Del Castillo Sm César, Cabrera C M Elena, Derio P Lea, Gaete V Fancy, Cavada Ch Gabriel
Servicio de Oncología, Hospital San Borja Arriarán, Santiago, Chile.
Ministerio de Salud, Santiago, Chile.
Rev Med Chil. 2017 Dec;145(12):1507-1513. doi: 10.4067/s0034-98872017001201507.
Background Breast cancer is the most common malignant tumor in women in the world. In 2005, it was incorporated to the Explicit Guaranties Health System (GES) in Chile. Aim To describe the demographic and clinical characteristics of breast cancer patients and to determine the effect of incorporating these women to GES. Material and Methods Medical records of 5,119 women with breast cancer aged 59 ± 14 years, attended at six public hospitals between 2000 and 2010 were reviewed. Median follow up was 87 months (range 1-182). Mortality was assessed using death certificates obtained at the National Identification Registry. Results Sixty six percent of women were in stage I-II, 29% in stage III and 5% in stage IV. Surgery was performed in 4023/5119 cases (79%), adyuvant radiotherapy in 3627/4517 cases (80%), chemotherapy in 3,204/3,424 cases (94%) and hormone therapy in 1,695/2,375 cases (71%). Between 2000 and 2010, there was a significant increase in the proportion of cases in stage I, from 8% to 25%, (p < 0.01). Overall survival (OS) increased 1% per year, since the beginning of GES system (p = 0.024). Five year OS was 75.1%. The figures for Stage I, II, III and IV were 93, 84, 62 and 27% respectively (p < 0.01). Patients without lymph node involvement and who were not triple negative, had a significantly better OS. Conclusions There was a significant increase in stage I cases, and a 1% per year OS improvement after GES system started, compared with the previous period.
乳腺癌是全球女性中最常见的恶性肿瘤。2005年，智利将其纳入明确保障卫生系统（GES）。目的：描述乳腺癌患者的人口统计学和临床特征，并确定将这些女性纳入GES的效果。材料与方法：回顾了2000年至2010年间在六家公立医院就诊的5119例年龄为59±14岁的乳腺癌女性患者的病历。中位随访时间为87个月（范围1 - 182个月）。使用在国家身份登记处获得的死亡证明评估死亡率。结果：66%的女性处于I - II期，29%处于III期，5%处于IV期。4023/5119例（79%）进行了手术，3627/4517例（80%）进行了辅助放疗，3204/3424例（94%）进行了化疗，1695/2375例（71%）进行了激素治疗。2000年至2010年间，I期病例的比例从8%显著增加到25%（p < 0.01）。自GES系统启动以来，总生存率（OS）每年提高1%（p = 0.024）。五年OS为75.1%。I、II、III和IV期的数字分别为93%、84%、62%和27%（p < 0.01）。无淋巴结受累且非三阴性的患者OS明显更好。结论：与前一时期相比，I期病例显著增加，GES系统启动后OS每年提高1%。
