Zamorano Abigail S, Barnoya Joaquin, Gharzouzi Eduardo, Chrisman Robbins Camaryn, Orozco Emperatriz, Polo Guerra Sarita, Mutch David G
Washington University School of Medicine, St Louis, MO.
Unidad de Cirugía Cardiovascular de Guatemala, Guatemala City, Guatemala.
J Glob Oncol. 2019 May;5:1-5. doi: 10.1200/JGO.18.00243.
Despite being the only hospital to provide comprehensive cervical cancer treatment to many medically underserved Guatemalan women, no assessment of the cervical cancer patient population at the Guatemala Cancer Institute has been performed. To understand the demographics of the patient population, their treatment outcomes, and access to care, we sought to assess treatment compliance of patients with cervical cancer at the Guatemala Cancer Institute and its effects on patient outcomes.
A retrospective chart review was conducted of patients with cervical cancer between 2005 and 2007 and assessed for follow-up through December 2015. Demographics and clinical characteristics were tabulated. A Kaplan-Meier curve to model compliance was generated.
Ninety-two patients with invasive cancer were analyzed. Most presented with squamous cell carcinoma (73%) and at locally advanced stages (IIB, 51%; IIIB, 33%). Most (75 of 92, 81.5%) initiated treatment after diagnosis, but 18.5% (17 of 92) were lost to follow-up before treatment initiation. For treatment, 97% received external beam radiation, 84% brachytherapy, and 4% concomitant chemotherapy. Nearly 20% of patients were lost to follow-up in the first 6 months and 65% in the first 5 years. Of the 67 patients who completed treatment, only 15 (16% of the initial cohort) were diagnosed with a recurrence. No deaths were recorded.
The low recurrence rate and no documented deaths suggest a correlation with the low compliance rate and poor follow-up. This finding highlights the need to examine more fully the barriers to compliance and access to care among this population to optimize the treatment of cervical cancer.
尽管危地马拉癌症研究所是唯一一家为许多医疗服务不足的危地马拉妇女提供全面宫颈癌治疗的医院，但尚未对该研究所的宫颈癌患者群体进行评估。为了解患者群体的人口统计学特征、治疗结果以及获得医疗服务的情况，我们试图评估危地马拉癌症研究所宫颈癌患者的治疗依从性及其对患者预后的影响。
对2005年至2007年期间的宫颈癌患者进行回顾性病历审查，并评估至2015年12月的随访情况。将人口统计学和临床特征制成表格。生成了用于模拟依从性的Kaplan-Meier曲线。
分析了92例浸润性癌患者。大多数患者为鳞状细胞癌（73%），且处于局部晚期（IIB期，51%；IIIB期，33%）。大多数（92例中的75例，81.5%）在诊断后开始治疗，但18.5%（92例中的17例）在开始治疗前失访。在治疗方面，97%接受了外照射放疗，84%接受了近距离放疗，4%接受了同步化疗。近20%的患者在最初6个月失访，65%在最初5年失访。在完成治疗的67例患者中，只有15例（占初始队列的16%）被诊断为复发。无死亡记录。
低复发率和无死亡记录表明与低依从率和随访不佳有关。这一发现凸显了需要更全面地研究该人群中依从性和获得医疗服务的障碍，以优化宫颈癌的治疗。
