. Data with p-value < 0.20 in the univariate analysis were included in the logistic regression analysis by using the stepwise forward method, in order to control for potential confounders. Results: This study evaluated 23,462 patients with lung cancer diagnosed between 2010 and 2016 in Brazil. In general, the average age of all patients was 63.7 + 10.7 years old. Never smokers, former smokers and current smokers corresponded to 18.9 %, 35.2% and 45.9% of cases in the moment of the diagnosis, respectively. Current smokers were the most frequent smoking status, albeit its frequency decreased significantly during the period. Male and female former smokers had its frequency increasing over the period and male former smokers became more frequent than males current smokers since 2015. In multivariate analysis, comparing former versus smokers, the follow variables were statistically significant: former drinkers, older age group, higher schooling, married or living married, from non-public (private) health system insurance, living in region North, Northeast and West Center and more recent year of diagnosis. Conclusions: Recently, former smokers with lung cancer is increasing and became the most frequent smoking status, as a result of the very effective policies against to smoking in Brazil since 1990’s. The increase in that specific population discloses some interesting challenges and opportunities in clinical and translational settings.

Objective: To characterize the clinical and histological profile, as well as treatment patterns, of patients with early-stage, locally advanced (LA), or advanced/metastatic (AM) lung cancer, diagnosed between 2000 and 2014, in Brazil. Methods: This was an analytical cross-sectional epidemiological study employing data obtained for the 2000-2014 period from the hospital cancer registries of two institutions in Brazil: the José Alencar Gomes da Silva National Cancer Institute, in the city of Rio de Janeiro; and the São Paulo Cancer Center Foundation, in the city of São Paulo. Results: We reviewed the data related to 73,167 patients with lung cancer. The proportions of patients with early-stage, LA, and AM lung cancer were 13.3%, 33.2%, and 53.4%, respectively. The patients with early-stage lung cancer were older and were most likely to receive a histological diagnosis of adenocarcinoma; the proportion of patients with early-stage lung cancer remained stable throughout the study period. In those with LA lung cancer, squamous cell carcinoma predominated, and the proportion of patients with LA lung cancer decreased significantly over the period analyzed. Those with AM lung cancer were younger and were most likely to have adenocarcinoma; the proportion of patients with AM lung cancer increased significantly during the study period. Small cell carcinoma accounted for 9.2% of all cases. In our patient sample, the main treatment modality was chemotherapy. Conclusions: It is noteworthy that the frequency of AM lung cancer increased significantly during the study period, whereas that of LA lung cancer decreased significantly and that of early-stage lung cancer remained stable. Cancer treatment patterns, by stage, were in accordance with international guidelines.

Lung cancer is the principal cause of death from cancer worldwide. However, little is known of its epidemiological and histological profile and of the incidence and mortality rates in Brazil according to sex.To evaluate the incidence, morbidity and mortality rates of lung cancer in Brazil from 2000 to 2014, as well as the epidemiological, clinical and morphological profile of women with lung cancer in Brazil is described.An ecological study was conducted using three reliable sources of secondary data: population-based cancer registries, hospital-based cancer registries and the national mortality database.The incidence rate in women increased from 7.92/100,000 in 2000 to 9.12/100,000 in 2012, while mortality increased from 6.02/100,000 in 2000 to 8.29/100,000 in 2014. In men, the incidence decreased from 23.40/100,000 in 2000 to 18.47/100,000 in 2012 and mortality also fell from 16.12/100,000 to 15.11/100,000 in 2014. There was a reduction in the male-to-female ratio from 2.54 in 2000 to 1.46 in 2014. Women tended to be younger (p 0.001), black (p 0.001), non-smokers (p 0.001), to have adenocarcinoma or small-cell lung cancer (p 0.001), and to have metastatic disease (p 0.001). In addition, the time between diagnosis and the start of cancer treatment was longer in women (p 0.001). In relation to treatment, women were more likely to have undergone chemotherapy, surgery or surgery in combination with chemotherapy (p 0.001) and to have response to the initial treatment (p 0.001).Incidence, morbidity and mortality rates of lung cancer in women of Brazil increased in the most recent years.

Lung cancer (LC) is the most common type of cancer and the principal cause of death from cancer worldwide. In 2018, data from Globocan estimated over 2.1 millions new cases of LC were reported, with 1.8 million deaths globally (1). Smoking is main cause of LC, and almost 85–90% of patients with LC are or were smokers (2). Smokers have 20–30 times more risk to developed LC (3).

Summary Background The combination therapy for non-small-cell lung cancer (NSCLC) with platinum-based treatment is well known, but its utility in elderly has not been explored systematically. Aim To examine whether aging compromises survival or exacerbates toxicity in patients with advanced lung cancer receiving platinumbased treatment. Methods We performed a nested case-control study in a cohort of chemotherapy naive patients enrolled January 1998–December 2003. Cases were consecutive patients over 70 at diagnosis with stage III or IV NSCLC. Controls were a subset of patients under 70 years matched by stage and year in which they had been treated. All patients received Cisplatin (80 mg/m2) or Carboplatin (4–6 AUC), every 4 weeks, followed by Vinorelbine (30 mg/m2) for a maximum of six courses. The medical history, physical examination and tumor imaging evaluation were performed at baseline and then monthly. Survival was calculated by Kaplan–Meier method and log-rank test was used for survival comparisons. Chi-squared test was used to compare side effects in the two groups. Results A total of 419 patients were identified for the case-control study (205 elderly/214 young) with 3.6 cycles per patient, on average. The 2- and 3-year survival rates were 20.5% and 6.8% for elderly patients and 9.8% and 2.3% for younger patients (p = 0.017 and 0.014, respectively for 2 and 3 years). The proportion of patients with adverse effects, either grade 3 or 4, was the same in both groups at 2 years (43.9% versus 43.9%; p = 0.99). Conclusions Although elderly patients may self-select or be selected to be healthier, our findings suggest that elderly patients currently undergoing chemotherapy for lung cancer do as well or better than younger patients. Elderly age alone should not preclude patients from receiving platinum-based chemotherapy, since it seems well tolerated and effective in non-small-cell lung cancer among elderly patients.

Relata-se o caso de um paciente exposto profissionalmente a asbesto por dez anos e portador de um tumor pleural muito raro, o hemangioendotelioma epitelióde. O paciente apresentava derrame pleural serohemorrágico, sem evidência de células neoplásicas e com predomínio de linfócitos. A biópsia pleural por agulha revelou processo inflamatório crônico inespecífico, com áreas de tecido mixóide. A videotoracoscopia mostrou nódulos difusos nas pleuras parietal e visceral. A biópsia revelou neoplasia mesenquimal e eram semelhantes às áreas focais observadas na primeira biópsia. O estudo imunohistoquímico demonstrou a presença dos marcadores vasculares CD31, CD34 e Fator VIII, caracterizando a origem vascular do tumor. O paciente foi tratado com cisplatina e ectoposide, tendo o óbito ocorrido três meses após o diagnóstico.