Division of Public Health, Department of Family and Preventive Medicine, University of Utah School of Medicine, and Huntsman Cancer Institute, Salt Lake City, UT, United States of America.
Intermountain Healthcare, Salt Lake City, UT, United States of America.
Gynecol Oncol. 2020 May;157(2):529-535. doi: 10.1016/j.ygyno.2020.02.028. Epub 2020 Feb 29.
While genitourinary complications during treatment for ovarian cancer are well-known, long-term adverse outcomes have not been well characterized. The number of ovarian cancer survivors has been increasing. The aim of this study was to investigate long-term adverse genitourinary outcomes in a population-based cohort.
We identified a cohort of 1270 ovarian cancer survivors diagnosed between 1996 and 2012 from the Utah Cancer Registry, and 5286 cancer-free women were matched on birth year and state from the Utah Population Database. Genitourinary disease diagnoses were identified through ICD-9 codes from electronic medical records and statewide healthcare facilities data. Cox proportional hazards models were used to estimate hazard ratios (HR) for genitourinary outcomes at 1 to <5 years and 5+ years after ovarian cancer diagnosis.
Ovarian cancer survivors had increased risks for urinary system disorders (HR: 2.53, 95% CI: 2.12-3.01) and genital organ disorders (HR: 1.88, 95% CI: 1.57-2.27) between 1 and <5 years after cancer diagnosis compared to the general population cohort. Increased risks were observed for acute renal failure, chronic kidney disease, calculus of kidney, hydronephrosis, pelvic peritoneal adhesions, and pelvic organ inflammatory conditions. Increased risks of several of these diseases were observed 5+ years after cancer diagnosis.
Ovarian cancer survivors experience increased risks of various genitourinary diseases compared to women in the general population in the long-term. Understanding the multimorbidity trajectory among ovarian cancer survivors is important to improve clinical care after cancer treatment is completed.
虽然在治疗卵巢癌期间发生泌尿生殖系统并发症是众所周知的,但长期不良后果尚未得到很好的描述。卵巢癌幸存者的数量一直在增加。本研究旨在调查基于人群的队列中长期不良泌尿生殖系统结局。
我们从犹他州癌症登记处确定了 1996 年至 2012 年间诊断出的 1270 名卵巢癌幸存者队列,并从犹他州人口数据库中按出生年份和州匹配了 5286 名无癌症女性。泌尿生殖系统疾病的诊断是通过电子病历和全州医疗保健设施数据中的 ICD-9 代码确定的。Cox 比例风险模型用于估计卵巢癌诊断后 1 至 <5 年和 5 年以上发生泌尿生殖系统结局的风险比 (HR)。
与普通人群队列相比,卵巢癌幸存者在癌症诊断后 1 至 <5 年内发生泌尿系统疾病(HR:2.53,95%CI:2.12-3.01)和生殖器官疾病(HR:1.88,95%CI:1.57-2.27)的风险增加。观察到急性肾衰竭、慢性肾脏病、肾结石、肾积水、盆腔腹膜粘连和盆腔器官炎症性疾病的风险增加。在癌症诊断 5 年以上后,观察到这些疾病中的几种疾病的风险增加。
与普通人群中的女性相比,卵巢癌幸存者在长期内经历各种泌尿生殖系统疾病的风险增加。了解卵巢癌幸存者的多种合并症轨迹对于癌症治疗完成后改善临床护理非常重要。