Choudhary Akansha, Jacob Linu A, Babu Suresh, K N Lokesh, A H Rudresha, L K Rajeev, Saldanha Smitha, Begum Tarjina
Medical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, IND.
Cureus. 2024 Mar 16;16(3):e56296. doi: 10.7759/cureus.56296. eCollection 2024 Mar.
Considerable advances in the diagnosis and treatment of cancer have made a huge impact on morbidity and mortality from neoplastic diseases. However, cancer remains the leading cause of death across the world. This is a retrospective study carried out at a tertiary cancer care centre (Kidwai Memorial Institute of Oncology, Bangalore) in South India. Case records of all cancer patients who died while receiving inpatient treatment between January 2022 and December 2022 under the Department of Medical Oncology were reviewed and studied. There was a total of 240 deaths. Out of these, the majority of deaths 147 (61.25%) were patients with haematological malignancies while the remaining 93 (38.75%) were patients with solid tumours. In patients with solid tumours, the majority 49 (52.7%) were in the age group of 40 to 60 years while only 18 (19.35%) patients were less than 40 years. The majority of patients were male sex i.e. 55(59.1%) and undergoing treatment with palliative intent 81 (87%). The most common organ was the lung in 21 patients (22.6%) followed by the breast while the most common system involved was the gastrointestinal tract in 28 (30.1%) patients. The most frequent cause of death was progressive disease in 72 (77.4%) while sepsis (11 patients; 11.8%) was the second most frequent cause of death in solid tumours. In haematological malignancies, also a significant number of 57 (38.8%) patients were in the age group of 40 to 60 years. Fifty-two (35.3%) patients were in the age group of 22 to 40 years. The majority were male sex (79 patients; 53.7%). About the phase of treatment, the majority of deaths 45 (30.6%) were during induction and under evaluation. Those with relapse/refractory disease were 38 (25.9%). A substantial number of patients had acute myeloid leukaemia 47 (32%) and five (3.4%) deaths were acute promyelocytic leukaemia patients. Twenty-three patients (15.6%) had acute lymphoblastic leukaemia. The most common cause of death was sepsis in 76 patients (51.7%) while intracranial bleeding was in 34 patients (23.1%). In some patients, there were multiple causes leading to death. Mortality audits are important to evaluate the services being provided at any centre. One can appreciate the lacunae in handling a particular disease or flaws in a treatment protocol or the staff delivering the treatment. Sepsis is the leading cause of death in patients with haematological malignancy; even in solid malignancy sepsis accounts for a substantial proportion of deaths and should be handled aggressively to save lives.
癌症诊断和治疗方面的重大进展对肿瘤疾病的发病率和死亡率产生了巨大影响。然而，癌症仍然是全球主要的死亡原因。这是一项在印度南部一家三级癌症护理中心（班加罗尔基德瓦伊纪念肿瘤研究所）开展的回顾性研究。对2022年1月至2022年12月期间在医学肿瘤学部门接受住院治疗期间死亡的所有癌症患者的病例记录进行了审查和研究。共有240例死亡病例。其中，大多数死亡病例147例（61.25%）为血液系统恶性肿瘤患者，其余93例（38.75%）为实体瘤患者。在实体瘤患者中，大多数49例（52.7%）年龄在40至60岁之间，而只有18例（19.35%）患者年龄小于40岁。大多数患者为男性，即55例（59.1%），且81例（87%）患者接受的是姑息性治疗。最常见的受累器官是肺，有21例患者（22.6%），其次是乳腺，而最常受累的系统是胃肠道，有28例患者（30.1%）。最常见的死亡原因是疾病进展，有72例（77.4%），而脓毒症（11例患者；11.8%）是实体瘤患者中第二常见的死亡原因。在血液系统恶性肿瘤患者中，也有相当数量的57例（38.8%）患者年龄在40至60岁之间。52例（35.3%）患者年龄在22至40岁之间。大多数为男性（79例患者；53.7%）。关于治疗阶段，大多数死亡病例45例（30.6%）发生在诱导治疗期间且正在评估中。复发/难治性疾病患者有38例（25.9%）。相当数量的患者患有急性髓系白血病47例（32%），5例（3.4%）死亡患者为急性早幼粒细胞白血病患者。23例患者（15.6%）患有急性淋巴细胞白血病。最常见的死亡原因是脓毒症，有76例患者（51.7%），而颅内出血有34例患者（23.1%）。在一些患者中，有多种原因导致死亡。死亡率审计对于评估任何中心提供的服务很重要。人们可以认识到在处理特定疾病方面的缺陷、治疗方案中的不足或提供治疗的工作人员的缺陷。脓毒症是血液系统恶性肿瘤患者的主要死亡原因；即使在实体恶性肿瘤中，脓毒症也占死亡病例的很大比例，应积极处理以挽救生命。
