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印度尼西亚女性非小细胞肺癌:一项回顾性队列研究

Non-Small Cell Lung Carcinoma in Women: A Retrospective Cohort Study in Indonesia.

作者信息

Sutandyo Noorwati, Suratman Eddy

机构信息

Division of Hematology and Medical Oncology, Dept. of Internal Medicine, Dharmais Cancer Hospital, Jakarta, Indonesia.

出版信息

Acta Med Indones. 2018 Oct;50(4):291-298.

Abstract

BACKGROUND

the increasing incidence of lung cancer in female patients has been observed in Indonesia. Lung cancer in female might have different biology process than male, but it has never been evaluated in Indonesia. This study aimed to know characteristics and survival of female patients with non-small-cell lung carcinoma (NSCLC) in Dharmais National Cancer Centre Hospital.

METHODS

a retrospective cohort study was performed among NSCLC female patients in Dharmais Cancer Hospital (DCH) between January 2005 and December 2015. Survival analysis was done using the Kaplan-Meir estimation curve with proportional assumption test. Independent prognostic factors were analyzed using the Cox proportional hazard model with a hazard ratio (HR) and its 95% confidence interval (CI).

RESULTS

a total of 956 NSCLC cases were retrieved during the study; 268 (28.0%) were female patients. Mean of age in female patients was 56.9 (11.87) years old. Among female patients, 21 (7.8%) were smokers, 244 (91.1%) had adenocarcinoma subtype, and 261 (98.0%) were in advanced stage (III-IV). Median survival was slightly longer in female than male patients (14.9 months vs. 12.2 months; log-rank p=0.055). Significant prognostic factors for survival were older age (>50 y.o) (HR = 0.681; 95% CI = 0.467 - 0.992; p= 0.045) and positive eGFR mutation (HR = 0.393; 95% CI = 0.251 - 0.615; p<0.001).

CONCLUSION

female patients contributed to about 28% of all NSCLC cases. They were mostly non-smokers, have more adenocarcinoma histopathology and eGFR mutation. Survival tended to be longer in female than male patients. Age over 50 years and the presence of eGFR mutation were good prognostic factors to survival in female lung cancer patients.

摘要

背景

在印度尼西亚,女性肺癌的发病率呈上升趋势。女性肺癌的生物学过程可能与男性不同,但在印度尼西亚尚未对此进行评估。本研究旨在了解达玛伊斯国家癌症中心医院非小细胞肺癌(NSCLC)女性患者的特征和生存率。

方法

对2005年1月至2015年12月期间在达玛伊斯癌症医院(DCH)的NSCLC女性患者进行回顾性队列研究。生存分析采用Kaplan-Meir估计曲线和比例假设检验。使用Cox比例风险模型分析独立预后因素,得出风险比(HR)及其95%置信区间(CI)。

结果

研究期间共检索到956例NSCLC病例;其中268例(28.0%)为女性患者。女性患者的平均年龄为56.9(11.87)岁。在女性患者中,21例(7.8%)为吸烟者,244例(91.1%)为腺癌亚型,261例(98.0%)处于晚期(III-IV期)。女性患者的中位生存期略长于男性患者(14.9个月对12.2个月;对数秩检验p=0.055)。生存的显著预后因素为年龄较大(>50岁)(HR = 0.681;95% CI = 0.467 - 0.992;p = 0.045)和eGFR突变阳性(HR = 0.393;95% CI = 0.251 - 0.615;p<0.001)。

结论

女性患者约占所有NSCLC病例的28%。她们大多不吸烟,腺癌组织病理学和eGFR突变较多。女性患者的生存期往往比男性患者长。50岁以上和存在eGFR突变是女性肺癌患者生存的良好预后因素。

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