Anfinan Nisreen, Sait Khalid
From the Department of Obstetrics and Gynecology, King Abdulaziz University, Jeddah, Saudi Arabia.
Ann Saudi Med. 2020 Jan-Feb;40(1):25-35. doi: 10.5144/0256-4947.2020.25. Epub 2020 Feb 6.
Investigating survival in cervical cancer at the local level is crucial to determine the effectiveness of overall management, as it reflects the level of care provided and awareness among the population about screening and early diagnosis.
Analyze overall survival (OS) and disease-free survival (DFS) among patients treated for cervical cancer and to investigate clinical, management- and outcome-related independent factors associated with survival.
A retrospective medical record review.
Gynecology oncology unit in a tertiary care center.
All women with cervical cancer who were treated and followed up between January 1999 and December 2017. Baseline demographic and clinical data, tumor characteristics, treatment options and outcomes including recurrence were collected and analyzed as factors and predictors of survival.
OS and DFS among patients treated for cervical cancer.
190 patients.
The 190 patients had a mean (SD) age of 54.2 (13.1) years (median 52.0, interquartile range, 46-62), and median (IQR) follow-up time was 37.0 (12.0-69.0) months. Tumor characteristics showed FIGO stage (I [19.0%], II [48.9%], III [18.4%], IV [13.6%]), grade (I [15.8%], II [46.8%], III [35.8%]) and the most frequent histological type was squamous cell carcinoma (77.4%). Patients received initial radiotherapy with concurrent chemotherapy (53.2%), initial radical hysterectomy (24.7%), systemic chemotherapy (6.3%) and palliative care (4.7%). Mean OS and DFS were 97.1 (82.2, 111.9) and 85.2 (70.4, 100.0) months, respectively. Recurrence and mortality rates were 25.8% and 46.8%, occurring after a median (IQR) time=13.0 (6.0-28.0) and 20.0 (9.0-45.0) months, respectively. Survival was independently associated with grade II (hazard ratio [HR]=3.6, 95%CI: 1.3-9.7, P=.012), grade III (HR=4.5, 95%CI:1.6-12.6, P=.004), number of regional organs involved (1-3 organs: HR=7.8, 95%CI: 1.2, 49.1, P=.030), and recurrence (HR=2.23, P=.001).
Survival was about 8 years in our institution, which is predicted by the tumor grade, regional organs involved and recurrence. Remarkably, this study found a high percentage of patients diagnosed at an advanced stage, which probably impacts survival and stresses the need for improving early detection.
Retrospective design, resulting in recall bias and missing data.
None.
在地方层面调查宫颈癌患者的生存率对于确定整体治疗效果至关重要，因为它反映了所提供的医疗护理水平以及人群对筛查和早期诊断的认知程度。
分析宫颈癌患者的总生存期（OS）和无病生存期（DFS），并研究与生存相关的临床、治疗及预后相关的独立因素。
回顾性病历审查。
三级医疗中心的妇科肿瘤科。
收集1999年1月至2017年12月期间接受治疗并随访的所有宫颈癌女性患者的基线人口统计学和临床数据、肿瘤特征、治疗方案及包括复发在内的预后情况，并将其作为生存的因素和预测指标进行分析。
宫颈癌患者的总生存期和无病生存期。
190例患者。
190例患者的平均（标准差）年龄为54.2（13.1）岁（中位数52.0，四分位间距46 - 62），中位（四分位间距）随访时间为37.0（12.0 - 69.0）个月。肿瘤特征显示国际妇产科联盟（FIGO）分期（I期[19.0%]，II期[48.9%]，III期[18.4%]，IV期[13.6%]）、分级（I级[15.8%]）、II级[46.8%]，III级[35.8%]），最常见的组织学类型为鳞状细胞癌（77.4%）。患者接受的初始治疗包括同步放化疗（53.2%）、根治性子宫切除术（24.7%）、全身化疗（6.3%）和姑息治疗（4.7%）。平均总生存期和无病生存期分别为97.1（82.2，111.9）个月和85.2（70.4，100.0）个月。复发率和死亡率分别为25.8%和46.8%，中位（四分位间距）复发时间和死亡时间分别为13.0（6.0 - 28.0）个月和20.0（9.0 - 45.0）个月。生存与II级（风险比[HR]=3.6，95%置信区间：1.3 - 9.7，P = 0.012）、III级（HR = 4.5，95%置信区间：1.6 - 12.6，P = 0.004）、受累区域器官数量（1 - 3个器官：HR = 7.8，95%置信区间：1.2，49.1，P = 0.030）及复发（HR = 2.23，P = 0.001）独立相关。
在我们机构，患者生存期约为8年，可通过肿瘤分级、受累区域器官及复发情况进行预测。值得注意的是，本研究发现晚期诊断的患者比例较高，这可能影响生存，并强调了改善早期检测的必要性。
回顾性设计，存在回忆偏倚和数据缺失。
无。
