[论文解读] Predictive factors associated with survival rate of cervical cancer patients in Brunei Darussalam

Fadhliah Madli, Elvynna Leong+3 more|arXiv (Cornell University)|Oct 21, 2021

Cervical Cancer and HPV Research被引用 8

一句话总结

本研究利用2007年至2017年布鲁奈尔的回顾性数据，分析了影响布鲁奈尔苏丹国宫颈癌患者生存率的预测因素。Kaplan-Meier与Cox比例风险模型识别出诊断时年龄、癌症分期和组织学类型为生存率的重要预测因子，5年生存率为68.6%，早期分期疾病与预后改善相关。

ABSTRACT

Introduction: Cervical cancer is the third most prevalent cancer among women in Brunei Darussalam. This study aims to report the overall survival rates and associated factors of patients diagnosed with malignant cervical cancer in Brunei Darussalam. Methods: A retrospective study of patients diagnosed with cervical cancer from 2007 to 2017 in Brunei Darussalam. The data were obtained from the population-based cancer registry in Brunei Darussalam. Kaplan- Meier survival analysis was used to estimate the overall survival rates at 1-, 3- and 5-year intervals while the log-rank test was used to assess differences in survival between groups. Cox Proportional Hazard (PH) regression analysis was used to examine the association of demographic and clinical factors on the survival of cervical cancer patients. Results: A total of 329 registered malignant cervical cancer cases were analyzed. The mean age at diagnosis of patients with cervical cancer was 46.7 years. There were 28.6% deaths and the overall survival rates at 1, 3 and 5 years were 85.4%, 72.6% and 68.6% respectively. Age at diagnosis, cancer stage and histology types were significant predictive factors for overall survival of the patients diagnosed with cervical cancers when analysed on both log rank tests and Cox PH model. Conclusion: Age at diagnosis, cancer stage and histology types were significantly associated with the overall survival rates of cervical cancer patients in Brunei Darussalam. Early detection and management of cervical cancer at early stages should be prioritized to improve the survival rate and quality of cancer care.

研究动机与目标

• 评估2007年至2017年布鲁奈尔苏丹国宫颈癌患者的总体生存率。
• 识别与宫颈癌患者生存结局相关的社会人口学和临床因素。
• 通过统计建模评估癌症分期、诊断时年龄和组织学亚型对生存率的影响。
• 通过突出可改变因素，为公共卫生策略提供依据，以改善宫颈癌预后。

提出的方法

• 对布鲁奈尔国家癌症登记系统中329例恶性宫颈癌病例进行回顾性分析。
• 采用Kaplan-Meier生存分析估算1年、3年和5年总体生存率。
• 应用log-rank检验比较不同患者亚组间的生存差异。
• 采用Cox比例风险（PH）回归模型评估社会人口学/临床变量与生存率之间的关联。
• 使用p值和95%置信区间（CI）的危险比（HR）确定统计显著性。
• 数据来自国家癌症登记记录，分析了影响生存率的预测因素。

实验结果

研究问题

• RQ1 布鲁奈尔苏丹国宫颈癌患者的1年、3年和5年总体生存率是多少？
• RQ2 诊断时年龄如何影响宫颈癌患者的生存结局？
• RQ3 诊断时癌症分期对生存率有何影响？
• RQ4 不同组织学类型的宫颈癌如何影响患者生存率？
• RQ5 在该人群中，哪些社会人口学和临床因素是生存率的显著预测因子？

主要发现

• 布鲁奈尔苏丹国宫颈癌患者的5年总体生存率为68.6%。
• 3年总体生存率为72.6%，1年生存率为85.4%。
• 在较老年诊断的患者中，生存率显著较低，且诊断时年龄在log-rank检验和Cox PH模型中均为显著预测因子。
• 诊断时癌症分期是生存率的强预测因子，早期分期与更好的预后相关。
• 组织学类型显著影响生存率，某些亚型表现出更高的死亡风险。
• 随访期间共有28.6%的患者死亡，表明疾病负担较重。