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阿联酋宫颈癌患者的临床结局与治疗效果:一项回顾性队列研究

Clinical Outcomes and Treatment Efficacy in Cervical Cancer Patients in the UAE: A Retrospective Cohort Study.

作者信息

Balaraj Khalid, Roy Shilpi, Shanbhag Nandan M, Hasnain Syed Mansoor, El-Koha Omran, AlKaabi Khalifa, Hassan Thikra A, Ansari Jawaher, Nasim Muhammad Y, Dawoud Emad A, Bin Sumaida Abdulrahman

机构信息

Radiation Oncology, Tawam Hospital, Al Ain, ARE.

College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE.

出版信息

Cureus. 2024 Jul 12;16(7):e64422. doi: 10.7759/cureus.64422. eCollection 2024 Jul.

Abstract

Background and objectives Cervical cancer remains a significant global health issue, particularly in low- and middle-income countries. While high-income countries have seen reduced incidence and mortality rates due to effective screening and HPV vaccination programs, these rates are still high in areas with limited healthcare infrastructure. In the United Arab Emirates (UAE), recent efforts are improving public health initiatives and awareness. This retrospective cohort study evaluates clinical outcomes and treatment efficacy in cervical cancer patients at a tertiary cancer center in Al Ain, Abu Dhabi. It analyzes treatment regimens, their effectiveness, and factors affecting survival, disease progression, and treatment completion. Methods and material The study included 275 cervical cancer patients treated between January 2008 and December 2021. Data were extracted from medical records, including demographic information, clinical characteristics, and treatment details. Statistical analyses, including Kaplan-Meier survival curves and Cramér's V correlation matrix, were used to evaluate survival outcomes and the relationships between various categorical variables. Results The mean age of patients was 48.88 years, with the majority being non-nationals, 221 (80.37%). Histopathologically, there were 234 (85.18%) cases of squamous cell carcinoma (SCC) and 33 (11.85%) cases of adenocarcinomas. The International Federation of Gynecology and Obstetrics (FIGO) staging indicated that 137 (49.80%) patients were in stage II and 60 (21.81%) were in stage III. Pelvic lymph node involvement was observed in 139 (50.54%) patients. The treatment modalities included surgery in 39 (14.18%) patients, 3D conformal radiotherapy (3D-CRT) in 247 (89.81%) patients, intensity-modulated radiation therapy (IMRT) in 11 (4.00%) patients, brachytherapy in 213 (77.45%) patients, and chemotherapy in 248 (90.18%) patients. The survival analysis showed no significant differences in survival among different treatment groups, as indicated by the Log-rank test (p = 0.4060). Conclusion The study highlights the demographic and clinical characteristics of cervical cancer patients in the UAE, emphasizing the prevalence of advanced-stage diagnoses and high-grade tumors. Despite significant efforts to improve screening and treatment, cervical cancer remains a concern in the UAE. The findings underscore the need for enhanced early detection and comprehensive treatment strategies. Addressing the study's limitations, such as the retrospective design and the absence of human papillomavirus (HPV) data, could further refine cervical cancer management and improve patient outcomes in future research.

摘要

背景与目的 宫颈癌仍然是一个重大的全球健康问题,尤其是在低收入和中等收入国家。虽然高收入国家由于有效的筛查和人乳头瘤病毒(HPV)疫苗接种计划,发病率和死亡率有所下降,但在医疗基础设施有限的地区,这些比率仍然很高。在阿拉伯联合酋长国(阿联酋),最近正在努力改善公共卫生举措和提高公众意识。这项回顾性队列研究评估了位于阿布扎比艾因的一家三级癌症中心的宫颈癌患者的临床结局和治疗效果。它分析了治疗方案、其有效性以及影响生存、疾病进展和治疗完成的因素。

方法与材料 该研究纳入了2008年1月至2021年12月期间接受治疗的275例宫颈癌患者。数据从医疗记录中提取,包括人口统计学信息、临床特征和治疗细节。使用统计分析,包括Kaplan-Meier生存曲线和Cramér's V相关矩阵,来评估生存结局以及各种分类变量之间的关系。

结果 患者的平均年龄为48.88岁,大多数为非本国居民,共221例(80.37%)。组织病理学上,有234例(85.18%)为鳞状细胞癌(SCC),33例(11.85%)为腺癌。国际妇产科联合会(FIGO)分期表明,137例(49.80%)患者处于II期,60例(21.81%)处于III期。139例(50.54%)患者观察到盆腔淋巴结受累。治疗方式包括39例(14.18%)患者接受手术,247例(89.81%)患者接受三维适形放疗(3D-CRT),11例(4.00%)患者接受调强放射治疗(IMRT),213例(77.45%)患者接受近距离放疗,248例(90.18%)患者接受化疗。生存分析显示,不同治疗组之间的生存无显著差异,对数秩检验表明(p = 0.4060)。

结论 该研究突出了阿联酋宫颈癌患者的人口统计学和临床特征,强调了晚期诊断和高级别肿瘤的普遍性。尽管在改善筛查和治疗方面做出了重大努力,但宫颈癌在阿联酋仍然是一个令人担忧的问题。研究结果强调了加强早期检测和综合治疗策略的必要性。解决该研究的局限性,如回顾性设计和缺乏人乳头瘤病毒(HPV)数据,可能会在未来研究中进一步优化宫颈癌管理并改善患者结局。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/bc34/11317079/ca1b01324d19/cureus-0016-00000064422-i01.jpg

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