Muddather Hiba Faroug, Faggad Areeg, Elhassan Moawia Mohammed Ali
Department of Clinical Pharmacy and Pharmacy Practice, Faculty of Pharmacy, University of Gezira, Wad Medani, Sudan.
Department of Molecular Biology, National Cancer Institute - University of Gezira (NCI-UG), Wad Medani, Sudan.
Glob Epidemiol. 2022 Sep 8;4:100082. doi: 10.1016/j.gloepi.2022.100082. eCollection 2022 Dec.
Breast cancer (BC) is the most frequently diagnosed cancer and a major cause of cancer mortality in Sudan. However, there is lack of data related to BC relapse. Therefore, this study was undertaken to estimate the 5-year relapse free survival (RFS) rate and factors related to BC relapse in Sudanese women with non-metastatic BC.
Data of BC women with BC diagnosed and treated at the National Cancer Institute-University of Gezira during 2012 were retrieved from medical records. The cases were followed-up through hospital records and telephone contact. Survival functions were calculated using Kaplan-Meier method and compared by log-rank test. The prognostic factors were tested using univariate and multivariable Cox regression analyses.
We included 168 women with median age of 45 years (range, 22-83 years). 53.5%of women had stage III at time of diagnosis, whereas 4.2% and 42.3% of women presented with stage I and stage II, respectively. At the end of 5 years follow-up, with median follow-up period of 64 months, 94 (56.0%) women were alive in remission, 11 (6.5%) were alive with BC relapse, 49 (29.2%) were dead, and survival status was unknown in 14 (8.3%) women. Most of the occurred relapses were distant relapses. The 5-year RFS was 59%. The independent predictors of relapse were: larger primary tumor size (HR:1.84, 95% CI: 1.54-5.48, p=0.018); involved axillary lymph nodes with tumour (HR: 2.91, 95% CI: 1.53-7.91, p=0.001); not receiving adjuvant radiotherapy (HR: 2.2, 95% CI: 1.22-3.95, p=0.009); and not receiving hormone therapy (HR: 1.67, 95% CI: 1.01-2.76, p= 0.046).
We found a high risk of BC relapse in our resource-constrained settings. Advanced stages, not receiving adjuvant radiotherapy, and not receiving adjuvant hormone therapy were independent predictors associated with worse 5-year RFS. Therefore, enhancing the early diagnosis of BC and improving timely access to appropriate treatments represent key approaches to achieving better treatment outcomes.
乳腺癌（BC）是苏丹最常被诊断出的癌症，也是癌症死亡的主要原因。然而，缺乏与BC复发相关的数据。因此，本研究旨在评估苏丹非转移性BC女性的5年无复发生存率（RFS）以及与BC复发相关的因素。
从病历中检索2012年在杰济拉大学国家癌症研究所诊断和治疗的BC女性的数据。通过医院记录和电话联系对病例进行随访。使用Kaplan-Meier方法计算生存函数，并通过对数秩检验进行比较。使用单变量和多变量Cox回归分析来检验预后因素。
我们纳入了168名女性，中位年龄为45岁（范围22-83岁）。53.5%的女性在诊断时为III期，而分别有4.2%和42.3%的女性为I期和II期。在5年随访结束时，中位随访期为64个月，94名（56.0%）女性处于缓解期存活，11名（6.5%）女性BC复发存活，49名（29.2%）女性死亡，14名（8.3%）女性的生存状况未知。大多数复发为远处复发。5年RFS为59%。复发的独立预测因素为：原发肿瘤较大（HR：1.84，95%CI：1.54-5.48，p=0.018）；腋窝淋巴结有肿瘤累及（HR：2.91，95%CI：1.53-7.91，p=0.001）；未接受辅助放疗（HR：2.2，95%CI：1.22-3.95，p=0.009）；未接受激素治疗（HR：1.67，95%CI：1.01-2.76，p=0.046）。
我们发现在我们资源有限的环境中BC复发风险很高。晚期、未接受辅助放疗以及未接受辅助激素治疗是与较差的5年RFS相关的独立预测因素。因此，加强BC的早期诊断并改善及时获得适当治疗的机会是实现更好治疗效果的关键途径。
