Grover Surbhi, George Jessica, Tuli Shawna, Lichter Katie, Bhatia Rohini, Monare Barati, Chinniah Ganen, Bazzett-Matabele Lisa, Bvochora-Nsingo Memory, Chiyapo Sebathu, Balang Dawn, Ralefala Tlotlo, Vuylsteke Peter, Luckett Rebecca, Shin Sanghyuk, Zetola Nicola, Ramogola-Masire Doreen
Department of Radiation Oncology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, USA.
Botswana-University of Pennsylvania Partnership, Gaborone, Botswana.
Gynecol Oncol Rep. 2022 Oct 26;44:101094. doi: 10.1016/j.gore.2022.101094. eCollection 2022 Dec.
To present the stage distribution, patterns of care, and outcomes of patients from Botswana with invasive cervical cancer, living with or without HIV.
Between 2013 and 2020, women with cervical cancer were prospectively enrolled in an observational cohort study.
A total of 1,043 patients were enrolled; 69% were women living with HIV. The median age of the cohort was 47 years (interquartile range [IQR] 40-58 years), with women living with HIV presenting at a younger age compared to women without HIV (44 versus 61 years, p < 0.001). Among women living with HIV, the median CD4 count at the time of cancer diagnosis was 429.5 cells/μL (IQR 240-619.5 cells/μL), 13% had a detectable viral load, and 95% were on antiretroviral therapy. In regard to treatment, 6% (n = 58) underwent surgery, 33% (n = 341) received radiation therapy, 51% (n = 531) received chemoradiation, and 7% (n = 76) did not receive treatment. Stage distribution in the cohort was as follows: I 17% (n = 173), II 37% (n = 388), III 35% (n = 368), and IV 8% (n = 88). For all patients, 2-year OS was 67%. In multivariable Cox regression, worse OS was associated with stage: II (HR 1.91, p = 0.007), III (HR 3.99, p < 0.001), and IV (HR 5.06, p < 0.001) compared to stage I. Improved OS was associated with hemoglobin > 10 g/dL (HR 0.51, p < 0.001) compared to Hb ≤ 10 g/dL.
Among women in Botswana with cervical cancer, most patients presented with stage II or III disease warranting radiation therapy or chemoradiation. While two-thirds of cervical cancer patients were women living with HIV, HIV did not impact OS.
介绍博茨瓦纳侵袭性宫颈癌患者（无论是否感染艾滋病毒）的分期分布、治疗模式及治疗结果。
2013年至2020年期间，宫颈癌女性患者前瞻性纳入一项观察性队列研究。
共纳入1043例患者；69%为感染艾滋病毒的女性。队列的中位年龄为47岁（四分位间距[IQR]40 - 58岁），感染艾滋病毒的女性比未感染艾滋病毒的女性就诊时年龄更小（44岁对61岁，p < 0.001）。在感染艾滋病毒的女性中，癌症诊断时的中位CD4细胞计数为429.5个/μL（IQR 240 - 619.5个/μL），13%的患者病毒载量可检测到，95%的患者接受抗逆转录病毒治疗。在治疗方面，6%（n = 58）接受了手术，33%（n = 341）接受了放射治疗，51%（n = 531）接受了放化疗，7%（n = 76）未接受治疗。队列中的分期分布如下：I期17%（n = 173），II期37%（n = 388），III期35%（n = 368），IV期8%（n = 88）。所有患者的2年总生存率为67%。在多变量Cox回归分析中，与I期相比，II期（HR 1.91，p = 0.007）、III期（HR 3.99，p < 0.001）和IV期（HR 5.06，p < 0.001）的总生存率较差。与血红蛋白≤10 g/dL相比，血红蛋白>10 g/dL时总生存率提高（HR 0.51，p < 0.001）。
在博茨瓦纳宫颈癌女性患者中，大多数患者为II期或III期疾病，需要放射治疗或放化疗。虽然三分之二的宫颈癌患者为感染艾滋病毒的女性，但艾滋病毒并未影响总生存率。
