Makanjuola Samira B L, Popoola Abiodun O, Oludara Mobolaji A
Department of Pharmacology, Lagos State University, College of Medicine (LASUCOM), Ikeja, Nigeria.
Department of Radiology & Oncology, Lagos State University Teaching Hospital (LASUTH), Ikeja, Nigeria.
Radiother Oncol. 2014 May;111(2):321-6. doi: 10.1016/j.radonc.2014.03.013. Epub 2014 Apr 17.
This retrospective study was carried out to examine five-year survival from breast cancer cases diagnosed between 2005 and May 2008 in Nigerian women.
Two hundred and twenty-four patients were entered into the study. Five-year survival was evaluated using proportional hazard model proposed by Cox to assess variables such as age of diagnosis, menopausal status, and stage of the disease in the two treatment groups: surgery/chemotherapy or surgery/chemotherapy/radiotherapy.
Findings revealed that the different staging of disease and treatment are independent predictors of disease outcome whereas age of diagnosis and menopausal status although associated with low hazards, are not significant. TNM Stage I (Hazard Ratio=0.153, 95% CI 0.45-0.51, P=0.003), II (Hazard Ratio=0.245, 95% CI 0.12-0.46, P=0.0001), and III (Hazard Ratio=0.449, 95% CI 0.31-0.46, P=0.0001) showed significantly greater survival rates compared to TNM Stage IV for patients receiving surgery/chemotherapy. Similarly, for patients receiving surgery/chemotherapy/radiotherapy TNM Stage II (Hazard Ratio=0.110, 95% CI 0.02-0.46, P=0.003) and III (Hazard Ratio=0.238, 95% CI 0.07-0.73, P=0.012) also showed significantly greater survival rates compared to TNM Stage IV. Treatment had a significant impact on survival independent of stage, age, and menopausal status. Patients receiving surgery/chemotherapy/radiotherapy had a significant increase in survival outcome for TNM Stage (II, P=0.045; III, P=0.0001); age groups (40-49, P=0.021; 50-59, P=0.016; 60-69, P=0.017; >70, P=0.025); and menopausal status (premenopausal, P=0.049; postmenopausal, P=0.0001) compared to those receiving surgery/chemotherapy.
The five-year breast cancer survival rate in Lagos, Nigeria 24.1% (54/224) is relatively poor compared to most countries in the world and needs to be improved. Poor survival rates are mainly attributed to late presentation and poor follow-up, hence early detection through breast cancer awareness programs, appropriate logistics and better management of patients through guidelines for the treatment of breast need to be implemented to improve survival.
本回顾性研究旨在调查2005年至2008年5月期间确诊的尼日利亚女性乳腺癌患者的五年生存率。
224例患者纳入本研究。采用Cox提出的比例风险模型评估五年生存率，以评估两个治疗组（手术/化疗或手术/化疗/放疗）中诸如诊断年龄、绝经状态和疾病分期等变量。
研究结果显示，疾病的不同分期和治疗是疾病预后的独立预测因素，而诊断年龄和绝经状态虽然与低风险相关，但并不显著。对于接受手术/化疗的患者，TNM I期（风险比=0.153，95%置信区间0.45 - 0.51，P = 0.003）、II期（风险比=0.245，95%置信区间0.12 - 0.46，P = 0.0001）和III期（风险比=0.449，95%置信区间0.31 - 0.46，P = 0.0001）的生存率显著高于TNM IV期。同样，对于接受手术/化疗/放疗的患者，TNM II期（风险比=0.110，95%置信区间0.02 - 0.46，P = 0.003）和III期（风险比=0.238，95%置信区间0.07 - 0.73，P = 0.012）的生存率也显著高于TNM IV期。治疗对生存率有显著影响，且独立于分期、年龄和绝经状态。与接受手术/化疗的患者相比，接受手术/化疗/放疗的患者在TNM分期（II期，P = 0.045；III期，P = 0.0001）、年龄组（40 - 49岁，P = 0.021；50 - 59岁，P = 0.016；60 - 69岁，P = 0.017；>70岁，P = 0.025）以及绝经状态（绝经前，P = 0.049；绝经后，P = 0.0001）方面的生存结局有显著改善。
尼日利亚拉各斯的乳腺癌五年生存率为24.1%（54/224），与世界上大多数国家相比相对较低，需要改善。生存率低主要归因于就诊延迟和随访不佳，因此需要通过乳腺癌宣传项目进行早期检测，配备适当的后勤保障，并通过乳腺癌治疗指南对患者进行更好的管理，以提高生存率。
