АНАЛИЗ ВЫЖИВАЕМОСТИ ПРИ РАКЕ ШЕЙКИ МАТКИ В ВОСТОЧНО-КАЗАХСТАНСКОЙ ОБЛАСТИ
Введение. Рак шейки матки (РШМ) является четвертым по распространенности онкологическим заболеванием среди женщин во всем мире. На прогноз заболевания влияют стадия болезни, состояние лимфатических узлов, глубина и объем опухоли. Пятилетняя выживаемость при непораженных опухолью лимфатических узлах составляет 88-99%, при наличии метастазов в лимфоузлах таза 50-74%.
Целью исследования был анализ выживаемости при раке шейки матке в Восточно-Казахстанской области.
Материалы и методы. Были использованы данные Регионального онкологического диспансера г. Семей (РОД г.Семей) и областного онкологического диспансера г.Усть-Каменогораска (ООД г.Усть-Каменогорск). В исследование были включены все смертельные исходы от РШМ (337 случая) за период с 2011 по 2016 гг. Анализ выживаемости проводился с помощью метода Каплана-Мейера. Сравнение проводилось между видами лечения.
Результаты. Лучевая терапия проводилась у 50,7% (n=171) пациенток, химиотерапия проводилась у 8,6% (n=29) женщин, симптоматическая терапия проводилась у 35,6% (n=120) пациенток, хирургическое лечение проводилась у 4,5% (n=15), конизация проводилась у 0,6% (n=2). Среднее время дожития при хирургическом лечении было 29,7 (95%ДИ:15,4-43,9) месяцев, при лучевой терапии было 25,0 (95%ДИ:21,5-28,6) месяцев, при конизации было 18,5 (95%ДИ:0,0-116,3) месяцев, при химиотерапии 12,4 (95%ДИ:9,9-14,8) месяцев, при симптоматической терапии 8,8 (95%ДИ:6,4-11,2) месяцев. Кривые выживаемости при всех видах лечения статистически отличаются, наибольшую частоту событий имеют пациентки, получившие симптоматическое лечение.
Выводы. Самое длительное время, свободное от исхода, приходится на хирургическое лечение, прогноз закономерно хуже у пациенток, получавших симптоматическое лечение.
Гульнар М. Шалгумбаева 1,
Нурбике С. Зготова 1,
Раида И. Фаизова 1,
Амина М. Хисметова 1,
Куралай Ш. Амренова 1,
Айнагуль М. Досбаева 1,
Антон О. Юрковский 2
1 Кафедра персонализированной медицины, Государственный медицинский университет города Семей, г. Семей, Республика Казахстан;
2 Новосибирский государственный медицинский университет, студент 1 курса, лечебного факультета, г. Новосибирск, Российская Федерация
1. Шарашова Е.Е., Холматова К.К., Горбатова М.А., Гржибовский А.М. Применение анализа выживаемости в здравоохранении с использованием пакета статистических программ SPSS // Наука и Здравоохранение. 2017. №5. С. 5-28.
2. Aamod Dhoj Shrestha et al. Cervical Cancer Prevalence, Incidence and Mortality in Low and Middle Income Countries: A Systematic Review. // Asian Pacific Journal of Cancer Prevention, Vol 19. DOI:10.22034/APJCP.2018.19.2.319
3. Cervical cancer [Internet]. [cited 2015 Aug 12]. Available from: http://www.paho.org/hq/index.php
4. Chen T., Jansen L., Gondos A., et al. Survival of cervical cancer patients in 3 Germany in the early 21st century: a period analysis by age, histology, and stage. // Acta Oncol. 2012; 51:915–21. [PubMed: 22928692]
5. Eun-Kyeong Moon et all. Trends and age-period-cohort effects on the incidence and mortality rate of cervical cancer in Korea. // Cancer Res Treat. 2017;49(2):526-533
6. GLOBOCAN cancer fact sheets: cervical cancer [Internet]. [cited 2015 Aug 12]. Available from: http:// globocan.iarc.fr/old/FactSheets/cancers/cervix-new.asp
7. Green J.A., Kirwan J.M., Tierney J.F., Symonds P., Fresco L., Collingwood M., Williams C.J. Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and metaanalysis. // Lancet. 2001;358(9284):781–6.
8. Jinyao Wang, Zhiqiang Bai, Zhenkun Wang and Chuanhua Yu. Comparison of secular trends in cervical cancer mortality in China and the United States: an age-period-cohort analysis // Int. J. Environ. Res. Public Health 2016, 13, 1148; doi:10.3390/ijerph13111148 www.mdpi.com/journal/ijerph
9. Kachuri L., De P., Ellison L.F., Semenciw R. Cancer incidence, mortality and survival trends in Canada, 1970–2007 // Chronic Dis Inj Can. 2013; 33:69–80. [PubMed: 23470172]
10. Levinson K.L., Bristow R.E., Donohue P.K., Kanarek N.F., Trimble C.L. Impact of payer status on treatment of cervical cancer at a tertiary referral center.// Gynecologic oncology. 2011; 122(2):324–7. PubMed Central PMCID: PMCPMC4612589. doi: 10.1016/j.ygyno.2011.04.038 PMID: 21620446
11. Network NCC. Cervical Cancer [https://www.nccn.org/professionals/ physician_gls/pdf/cervical.pdf]. Accessed 9 Aug 2017
12. Obrzut B. et al. Prediction of 5–year overall survival in cervical cancer patients treated with radical hysterectomy using computational intelligence methods. // BMC. Cancer. (2017) 17:840. doi: 10.1186/s12885-017-3806-3
13. Parkhurst J.O., Vulimiri M. Cervical cancer and the global health agenda: insights from multiple policy-analysis frameworks // Glob Public Health. 2013; 8(10):1093–108.
14. Rose P.G., Ali S., Whitney C.W., Lanciano R., Stehman F.B. Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: a Gynecologic Oncology Group study. // Gynecol Oncol. 2011;121(3):542–5. doi:10.1016/j.ygyno.2011.02.024
15. Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2015 // CA Cancer J Clin 2015;65:5-29. PUBMED | CROdptmejSSREF
16. Torre L.A., Bray F., Siegel R.L., Ferlay J., Lortet-Tieulent J, Jemal A. Global cancerstatistics, 2012. // CA: Cancer J Clin.2015;65(2):87–108.
17. Wright Jason D. et al. Influence of treatment center and hospital volume on survival for locally advanced cervical cancer // Gynecol Oncol. 2015 December; 139(3): 506–512. doi:10.1016/j.ygyno.2015.07.015.
18. Wright Jason D. et al. Population-Level Trends in Relative Survival for Cervical Cancer. //Am J Obstet Gynecol. 2015; November;213(5):670.e1–670.e7. doi:10.1016/j.ajog.2015.07.012
References:
1. Sharashova E.E., Kholmatova K.K., Gorbatova M.A., Grjibovski A.M. Primenenie analiza vyzhivaemosti v zdravoohranenii s ispol'zovaniem paketa statisticheskih programm SPSS [Survival analysis in health sciences using SPSS software]. Nauka i Zdravookhranenie [Science & Healthcare]. 2017, 5, pp. 5-28.
2. Aamod Dhoj Shrestha et al. Cervical Cancer Prevalence, Incidence and Mortality in Low and Middle Income Countries: A Systematic Review. Asian Pacific Journal of Cancer Prevention, Vol 19. DOI:10.22034/APJCP.2018.19.2.319
3. Cervical cancer [Internet]. [cited 2015 Aug 12]. Available from: http://www.paho.org/hq/index.php
4. Chen T., Jansen L., Gondos A., et al. Survival of cervical cancer patients in 3 Germany in the early 21st century: a period analysis by age, histology, and stage. Acta Oncol. 2012; 51:915–21. [PubMed: 22928692]
5. Eun-Kyeong Moon et all. Trends and age-period-cohort effects on the incidence and mortality rate of cervical cancer in Korea. Cancer Res Treat. 2017;49(2):526-533
6. GLOBOCAN cancer fact sheets: cervical cancer [Internet]. [cited 2015 Aug 12]. Available from: http:// globocan.iarc.fr/old/FactSheets/cancers/cervix-new.asp
7. Green J.A., Kirwan J.M., Tierney J.F., Symonds P., Fresco L., Collingwood M., Williams C.J. Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and metaanalysis. Lancet. 2001;358(9284):781–6.
8. Jinyao Wang, Zhiqiang Bai, Zhenkun Wang and Chuanhua Yu. Comparison of secular trends in cervical cancer mortality in China and the United States: an age-period-cohort analysis. Int. J. Environ. Res. Public Health 2016, 13, 1148; doi:10.3390/ijerph13111148 www.mdpi.com/journal/ijerph
9. Kachuri L., De P., Ellison L.F., Semenciw R. Cancer incidence, mortality and survival trends in Canada, 1970–2007. Chronic Dis Inj Can. 2013; 33:69–80. [PubMed: 23470172]
10. Levinson K.L., Bristow R.E., Donohue P.K., Kanarek N.F., Trimble C.L. Impact of payer status on treatment of cervical cancer at a tertiary referral center. Gynecologic oncology. 2011; 122(2):324–7. PubMed Central PMCID: PMCPMC4612589. doi: 10.1016/j.ygyno.2011.04.038 PMID: 21620446
11. Network N.C.C. Cervical Cancer [https://www.nccn.org/professionals/ physician_gls/pdf /cervical.pdf]. Accessed 9 Aug 2017
12. Obrzut B. et al. Prediction of 5–year overall survival in cervical cancer patients treated with radical hysterectomy using computational intelligence methods. BMC. Cancer. (2017) 17:840. doi: 10.1186/s12885-017-3806-3
13. Parkhurst J.O., Vulimiri M. Cervical cancer and the global health agenda: insights from multiple policy-analysis frameworks. Glob Public Health. 2013; 8(10):1093–108.
14. Rose P.G., Ali S., Whitney C.W., Lanciano R., Stehman F.B. Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: a Gynecologic Oncology Group study. Gynecol Oncol. 2011; 121(3): 542–5. doi:10.1016/j.ygyno.2011.02.024
15. Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015;65:5-29. PUBMED | CROdptmejSSREF
16. Torre L.A., Bray F., Siegel R.L., Ferlay J., Lortet-Tieulent J, Jemal A. Global cancerstatistics, 2012. CA: Cancer J Clin. 2015;65(2):87–108.
17. Wright Jason D. et al. Influence of treatment center and hospital volume on survival for locally advanced cervical cancer. Gynecol Oncol. 2015 December ; 139(3): 506–512. doi:10.1016/j.ygyno.2015.07.015.
18. Wright Jason D. et al. Population-Level Trends in Relative Survival for Cervical Cancer. Am J Obstet Gynecol. 2015; November; 213(5): 670.e1–670.e7. doi:10.1016/j.ajog.2015.07.012
2. Aamod Dhoj Shrestha et al. Cervical Cancer Prevalence, Incidence and Mortality in Low and Middle Income Countries: A Systematic Review. // Asian Pacific Journal of Cancer Prevention, Vol 19. DOI:10.22034/APJCP.2018.19.2.319
3. Cervical cancer [Internet]. [cited 2015 Aug 12]. Available from: http://www.paho.org/hq/index.php
4. Chen T., Jansen L., Gondos A., et al. Survival of cervical cancer patients in 3 Germany in the early 21st century: a period analysis by age, histology, and stage. // Acta Oncol. 2012; 51:915–21. [PubMed: 22928692]
5. Eun-Kyeong Moon et all. Trends and age-period-cohort effects on the incidence and mortality rate of cervical cancer in Korea. // Cancer Res Treat. 2017;49(2):526-533
6. GLOBOCAN cancer fact sheets: cervical cancer [Internet]. [cited 2015 Aug 12]. Available from: http:// globocan.iarc.fr/old/FactSheets/cancers/cervix-new.asp
7. Green J.A., Kirwan J.M., Tierney J.F., Symonds P., Fresco L., Collingwood M., Williams C.J. Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and metaanalysis. // Lancet. 2001;358(9284):781–6.
8. Jinyao Wang, Zhiqiang Bai, Zhenkun Wang and Chuanhua Yu. Comparison of secular trends in cervical cancer mortality in China and the United States: an age-period-cohort analysis // Int. J. Environ. Res. Public Health 2016, 13, 1148; doi:10.3390/ijerph13111148 www.mdpi.com/journal/ijerph
9. Kachuri L., De P., Ellison L.F., Semenciw R. Cancer incidence, mortality and survival trends in Canada, 1970–2007 // Chronic Dis Inj Can. 2013; 33:69–80. [PubMed: 23470172]
10. Levinson K.L., Bristow R.E., Donohue P.K., Kanarek N.F., Trimble C.L. Impact of payer status on treatment of cervical cancer at a tertiary referral center.// Gynecologic oncology. 2011; 122(2):324–7. PubMed Central PMCID: PMCPMC4612589. doi: 10.1016/j.ygyno.2011.04.038 PMID: 21620446
11. Network NCC. Cervical Cancer [https://www.nccn.org/professionals/ physician_gls/pdf/cervical.pdf]. Accessed 9 Aug 2017
12. Obrzut B. et al. Prediction of 5–year overall survival in cervical cancer patients treated with radical hysterectomy using computational intelligence methods. // BMC. Cancer. (2017) 17:840. doi: 10.1186/s12885-017-3806-3
13. Parkhurst J.O., Vulimiri M. Cervical cancer and the global health agenda: insights from multiple policy-analysis frameworks // Glob Public Health. 2013; 8(10):1093–108.
14. Rose P.G., Ali S., Whitney C.W., Lanciano R., Stehman F.B. Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: a Gynecologic Oncology Group study. // Gynecol Oncol. 2011;121(3):542–5. doi:10.1016/j.ygyno.2011.02.024
15. Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2015 // CA Cancer J Clin 2015;65:5-29. PUBMED | CROdptmejSSREF
16. Torre L.A., Bray F., Siegel R.L., Ferlay J., Lortet-Tieulent J, Jemal A. Global cancerstatistics, 2012. // CA: Cancer J Clin.2015;65(2):87–108.
17. Wright Jason D. et al. Influence of treatment center and hospital volume on survival for locally advanced cervical cancer // Gynecol Oncol. 2015 December; 139(3): 506–512. doi:10.1016/j.ygyno.2015.07.015.
18. Wright Jason D. et al. Population-Level Trends in Relative Survival for Cervical Cancer. //Am J Obstet Gynecol. 2015; November;213(5):670.e1–670.e7. doi:10.1016/j.ajog.2015.07.012
References:
1. Sharashova E.E., Kholmatova K.K., Gorbatova M.A., Grjibovski A.M. Primenenie analiza vyzhivaemosti v zdravoohranenii s ispol'zovaniem paketa statisticheskih programm SPSS [Survival analysis in health sciences using SPSS software]. Nauka i Zdravookhranenie [Science & Healthcare]. 2017, 5, pp. 5-28.
2. Aamod Dhoj Shrestha et al. Cervical Cancer Prevalence, Incidence and Mortality in Low and Middle Income Countries: A Systematic Review. Asian Pacific Journal of Cancer Prevention, Vol 19. DOI:10.22034/APJCP.2018.19.2.319
3. Cervical cancer [Internet]. [cited 2015 Aug 12]. Available from: http://www.paho.org/hq/index.php
4. Chen T., Jansen L., Gondos A., et al. Survival of cervical cancer patients in 3 Germany in the early 21st century: a period analysis by age, histology, and stage. Acta Oncol. 2012; 51:915–21. [PubMed: 22928692]
5. Eun-Kyeong Moon et all. Trends and age-period-cohort effects on the incidence and mortality rate of cervical cancer in Korea. Cancer Res Treat. 2017;49(2):526-533
6. GLOBOCAN cancer fact sheets: cervical cancer [Internet]. [cited 2015 Aug 12]. Available from: http:// globocan.iarc.fr/old/FactSheets/cancers/cervix-new.asp
7. Green J.A., Kirwan J.M., Tierney J.F., Symonds P., Fresco L., Collingwood M., Williams C.J. Survival and recurrence after concomitant chemotherapy and radiotherapy for cancer of the uterine cervix: a systematic review and metaanalysis. Lancet. 2001;358(9284):781–6.
8. Jinyao Wang, Zhiqiang Bai, Zhenkun Wang and Chuanhua Yu. Comparison of secular trends in cervical cancer mortality in China and the United States: an age-period-cohort analysis. Int. J. Environ. Res. Public Health 2016, 13, 1148; doi:10.3390/ijerph13111148 www.mdpi.com/journal/ijerph
9. Kachuri L., De P., Ellison L.F., Semenciw R. Cancer incidence, mortality and survival trends in Canada, 1970–2007. Chronic Dis Inj Can. 2013; 33:69–80. [PubMed: 23470172]
10. Levinson K.L., Bristow R.E., Donohue P.K., Kanarek N.F., Trimble C.L. Impact of payer status on treatment of cervical cancer at a tertiary referral center. Gynecologic oncology. 2011; 122(2):324–7. PubMed Central PMCID: PMCPMC4612589. doi: 10.1016/j.ygyno.2011.04.038 PMID: 21620446
11. Network N.C.C. Cervical Cancer [https://www.nccn.org/professionals/ physician_gls/pdf /cervical.pdf]. Accessed 9 Aug 2017
12. Obrzut B. et al. Prediction of 5–year overall survival in cervical cancer patients treated with radical hysterectomy using computational intelligence methods. BMC. Cancer. (2017) 17:840. doi: 10.1186/s12885-017-3806-3
13. Parkhurst J.O., Vulimiri M. Cervical cancer and the global health agenda: insights from multiple policy-analysis frameworks. Glob Public Health. 2013; 8(10):1093–108.
14. Rose P.G., Ali S., Whitney C.W., Lanciano R., Stehman F.B. Outcome of stage IVA cervical cancer patients with disease limited to the pelvis in the era of chemoradiation: a Gynecologic Oncology Group study. Gynecol Oncol. 2011; 121(3): 542–5. doi:10.1016/j.ygyno.2011.02.024
15. Siegel R.L., Miller K.D., Jemal A. Cancer statistics, 2015. CA Cancer J Clin 2015;65:5-29. PUBMED | CROdptmejSSREF
16. Torre L.A., Bray F., Siegel R.L., Ferlay J., Lortet-Tieulent J, Jemal A. Global cancerstatistics, 2012. CA: Cancer J Clin. 2015;65(2):87–108.
17. Wright Jason D. et al. Influence of treatment center and hospital volume on survival for locally advanced cervical cancer. Gynecol Oncol. 2015 December ; 139(3): 506–512. doi:10.1016/j.ygyno.2015.07.015.
18. Wright Jason D. et al. Population-Level Trends in Relative Survival for Cervical Cancer. Am J Obstet Gynecol. 2015; November; 213(5): 670.e1–670.e7. doi:10.1016/j.ajog.2015.07.012
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Шалгумбаева Г.М., Зготова Н.С., Фаизова Р.И., Хисметова А.М., Амренова К.Ш. Досбаева А.М., Юрковский А.О. Анализ выживаемости при раке шейки матки в Восточно-Казахстанской области // Наука и Здравоохранение. 2018. 5 (Т.20). С. 68-73. Shalgumbayeva G.M., Zgotava N.S., Faizova R.I., Khismetova A.M., Amrenova K.Sh., Dosbaeva A.M., Yurkovsky A.O. Survival analysis for cervical cancer in the East Kazakhstan region. Nauka i Zdravookhranenie [Science & Healthcare]. 2018, (Vol.20) 5, pp. 68-73. Шалгумбаева Г.М., Зготова Н.С., Фаизова Р.И., Хисметова А.М., Амренова К.Ш., Досбаева А.М., Юрковский А.О. Шығыс Қазақстан облысындағы жатыр мойнының қатерлі ісігі кезіндегі өміршеңдікке талдау // Ғылым және Денсаулық сақтау. 2018. 5 (Т.20). Б. 68-73.Похожие публикации:
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