بررسی زمان بقا و عود بیماران مبتلا به سرطان کولون در مراجعین به مرکز آموزشی- درمانی الزهرای (س) اصفهان در سال‌های 90-1381

نوع مقاله : مقاله های پژوهشی

نویسندگان

1 دانشیار، گروه جراحی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

2 دانشجوی پزشکی، کمیته‌ی تحقیقات دانشجویی، دانشکده‌ی پزشکی، دانشگاه علوم پزشکی اصفهان، اصفهان، ایران

چکیده

مقدمه: سرطان کولون در مقایسه با سایر بدخیمی‌ها، شیوع بالایی دارد و از طرفی، این بیماری دارای علایم بسیار شدید و پیش‌آگهی ضعیفی است. از این رو، هدف از انجام مطالعه‌ی حاضر، بررسی زمان بقا و عود بیماران مبتلا به سرطان کولون در طی 10 سال بود.روش‌ها: مطالعه‌ی حاضر، بر روی 100 بیمار انجام گرفت. برای جمع‌آوری اطلاعات مربوط به هر یک از بیماران، از پرونده‌های بیمارستانی آن‌ها استفاده شد. در صورت وجود نقص در پرونده و یا عدم اطلاع از وضعیت فعلی بیمار، از طریق آدرس و یا شماره‌ی تلفن با بیماران تماس گرفته شد و نواقص موجود در پرونده برطرف گردید. جهت تعیین میزان بقا، از روش Kaplan-Meier و برای مقایسه‌ی میزان بقا، از روش Log rank استفاده شد.یافته‌ها: از میان شرکت کنندگان، 64 نفر (64 درصد) مرد و 36 نفر (36 درصد) زن بودند. همچنین، بقای یک ساله برابر 89 درصد و بقای 5 ساله برابر 47 درصد بود. تعداد 54 درصد از مراجعین در قید حیات بودند و میانگین و میانه‌ی زمان بقای بیماران به ترتیب 78/57 و 00/62 ماه (81/4 و 17/5 سال) بود. همچنین، مشخص شد که دریافت شیمی‌درمانی بعد از عمل و عود موضعی، بر روی بقای بیماران تأثیر معنی‌داری دارد (050/0 > P). در عود موضعی، تنها 22 درصد از مراجعین دچار عود شده بودند و جنسیت، مرحله‌ی (Stage) بیماری، متاستاز کبدی، وضعیت فعلی بیمار و درگیری گره‌ی لنفاوی بر روی زمان عود بیماری افراد مبتلا به سرطان کولون مؤثر بود (050/0 > P).نتیجه‌گیری: مرحله‌ی بیماری، شیمی‌درمانی بعد از عمل، عود موضعی و درگیری گره‌ی لنفاوی در میزان بقای بیماران مؤثر است و سبب تغییر میزان بقای بیماران می‌شود. از این رو، با تشخیص زود هنگام بیماران و ترکیب چندین روش درمانی، می‌توان میزان بقای بیماران را افزایش داد.

کلیدواژه‌ها

عنوان مقاله [English]

Survival and Recurrence Time among Patients with Colon Cancer Reffered to Alzahra Hospital, Isfahan, Iran, during 2001-2010

نویسندگان [English]

  • Behnam Sanei 1
  • Mohsen Mahmoudieh 1
  • Mohammad Hossein Nasr-Esfahani 2
1 Associate Professor, Department of Surgery, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
2 Student of Medicine, Student Research Committee, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
چکیده [English]

Background: The incidence of colon cancers is more than any other types of malignancies; however, they have severe symptoms and poor prognosis. The aim of this study was to determine the survival and recurrence rate among patients with colon cancers reffered to Alzahra hospital, Isfahan, Iran, during 2001-2010.Methods: This study was performed on 100 patients. Hospital records were used to gather information about each patient and in cases with missing information about their current status, patient's address or phone number were used to resolve the shortcomings. Kaplan-Meier method was used to determine the survival rate and log rank test to compare survival rates.Findings: 36 patients (36%) were women and 64 (64%) were men. One-year and 5-year survival was 89% and 47%, respectvely. Moreover, 54% of patients were alive and mean and median survival time was 57.78 and 62.00 months (4.81 and 5.17 years), respectvely. It was also found that only receiving chemotherapy after surgery and local recurrence had significant impact on survival (P < 0.050). Furthermore, in local recurrence, only 22% of patients relapsed; gender, stage of disease, liver metastases, patient's current status, and involvement of lymph nodes in patients with colon cancer had impact on recurrence rate (P < 0.050).Conclusion: This study showed that disease stage, chemotherapy after surgery, local recurrence, and lymph node involvement are effective on patient's survival. Therefore, early diagnosis and combined treatment could increase survival rate in patients with colon cancers.

کلیدواژه‌ها [English]

  • Survival
  • Recurrence
  • Colon Cancer

مراجع

  1. Corman ML. Colon and rectal surgery. 4th ed. Philadelphia, PA, PA: Lippincott–Raven; 1998. p. 625-762.
  2. Becker N. Epidemiology of colorectal cancer. Radiologe 2003; 43(2): 98-104. [In German].
  3. Siegel R, Ward E, Brawley O, Jemal A. Cancer statistics, 2011: the impact of eliminating socioeconomic and racial disparities on premature cancer deaths. CA Cancer J Clin 2011; 61(4): 212-36.
  4. Capdevila J, Saura C, Macarulla T, Casado E, Ramos FJ, Tabernero J. Monoclonal antibodies in the treatment of advanced colorectal cancer. Eur J Surg Oncol 2007; 33(Suppl 2): S24-S34.
  5. Perencevich M, Ojha RP, Steyerberg EW, Syngal S. Racial and ethnic variations in the effects of family history of colorectal cancer on screening compliance. Gastroenterology 2013; 145(4): 775-81.
  6. Doubeni CA, Laiyemo AO, Major JM, Schootman M, Lian M, Park Y, et al. Socioeconomic status and the risk of colorectal cancer: an analysis of more than a half million adults in the National Institutes of Health-AARP Diet and Health Study. Cancer 2012; 118(14): 3636-44.
  7. Ponz de LM, Marino M, Benatti P, Rossi G, Menigatti M, Pedroni M, et al. Trend of incidence, subsite distribution and staging of colorectal neoplasms in the 15-year experience of a specialised cancer registry. Ann Oncol 2004; 15(6): 940-6.
  8. Jackson-Thompson J, Ahmed F, German RR, Lai SM, Friedman C. Descriptive epidemiology of colorectal cancer in the United States, 1998-2001. Cancer 2006; 107(5 Suppl): 1103-11.
  9. Zheng XE, Li T, Lipka S, Levine E, Vlacancich R, Takeshige U, et al. Location-dependent ethnic differences in the risk of colorectal adenoma: a retrospective multiethnic study. J Clin Gastroenterol 2014; 48(1): e1-e7.
  10. Sung JJ, Lau JY, Goh KL, Leung WK. Increasing incidence of colorectal cancer in Asia: implications for screening. Lancet Oncol 2005; 6(11): 871-6.
  11. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011; 61(2): 69-90.
  12. Potter V, Conn A. Chemotherapy and radiotherapy in the treatment of colorectal cancer. Surgery 2006; 24(4): 137-40.
  13. Tappenden P, Jones R, Paisley S, Carroll C. The cost-effectiveness of bevacizumab in the first-line treatment of metastatic colorectal cancer in England and Wales. Eur J Cancer 2007; 43(17): 2487-94.
  14. Cunningham D, Humblet Y, Siena S, Khayat D, Bleiberg H, Santoro A, et al. Cetuximab monotherapy and cetuximab plus irinotecan in irinotecan-refractory metastatic colorectal cancer. N Engl J Med 2004; 351(4): 337-45.
  15. Moradi A, Khayamzadeh M, Guya M, Mirzaei HR, Salmanian R, Rakhsha A, et al. Survival of colorectal cancer in Iran. Asian Pac J Cancer Prev 2009; 10(4): 583-6.
  16. Asghari Jafarabadi M, Mohammadi S M, Hajizadeh E, Fatemi S R. An evulation of 5-year survival of metastatic colon and rectal cancer patients using cumulative incidence models. Koomesh 2013; 14(2): 207-14. [In Persian].
  17. Adam R, Delvart V, Pascal G, Valeanu A, Castaing D, Azoulay D, et al. Rescue surgery for unresectable colorectal liver metastases downstaged by chemotherapy: a model to predict long-term survival. Ann Surg 2004; 240(4): 644-57.
  18. Aldrighetti L, Castoldi R, Di PaloS, Arru M, Stella M, Orsenigo E, et al. Prognostic factors for long-term outcome of hepatic resection for colorectal liver metastases. Chir Ital 2005; 57(5): 555-70. [In Italian].
  19. Ambiru S, Miyazaki M, Isono T, Ito H, Nakagawa K, Shimizu H, et al. Hepatic resection for colorectal metastases: analysis of prognostic factors. Dis Colon Rectum 1999; 42(5): 632-9.
  20. Bakalakos EA, Kim JA, Young DC, Martin EW, Jr. Determinants of survival following hepatic resection for metastatic colorectal cancer. World J Surg 1998; 22(4): 399-404.
  21. Brachet D, Lermite E, Rouquette A, Lorimier G, Hamy A, Arnaud JP. Prognostic factors of survival in repeat liver resection for recurrent colorectal metastases: review of sixty-two cases treated at a single institution. Dis Colon Rectum 2009; 52(3): 475-83.
  22. Zhou ZW, Ren JQ, Wan DS, Chen G, Lu ZH, Pan ZZ, et al. Multivariate regressive analysis of prognosis of liver metastases from colorectal cancer. Ai Zheng 2006; 25(9): 1149-52. [In Chinese].
  23. GLOBOCAN 2008: Cancer incidence and mortality worldwide [Online]. [cited 2010]; Available from: URL: https://www.iarc.fr/en/media-centre/iarcnews/ 2010/globocan2008.php
  24. Hosseini SV, Izadpanah A, Yarmohammadi H. Epidemiological changes in colorectal cancer in Shiraz, Iran: 1980-2000. ANZ J Surg 2004; 74(7): 547-9.
  25. Saltz LB, Meropol NJ, Loehrer PJ, Sr., Needle MN, Kopit J, Mayer RJ. Phase II trial of cetuximab in patients with refractory colorectal cancer that expresses the epidermal growth factor receptor. J Clin Oncol 2004; 22(7): 1201-8.
  26. Sobrero AF, Maurel J, Fehrenbacher L, Scheithauer W, Abubakr YA, Lutz MP, et al. EPIC: phase III trial of cetuximab plus irinotecan after fluoropyrimidine and oxaliplatin failure in patients with metastatic colorectal cancer. J Clin Oncol 2008; 26(14): 2311-9.
  27. Lenz HJ, Van CE, Khambata-Ford S, Mayer RJ, Gold P, Stella P, et al. Multicenter phase II and translational study of cetuximab in metastatic colorectal carcinoma refractory to irinotecan, oxaliplatin, and fluoropyrimidines. J Clin Oncol 2006; 24(30): 4914-21.
  28. Ries LAG, Melbert D, Krapcho M, Mariotto A, Miller BA, Feuer EJ, et al. SEER Cancer Statistics Review, 1975-2004. Bethesda, MD: National Cancer Institute; 2007.
  29. Sant M, Capocaccia R, Verdecchia A, Gatta G, Micheli A, Mariotto A, et al. Comparisons of colon-cancer survival among European countries: The Eurocare Study. Int J Cancer 1995; 63(1): 43-8.
  30. Lamberti C, Di BK, Archut D, Fimmers R, Mathiak M, Bollmann M, et al. Population-based registration of unselected colorectal cancer patients: five-year survival in the region of Bonn/Rhine-Sieg, Germany. Z Gastroenterol 2005; 43(2): 149-54.
  31. Yeole BB, Sunny L, Swaminathan R, Sankaranarayanan R, Parkin DM. Population-based survival from colorectal cancer in Mumbai, (Bombay) India. Eur J Cancer 2001; 37(11): 1402-8.
  32. Capocaccia R, De AR, Frova L, Gatta G, Sant M, Micheli A, et al. Estimation and projections of colorectal cancer trends in Italy. Int J Epidemiol 1997; 26(5): 924-32.
  33. Ries LAG, Eisner MP, Kosary CL, Hankey BF, Miller BA, Clegg L, et al. SEER Cancer Statistics Review, 1975-2002. Bethesda, MD: National Cancer Institute; 2005.
  34. Mehrabani D, Almasi-Hashiani A, Moshfeghi K, Khedmati E. Srvival Rate and its Predictors in Colorectal Cancer Patients, Southern Iran. Middle-East J Sci Res 2012; 12(8): 1072-7.
  35. Karimi Zarchi AA, Saadat AR, Jalalian HR, Esmaeili M. Epidemiology and survival analysis of colorectal cancer and its related factors. Kowsar Med J 2011; 15(4): 239-43. [In Persian].
  36. Akhoond M, Kazemnejad A, Hajizadeh E, Fatemi S, Motlagh A. Investigation of Influential Factors Affecting Survival Rate of Patients with Colorectal Cancer using Copula Function. Iran J Epidemiol 2011; 6(4): 40-9. [In Persian].
  37. Mehrkhani F, Nasiri S, Donboli K, Meysamie A, Hedayat A. Prognostic factors in survival of colorectal cancer patients after surgery. Colorectal Dis 2009; 11(2): 157-61.
  38. Birgisson H, Talback M, Gunnarsson U, Pahlman L, Glimelius B. Improved survival in cancer of the colon and rectum in Sweden. Eur J Surg Oncol 2005; 31(8): 845-53.
  39. Xu FY, Di MJ, Dong JK, Wang FJ, Jin YS, Zhu YM, et al. Influence of clinical and pathomorphological parameters on prognosis in colon carcinoma and rectal carcinoma. Zhejiang Da Xue Xue Bao Yi Xue Ban 2006; 35(3): 303-10. [In Chinese].
  40. Liang H, Wang XN, Wang BG, Pan Y, Liu N, Wang DC, et al. Prognostic factors of young patients with colon cancer after surgery. World J Gastroenterol 2006; 12(9): 1458-62.
  41. Akhoond MR, Kazemnejad A, Hajizadeh E, Ganbary Motlagh A, Zali MR. Comparison of influential factors affecting survival of patients with colon and rectum cancer using competing risks model. Koomesh 2011; 12(2): 119-28. [In Persian].
مجله دانشکده پزشکی اصفهان
دوره 35، شماره 431 - شماره پیاپی 431
خرداد و تیر 1396
صفحه 598-608

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سابقه مقاله

  • تاریخ دریافت: 12 مرداد 1394
  • تاریخ بازنگری: 11 آبان 1403
  • تاریخ پذیرش: 17 فروردین 1401

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