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Carcinoma pavimento-celular: o papel do médico dentista
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Abstract(s)
O carcinoma pavimento-celular da cavidade oral, identificado internacionalmente pela designação em inglês oral squamous cell carcinoma (OSCC) representa genericamente um grupo de neoplasias de origem epitelial localizadas em diversos locais anatómicos da cavidade oral, e muito similar dos pontos de vista clínico e fisiopatológico a outros carcinomas pavimento-celulares em localizações anexas. O OSCC é considerado a nível mundial como a décima neoplasia mais comum, sendo mais frequente em indivíduos do género masculino.
Seu comportamento clínico envolve normalmente capacidades de invasão local e de metastização. Por outro lado, existem agentes tóxicos, aos quais a mucosa oral pode estar sujeita e que se sabe poderem constituir estímulos conducentes ao aparecimento do tumor.
Os profissionais de Saúde Oral, particularmente os médicos dentistas, estão na primeira linha para a aplicação das técnicas de diagnóstico que possibilitem o desejado diagnóstico precoce. Uma correta semiologia com sistematizada inspeção e palpação da cavidade oral e regiões anexas periorais e o recurso sempre que necessário a exames auxiliares de diagnóstico são procedimentos que devem ser integrantes ao plano de tratamento em Medicina Dentária.
A terapêutica do OSCC é maioritariamente hospitalar e multidisciplinar, e envolve extensa bateria de exames que permitem definir o estadiamento e atingimento do Tumor. A decisão terapêutica pode incluir cirurgia, radioterapia, quimioterapia ou outras opções, tendo como possível resultado colateral a introdução de incapacidades funcionais, e isto apesar de eventuais procedimentos de cirurgia estética e reconstrutiva concomitantes. Cabe normalmente ao médico dentista a receção do doente medicamente tratado no sentido de acabar a etapa final da reabilitação oral, estética e funcional.
Apesar dos progressos verificados na terapêutica e meios de diagnóstico, não houve melhoria significativa da sobrevivência global a 5 anos nas últimas 3 décadas, traduzindo a necessidade do rastreio para detetar precocemente as lesões orais. A chave para o tratamento é um diagnóstico atempado.
Oral squamous cell carcinoma (OSCC) generally represents a group of epithelial origin cancer located at different anatomical sites of oral cavity, and very similar in a clinical and pathophysiological point of view to adjoining areas squamous cell carcinomas. OSCC represents globally the tenth most common cancer, and is more frequent in men than in women. His clinical behaviour usually involves local invasion and metastasis capacities. On the other hand, there are toxic agents to which the oral mucosa may be subject and which are known to be stimulus leading to the appearance of the tumour. Oral health professionals, particularly dentists, are at the front line for applying diagnostic techniques that enable the desired early diagnosis. A correct semiology with systematized inspection and palpation of the oral cavity and adjacent perioral regions and the use whenever necessary to auxiliary diagnostic tests are procedures that must be part of the treatment plan in dentistry. OSCC therapy is mostly multidisciplinary and carried out in hospital, and involves extensive battery of tests that allow defining the staging and attainment of the Tumour. The therapeutic decision may include surgery, radiotherapy or other, with the introduction of functional disabilities, and this despite possible concomitant aesthetic and reconstructive surgery procedures. It is usually up to the dentist to receive the medically treated patient in order to achieve the final stage of oral, aesthetic, and functional rehabilitation. Despite the advances in the therapy and diagnosis, there was no significant improvement in overall survival at 5 years in the last 3 decades, reflecting the need for screening to detect early oral. The key of the treatment is a due-time diagnosis.
Oral squamous cell carcinoma (OSCC) generally represents a group of epithelial origin cancer located at different anatomical sites of oral cavity, and very similar in a clinical and pathophysiological point of view to adjoining areas squamous cell carcinomas. OSCC represents globally the tenth most common cancer, and is more frequent in men than in women. His clinical behaviour usually involves local invasion and metastasis capacities. On the other hand, there are toxic agents to which the oral mucosa may be subject and which are known to be stimulus leading to the appearance of the tumour. Oral health professionals, particularly dentists, are at the front line for applying diagnostic techniques that enable the desired early diagnosis. A correct semiology with systematized inspection and palpation of the oral cavity and adjacent perioral regions and the use whenever necessary to auxiliary diagnostic tests are procedures that must be part of the treatment plan in dentistry. OSCC therapy is mostly multidisciplinary and carried out in hospital, and involves extensive battery of tests that allow defining the staging and attainment of the Tumour. The therapeutic decision may include surgery, radiotherapy or other, with the introduction of functional disabilities, and this despite possible concomitant aesthetic and reconstructive surgery procedures. It is usually up to the dentist to receive the medically treated patient in order to achieve the final stage of oral, aesthetic, and functional rehabilitation. Despite the advances in the therapy and diagnosis, there was no significant improvement in overall survival at 5 years in the last 3 decades, reflecting the need for screening to detect early oral. The key of the treatment is a due-time diagnosis.
Description
Dissertação para obtenção do grau de Mestre no Instituto Universitário Egas Moniz
Keywords
Carcinoma pavimento-celular da cavidade oral (OSCC) Diagnóstico Evolução Tratamento