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伊朗西北部住院胰腺癌患者的生存及预后因素

Survival and prognostic factors among hospitalized pancreatic cancer patients in northwestern Iran.

作者信息

Vahedi Leila, Asvadi Kermani Touraj, Asghari-Jafarabadi Mohammad, Asghari Elham, Mohammadi Seyedeh Momeneh, Khameneh Amin

机构信息

Road Traffic Injury Research Center, Tabriz University of Medical Sciences, Tabriz, Iran.

General and Vascular Surgery_trauma Fellowship, Tabriz University of Medical Sciences, Tabriz, Iran.

出版信息

J Res Med Sci. 2023 Jan 31;28:4. doi: 10.4103/jrms.jrms_54_21. eCollection 2023.

Abstract

BACKGROUND

Pancreatic cancer (PC) is associated with a poor prognosis, with various modifiable risk factors affecting the survival of patients. Our aim was to evaluate the survival rate and the prognostic factors influencing survival in PC patients in northwestern Iran.

MATERIALS AND METHODS

All the PC patients admitted to the Imam Reza Hospital of Tabriz, Iran, from 2016 to 2020, were enrolled in this study. The survival rate and time were calculated, and the risk factors related to survival were evaluated by Cox regressions. The data were analyzed using the Cox proportional hazards model using STATA software.

RESULTS

Of 110 patients, 12-, 24-, 36-, and 48-month survival rates were 29.1%, 19.8%, 14.1%, and 8.5%, respectively, with the median survival time of seven months. The mean age was 65.5 years. The results showed that a higher age (hazard ratio [HR] [95% confidence interval (CI)] = 2.04 [1.20-3.46]), lower education (1.72 [1.03-2.89]), delayed diagnosis (1.03 [1.02-1.05]), hypertension (1.53 [1.01-2.31]), concomitant heart disorders (2.67 [1.50-4.74]), COPD (4.23 [1.01-17.69]), consanguineous marriage (1.59 [1.01-2.50]), and the presence of icterus complications (adjusted HR = 3.64 [1.56-8.49]) were directly associated with a worse survival. On the contrary, radiotherapy (0.10 [0.01-0.85]), chemotherapy (0.57 [0.36-0.89]), and surgical therapy (AHR = 0.48 [0.23-0.99]) were directly related to a good prognosis.

CONCLUSION

Surgery, chemotherapy, and radiotherapy were the best predictors of survival in PC patients. Moreover, it seems that resolving jaundice can improve survival in these patients. It seems that increasing social awareness, treating underlying diseases, and employing an appropriate therapeutic method may promise a better outlook, improve the survival rate of patients, and reduce PC risk.

摘要

背景

胰腺癌(PC)预后较差,有多种可改变的风险因素影响患者生存。我们的目的是评估伊朗西北部PC患者的生存率及影响生存的预后因素。

材料与方法

纳入2016年至2020年入住伊朗大不里士伊玛目礼萨医院的所有PC患者。计算生存率和生存时间,并通过Cox回归评估与生存相关的风险因素。使用STATA软件通过Cox比例风险模型分析数据。

结果

110例患者中,12个月、24个月、36个月和48个月生存率分别为29.1%、19.8%、14.1%和8.5%,中位生存时间为7个月。平均年龄为65.5岁。结果显示,年龄较大(风险比[HR][95%置信区间(CI)]=2.04[1.20 - 3.46])、教育程度较低(1.72[1.03 - 2.89])、诊断延迟(1.03[1.02 - 1.05])、高血压(1.53[1.01 - 2.31])、合并心脏疾病(2.67[1.50 - 4.74])、慢性阻塞性肺疾病(COPD)(4.23[1.01 - 17.69])、近亲结婚(1.59[1.01 - 2.50])以及存在黄疸并发症(调整后HR = 3.64[1.56 - 8.49])与较差的生存直接相关。相反,放疗(0.10[0.01 - 0.85])、化疗(0.57[0.36 - 0.89])和手术治疗(调整后HR = 0.48[0.23 - 0.99])与良好预后直接相关。

结论

手术、化疗和放疗是PC患者生存情况的最佳预测因素。此外,似乎解决黄疸问题可改善这些患者的生存。似乎提高社会意识、治疗基础疾病并采用适当的治疗方法可能带来更好的前景,提高患者生存率并降低PC风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/f31a/10039100/ef3200853ace/JRMS-28-4-g001.jpg

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