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洪都拉斯特古西加尔巴圣费利佩综合医院癌症患者从临床表现出现到接受治疗的时间间隔。

Time Intervals From Onset of Clinical Manifestations to Treatment in Patients With Cancer at Hospital General San Felipe, Tegucigalpa, Honduras.

作者信息

Sánchez José A, Handal Mayra G, Vílchez Rodriguez Juan F, Mejía Sinthia I, Pagoaga Annye P

机构信息

Universidad Nacional Autónoma de Honduras, Tegucigalpa, Honduras.

出版信息

J Glob Oncol. 2019 Jun;5:1-7. doi: 10.1200/JGO.19.00107.

Abstract

PURPOSE

In cancer, clinical staging is related to outcomes, and this is linked to the evolution of the disease over time. In Honduras, cancer mortality is high, and time intervals from onset of symptoms to treatment of cancer are not known. We conducted a cross-sectional study to determine these intervals.

PATIENTS AND METHODS

This investigation was carried out from April 25 to August 30, 2018, and included 202 patients at the main cancer referral center in Honduras. For the purposes of the study, information was obtained from patients, their caregiver, medical records, or treatment cards. Patients older than age 18 years were included after informed consent was signed.

RESULTS

The mean time interval from onset of symptoms to cancer treatment was 232 days. Different intervals of time were identified, and the mean of these intervals was calculated in days as follows: 68 days from onset of symptoms to first medical evaluation; 146 days from first evaluation to oncologist consultation; 26 days from cancer specialist to the pathology report; and 86 days from the histopathologic diagnosis to the beginning of treatment. Once diagnosis was established, the average elapsed times to chemotherapy, radiotherapy, surgery, and chemoradiotherapy were 88, 102, 76, and 154 days, respectively ( < .05, when surgery is compared against chemotherapy and radiotherapy).

CONCLUSION

The mean time interval from symptom presentation to treatment in patients with cancer is more than 7 months. This could explain the advanced stages of disease seen at the time of treatment in Honduras, which decrease chance of cure and increase the mortality rate of cancer). Appropriate intervention to decrease these intervals must be taken to reduce mortality.

摘要

目的

在癌症中,临床分期与预后相关,且这与疾病随时间的演变有关。在洪都拉斯,癌症死亡率很高,而从症状出现到癌症治疗的时间间隔尚不清楚。我们开展了一项横断面研究来确定这些时间间隔。

患者与方法

本调查于2018年4月25日至8月30日进行,纳入了洪都拉斯主要癌症转诊中心的202例患者。为进行本研究,从患者、其护理人员、病历或治疗卡中获取信息。年龄超过18岁的患者在签署知情同意书后纳入研究。

结果

从症状出现到癌症治疗的平均时间间隔为232天。确定了不同的时间间隔,并以天为单位计算这些间隔的平均值如下:从症状出现到首次医学评估为68天;从首次评估到肿瘤学家会诊为146天;从癌症专科医生到病理报告为26天;从组织病理学诊断到开始治疗为86天。一旦确诊,到化疗、放疗、手术和放化疗的平均 elapsed 时间分别为88天、102天、76天和154天(与化疗和放疗相比,手术时P < .05)。

结论

癌症患者从症状出现到治疗的平均时间间隔超过7个月。这可以解释在洪都拉斯治疗时所见到的疾病晚期情况,这降低了治愈机会并增加了癌症死亡率。必须采取适当干预措施来缩短这些时间间隔以降低死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/741e/6613713/4a31620e9810/JGO.19.00107f1.jpg

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