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澳大利亚北昆士兰地区癌症中心针对农村及偏远地区晚期神经内分泌肿瘤患者的临床特征及治疗结果:一项回顾性研究

Clinical profile and treatment outcomes of advanced neuroendocrine tumours in rural and regional patients: a retrospective study from a regional cancer centre in North Queensland, Australia.

作者信息

Hafeez Umbreen, Joshi Abhishek, Bhatt Manoj, Kelly Jenny, Sabesan Sabe, Vangaveti Venkat

机构信息

Department of Medical Oncology, The Townsville Hospital, Townsville, Queensland, Australia.

Department of Nuclear Medicine, The Townsville Hospital, Townsville, Queensland, Australia.

出版信息

Intern Med J. 2017 Mar;47(3):284-290. doi: 10.1111/imj.13333.

Abstract

BACKGROUND

Neuroendocrine tumours (NET) arise from neuroendocrine cells, which are widely distributed throughout the body. However, diagnosing NET is difficult due to nonspecific symptoms and the paucity of experience among health professionals. This retrospective study was carried out to improve our understanding about NET. This knowledge can be used for optimal utilisation and distribution of limited resources.

AIM

To study the clinical profile, treatment and survival outcomes for advanced NET patients in Australian regional and remote settings.

METHODS

We reviewed all adult patients who were diagnosed with NET between 1994 and 2012. Patients' data were extracted from electronic databases of The Townsville Cancer Centre. Remoteness was based on postcodes, with patients stratified as regional or rural North Queensland according to Australian Standard Geographical Classification (ASGC). Overall survival was studied using survival analysis.

RESULTS

Data from 79 patients were included in the study. The median age at diagnosis was 60 years. A total of 48 patients (60.8%) was male and 31 (39.2%) female. The majority of the patients lived in rural areas (51, 64%) as compared to residing in regional areas (28, 36%). There were 34 deaths at the study cut-off point. Median overall survival of NET patients in rural areas is significantly less than those living in regional areas (1613 days vs. 2935 days, respectively), P = 0.03.

CONCLUSION

Remoteness has an adverse impact on overall survival of NET patients. This outcome may be because of varied access to health services and/or lack of access to specialised scans and medical and surgical expertise.

摘要

背景

神经内分泌肿瘤(NET)起源于神经内分泌细胞,这些细胞广泛分布于全身。然而,由于症状不具特异性且医疗专业人员经验不足,NET的诊断存在困难。开展这项回顾性研究是为了增进我们对NET的了解。这些知识可用于有限资源的优化利用和分配。

目的

研究澳大利亚地区和偏远地区晚期NET患者的临床特征、治疗及生存结果。

方法

我们回顾了1994年至2012年间所有被诊断为NET的成年患者。患者数据从汤斯维尔癌症中心的电子数据库中提取。偏远程度基于邮政编码,根据澳大利亚标准地理分类(ASGC)将患者分为北昆士兰地区或农村地区。使用生存分析研究总生存期。

结果

79例患者的数据纳入研究。诊断时的中位年龄为60岁。共有48例患者(60.8%)为男性,31例(39.2%)为女性。与居住在地区的患者(28例,36%)相比,大多数患者居住在农村地区(51例,64%)。在研究截止点时有34例死亡。农村地区NET患者的中位总生存期显著短于居住在地区的患者(分别为1613天和2935天),P = 0.03。

结论

偏远地区对NET患者的总生存期有不利影响。这一结果可能是由于获得医疗服务的机会不同和/或无法获得专业扫描以及医疗和外科专业知识。

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