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. 2020 Apr 28;20(1):206.
doi: 10.1186/s12872-020-01471-8.

Brazilian cardio-oncology: the 10-year experience of the Instituto do Cancer do Estado de Sao Paulo

Isabela B S da S Costa  1 , Cristina S Bittar  1   2 , Silvia M R Fonseca  1 , Carolina M P D E Silva  1 , Marilia H H Dos Santos Rehder  1 , Stéphanie I Rizk  1   2 , Cecilia B B V Cruz  1   2 , Clara S Figueiredo  1 , Fernanda T de A Andrade  1 , Ludmila de A Barberino  1 , Fernanda A de S Costa  1 , Letticya P Machado  1 , Thalita B González  1 , Marcel P C Almeida  1 , Julia T Fukushima  1 , Roberto Kalil Filho  1   2 , Ludhmila Abrahao Hajjar  3   4
Affiliations

Brazilian cardio-oncology: the 10-year experience of the Instituto do Cancer do Estado de Sao Paulo

Isabela B S da S Costa et al. BMC Cardiovasc Disord. .

Abstract

Background: In recent years, the field of cardio-oncology has grown worldwide, bringing benefits to cancer patients in terms of survival and quality of life. This study reports the experience of a pioneer cardio-oncology programme at University Cancer Hospital in Brazil over a period of 10 years, describing the clinical profile of patients and the clinical outcomes.

Methods: A retrospective study was conducted on a cohort of patients treated at the cardio-oncology programme from April 2009 to February 2019. We analysed the characteristics of patients and outcomes, including mortality, according to the type of clinical indication for outpatient care (general cardiology, perioperative evaluation and follow-up and treatment cardiotoxicity).

Results: From a total of 26,435 medical consultations, we obtained the data of 4535 individuals among the medical care outpatients. When we analysed the clinical characteristics of patients considering the clinical indication - general cardiology, perioperative evaluation and cardiotoxicity outpatient clinics, differences were observed with respect to age (59 [48-66], 66 [58-74] and 69 [62-76], p < 0.001), diabetes (67 [15%], 635 [22.6%] and 379 [29.8%]; p < 0.001), hypertension (196 [43.8%], 1649 [58.7%] and 890 [70.1%], p < 0.001) and dyslipidaemia (87 [19.7%), 735 [26.2%] and 459 [36.2%], p < 0.001). A similar overall mortality rate was observed in the groups (47.5% vs. 45.7% vs. 44.9% [p = 0.650]).

Conclusion: The number of oncologic patients in the Cardio-Oncology Programme has grown in the last decade. A well-structured cardio-oncology programme is the key to achieving the true essence of this area, namely, ongoing care for cancer patients throughout the disease treatment process, optimizing their cardiovascular status to ensure they can receive the best therapy against cancer.

Keywords: Cancer; Cardio-oncology; Cardiotoxicity.

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Conflict of interest statement

The authors declare that they have no competing interests.

Figures

Fig. 1
Fig. 1
Patients followed by clinical and surgical oncology medical teams are referred to the Cardio-Oncology Programme. To organize the programme, patients are referred to outpatient clinics initially separated by the reason for requesting referral: general, cardiotoxicity and perioperative. The cardiac imaging sector is interconnected with the outpatient programme. According to their clinical indication, patients can be evaluated by the collaborative network that follows in partnership with the clinical team. CMR, cardiac magnetic resonance; CTA, computed tomography angiography; EKG, electrocardiogram; GI, gastrointestinal; HER2, human epidermal growth factor receptor; IMIDs, immunomodulatory drugs; PET, positron emission tomography; PI, proteasome inhibitors; TKI, tyrosine kinase inhibitors; VEGF, vascular endothelial growth factor
Fig. 2
Fig. 2
Number of inpatients and outpatients seen over the years
Fig. 3
Fig. 3
Distribution of outpatients by type of care
Fig. 4
Fig. 4
Distribution of outpatients by type of cancer
See this image and copyright information in PMC

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