Fentaw Seid, Godana Anteneh Asmare, Abathun Dawit, Chekole Dessie Melese
Department of Statistics, College of Natural and Computational Sciences, Wollo University, Dessie, Ethiopia.
Department of Statistics, College of Natural and Computational Sciences, University of Gondar, Gondar, Ethiopia.
Breast Cancer (Dove Med Press). 2024 May 29;16:269-287. doi: 10.2147/BCTT.S447684. eCollection 2024.
One in five people will eventually develop cancer, and one in eleven women will lose their lives to the disease. The main aim of this study is to determinants of survival time of women with breast cancer using appropriate Frailty models.
A study involving 632 Ethiopian women with breast cancer was conducted between 2018 and 2020, utilizing medical records from Felege-Hiwot Referral Hospital, the University of Gondar, and Dessie Referral Hospital. To compare survival, the Kaplan-Meier plot (s) and Log rank test were employed; to assess mean survival, one-way analysis of variance and the test were utilized. The factors influencing women's survival times from breast cancer were identified using the parametric shared frailty model and the accelerated failure time model.
The median time to die for breast cancer patients treated at FHRH, UoGCSH, and DRH was 14.91 months, 11.14 months, and 12.32 months, respectively. The parametric model of shared frailty fit those who were statistically significant in univariate analysis. The results showed that survival of women with breast cancer was significantly influenced by age, tumor size, comorbidity, nodal status, stage, histologic grade, and type of primary treatment initiated. When comparing mean survival times between hospitals, the results showed a significant difference; patients who were treated in FHRH live significantly longer than patients treated in UoGCSH and DRH, whereas patients treated in UoGCSH have comparatively lower survival. Women with stage IV and comorbidities have 22.4% and 27.1% shorter expected survival, respectively.
This finding suggests that improving the availability and accessibility of radiation therapy and surgery, eliminating disparities between hospitals, raising awareness of early signs and symptoms of breast cancer and encouraging women to seek clinical help, and highlighting women with comorbidities at diagnosis are important ways to increase survival time.
五分之一的人最终会患上癌症，十一分之一的女性会死于该疾病。本研究的主要目的是使用适当的脆弱模型来确定乳腺癌女性患者生存时间的决定因素。
2018年至2020年期间，对632名埃塞俄比亚乳腺癌女性患者进行了一项研究，利用了贡德尔大学费莱格 - 希沃特转诊医院和德西转诊医院的病历。为了比较生存率，采用了Kaplan - Meier曲线和对数秩检验；为了评估平均生存时间，使用了单因素方差分析和检验。使用参数共享脆弱模型和加速失效时间模型确定影响乳腺癌女性患者生存时间的因素。
在费莱格 - 希沃特转诊医院、贡德尔大学综合医院和德西转诊医院接受治疗的乳腺癌患者的中位死亡时间分别为14.91个月、11.14个月和12.32个月。共享脆弱的参数模型适用于单因素分析中具有统计学意义的患者。结果表明，乳腺癌女性患者的生存受到年龄、肿瘤大小、合并症、淋巴结状态、分期、组织学分级和初始主要治疗类型的显著影响。比较各医院之间的平均生存时间时，结果显示存在显著差异；在费莱格 - 希沃特转诊医院接受治疗的患者比在贡德尔大学综合医院和德西转诊医院接受治疗的患者存活时间显著更长，而在贡德尔大学综合医院接受治疗的患者生存率相对较低。IV期和合并症女性患者的预期生存时间分别缩短22.4%和27.1%。
这一发现表明，提高放射治疗和手术的可及性、消除医院之间的差异、提高对乳腺癌早期症状和体征的认识并鼓励女性寻求临床帮助，以及在诊断时关注合并症女性患者，是增加生存时间的重要途径。
