Ibrahim E M, al-Mulhim F A, al-Amri A, al-Muhanna F A, Ezzat A A, Stuart R K, Ajarim D
College of Medicine and Medical Sciences, King Faisal University, Riyadh, Saudi Arabia.
Med Oncol. 1998 Dec;15(4):241-7. doi: 10.1007/BF02787207.
In the Kingdom of Saudi Arabia (KSA), hospital and population based statistics have shown that breast cancer has the highest crude frequency rate among Saudi women. The scarcity of reports about the disease in the KSA has been the impetus to this analysis about breast cancer in the eastern province of KSA. Data on female patients with invasive breast carcinoma seen at King Fahd Hospital of the University in the eastern province of KSA, were retrospectively reviewed. The analysis intended to examine the pattern of the disease and the outcome for patients. Between 1985 and 1995, 292 patients were identified. Their median age +/- SD (standard deviation) was 42 +/- 10.5 years. Most patients were younger than 50 years (78%) and were predominantly premenopausals (79%). Only 25 (9%) of patients had stage I cancer, whilst 130 (44%), 90 (30%), and 47 (16%) had stage II, III, and IV, respectively. Among patients with known axillary nodal status (242 patients), only 37% were node-negative whilst 32% and 31% had 1-3, and > or = 4 positive nodes, respectively. Adjuvant chemotherapy and tamoxifen were commonly offered; nonetheless, other adjuvant modalities were rarely utilised. The median follow-up +/- SD of all patients was 62.3 +/- 8.9 months: 152 patients (52%) were alive with no evidence of disease, 25 (9%) were alive with evidence of disease, and 115 (39%) were dead from breast cancer or its related complications. The median survival of the entire group was not obtained, but the 10-year projected survival was 55%. For stage I and II patients, 118 (76%) were alive with a projected 10-year actuarial survival of 64%. On the other hand, only 51 (57%) of patients with stage III disease were alive with a median survival of 41.5 months (95% Confidence interval (CI), 18.9 to 51.3). Patients with stage IV disease demonstrated a poor outcome with a median survival of 23.5 (95%, CI 12.2 to 31.4). Multivariate analyses were performed to explore the influence of independent variables on overall survival (OS) for patients with non-metastatic disease. Besides the expected adverse effect of disease progression, the favourable influence of adjuvant chemotherapy and tamoxifen prevailed. The amount of benefit gained from tamoxifen, however, was small. Similar analyses were undertaken to determine the influence of independent variables on progression-free survival (PFS). These analyses ascertained the adverse effects of advanced stage and the favourable impact of adjuvant chemotherapy. Breast cancer in the KSA has features that are distinctive from those of industrialised countries. Survival data, however, were comparable. The favourable influence of adjuvant chemotherapy was evident on both OS and PFS. Adjuvant tamoxifen, however, had little effect. Due to its infrequent use, the role of other adjuvant modalities could not be asserted.
在沙特阿拉伯王国（KSA），基于医院和人群的统计数据显示，乳腺癌在沙特女性中的粗发病率最高。沙特阿拉伯关于该疾病的报告稀缺，这推动了对沙特阿拉伯东部省份乳腺癌的这一分析。对沙特阿拉伯东部省份法赫德国王大学医院收治的浸润性乳腺癌女性患者的数据进行了回顾性研究。该分析旨在研究疾病模式及患者的预后情况。1985年至1995年期间，共确定了292例患者。她们的年龄中位数±标准差（SD）为42±10.5岁。大多数患者年龄小于50岁（78%），且主要为绝经前患者（79%）。仅25例（9%）患者为Ⅰ期癌症，而130例（44%）、90例（30%）和47例（16%）分别为Ⅱ期、Ⅲ期和Ⅳ期。在已知腋窝淋巴结状态的患者中（242例），仅37%为淋巴结阴性，而32%和31%分别有1 - 3个及≥4个阳性淋巴结。辅助化疗和他莫昔芬是常用的治疗方法；然而，其他辅助治疗方式很少使用。所有患者的随访时间中位数±标准差为62.3±8.9个月：152例患者（52%）存活且无疾病证据，25例（9%）存活但有疾病证据，115例（39%）死于乳腺癌或其相关并发症。未得出整个组的中位生存期，但预计10年生存率为55%。对于Ⅰ期和Ⅱ期患者，118例（76%）存活，预计10年精算生存率为64%。另一方面，Ⅲ期疾病患者中仅51例（57%）存活，中位生存期为41.5个月（95%置信区间（CI），18.9至51.3）。Ⅳ期疾病患者预后较差，中位生存期为23.5个月（95%，CI 12.2至31.4）。进行了多变量分析以探讨自变量对非转移性疾病患者总生存期（OS）的影响。除了疾病进展的预期不良影响外，辅助化疗和他莫昔芬的有利影响占主导。然而，从他莫昔芬获得的益处量很小。进行了类似分析以确定自变量对无进展生存期（PFS）的影响。这些分析确定了晚期的不良影响以及辅助化疗的有利影响。沙特阿拉伯的乳腺癌具有与工业化国家不同的特征。然而，生存数据具有可比性。辅助化疗对OS和PFS的有利影响均很明显。然而，辅助他莫昔芬的作用很小。由于其使用频率低，无法确定其他辅助治疗方式的作用。
