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口腔癌患者寻求专科治疗的延迟:来自一家三级癌症中心的经验

Delay in seeking specialized care for oral cancers: experience from a tertiary cancer center.

作者信息

Joshi P, Nair S, Chaturvedi P, Nair D, Agarwal J P, D'Cruz A K

机构信息

Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, Maharashtra, India.

出版信息

Indian J Cancer. 2014 Apr-Jun;51(2):95-7. doi: 10.4103/0019-509X.137934.

Abstract

OBJECTIVE

Advanced oral cancers are a challenge for treatment, as they require complex procedures for excision and reconstruction. Despite being occurring at a visible site and can be detected easily, many patients present in advanced stages with large tumors. Timely intervention is important in improving survival and quality of life in these patients. The aim of the present study was to find out the causes of delay in seeking specialist care in advanced oral cancer patients.

MATERIALS AND METHODS

A prospective questionnaire based study was done on 201 consecutive advanced oral squamous cancer patients who underwent surgery at our hospital. All patients had either cancer of gingivobuccal complex (GBC) or tongue and had tumors of size more than 4 cm (T3/T4) and were treatment naοve at presentation.

RESULTS

Even though most patients observed abnormal lesions in their mouth, majority delayed the decision to visit a physician early. A significant percentage of patients (50%) also reported a delayed diagnosis by the primary care physician before being referred to a tertiary care center for definitive treatment. The average total duration from symptoms to treatment was 7 months.

CONCLUSION

The main reasons of this delay in receiving treatment were due to patients themselves (primary delay) or due to time taken by the primary physician to diagnose the condition (secondary delay). Oral self-examination can be helpful in detecting oral cancers early.

摘要

目的

晚期口腔癌的治疗颇具挑战,因为其切除和重建需要复杂的手术程序。尽管口腔癌发生在可见部位且易于发现,但许多患者就诊时已处于晚期,肿瘤较大。及时干预对于提高这些患者的生存率和生活质量至关重要。本研究的目的是找出晚期口腔癌患者寻求专科治疗延迟的原因。

材料与方法

对我院连续接受手术治疗的201例晚期口腔鳞状癌患者进行了一项基于问卷的前瞻性研究。所有患者均患有牙龈颊部复合体(GBC)癌或舌癌,肿瘤大小超过4厘米(T3/T4),就诊时均未接受过治疗。

结果

尽管大多数患者观察到口腔内有异常病变,但大多数患者都推迟了尽早就诊的决定。相当比例的患者(50%)还报告称,在被转诊至三级医疗中心进行确定性治疗之前,初级保健医生的诊断存在延迟。从出现症状到接受治疗的平均总时长为7个月。

结论

治疗延迟的主要原因在于患者自身(原发性延迟)或初级医生诊断病情所花费的时间(继发性延迟)。口腔自我检查有助于早期发现口腔癌。

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