8 research outputs found
ΠΠ½Π°Π»ΠΈΠ· Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Π² ΠΠΎΠ²ΠΎΡΠΈΠ±ΠΈΡΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ Π·Π° ΠΏΠ΅ΡΠΈΠΎΠ΄ 2015β2019 Π³Π³.
Rationale: Lung cancer is the leader in high mortality rates among other malignancies. This is largely due to the asymptomatic course of the disease and, as a consequence, to its late diagnosis. To optimize the oncology service of the Novosibirsk region in terms of diagnosis, treatment, follow-up and management of this patient category, it seems prudent to study the epidemiological characteristics of non-small cell lung cancer (NSCLC) with consideration of its histologic types.
Aim: To perform the survival analysis in patients with squamous cell lung cancer (SCLC) and adenocarcinoma of the lung (ACL) depending on their age, sex and disease stage.
Materials and methods: We analyzed medical files of patients diagnosed with SCLC (n = 3007) and ACL (n = 3049) who were treated in the Novosibirsk Regional Oncologic Dispensary from 2015 to 2019. The study included 4758 men and 1298 women (mean age, 68 years; men 66.8 years, women 69.1 years).
Results: The majority (96%) of the NSCLC patients were above 50 years of age. The 5-year survival rate of the patients with SCLC and ACL was below 20%. Median survival of the SCLC patients was 443 days (interquartile range [IQR] 138; 1241), of those with ACL, 552 (IQR 107; 1511) days. At the diagnosis of NSCLC, 67% of the patients had stage III/IV of the disease. Maximal survival (10 to 15 years) was found in the NSCLC patients aged 61 years who had been diagnosed at stage III of the disease. Testing of the hypothesis on the impact of histological type of NSCLC on survival at a particular disease stage (Wilcoxon-Gehan test for unpaired samples) showed an association between the survival and histological type only for stage IV (p = 0.000001); median survival in ACL IV was 80 days and in SCLC IV, 104 days.
Men comprised 87% of the SCLC group and 73% of the ACL one. In SCLC, there was no gender difference in the median survival rates (log rank test, p = 0.48). The median survival of the female patients with ACL was longer than that of the male ones (329 vs 169 days, log rank test, p = 0.000001).
The major proportion of the SCLC and ACL patients was in the age range of 61 to 75 years (59% and 50%, respectively). The least favorable outcomes were seen in the patients below 50 years of age, and the most favorable, in those above 75 years. In SCLC, the median survival was 156 days in the patients below 50 years of age, 238.5 days in those aged from 51 to 60 years, 300 days in the age of 61 to 75 years, and 487 days in the patients above 75 years of age (chi-square test 98.77097; df = 3; p = 0.000001). In ACL, the respective values were 143, 201, 210.5, and 230 days (chi-square test 23.93492; df = 3; p = 0.00003).
Conclusion: The analysis of survival of the patients with SCLC and ACL in the Novosibirsk region has shown that the disease stage and age significantly impact the median survival. These are the characteristic features of the general morbidity and mortality from NSCLC.ΠΠ±ΠΎΡΠ½ΠΎΠ²Π°Π½ΠΈΠ΅. Π Π°ΠΊ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ Π·Π°Π½ΠΈΠΌΠ°Π΅Ρ Π»ΠΈΠ΄ΠΈΡΡΡΡΠΈΠ΅ ΠΏΠΎΠ·ΠΈΡΠΈΠΈ ΠΏΠΎ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»ΡΠΌ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΡΡΠ΅Π΄ΠΈ Π΄ΡΡΠ³ΠΈΡ
Π·Π»ΠΎΠΊΠ°ΡΠ΅ΡΡΠ²Π΅Π½Π½ΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠΉ. ΠΠΎ ΠΌΠ½ΠΎΠ³ΠΎΠΌ ΡΡΠΎ ΡΠ²ΡΠ·Π°Π½ΠΎ Ρ Π±Π΅ΡΡΠΈΠΌΠΏΡΠΎΠΌΠ½ΡΠΌ ΡΠ΅ΡΠ΅Π½ΠΈΠ΅ΠΌ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΈ, ΠΊΠ°ΠΊ ΡΠ»Π΅Π΄ΡΡΠ²ΠΈΠ΅, Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠΎΠΉ Π½Π° ΠΏΠΎΠ·Π΄Π½ΠΈΡ
ΡΡΠ°Π΄ΠΈΡΡ
. ΠΠ»Ρ ΠΎΠΏΡΠΈΠΌΠΈΠ·Π°ΡΠΈΠΈ ΡΠ°Π±ΠΎΡΡ ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΉ ΡΠ»ΡΠΆΠ±Ρ ΠΠΎΠ²ΠΎΡΠΈΠ±ΠΈΡΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ ΠΏΠΎ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΠΊΠ΅, Π»Π΅ΡΠ΅Π½ΠΈΡ, Π½Π°Π±Π»ΡΠ΄Π΅Π½ΠΈΡ ΠΈ Π²Π΅Π΄Π΅Π½ΠΈΡ ΡΡΠΎΠΉ ΠΊΠ°ΡΠ΅Π³ΠΎΡΠΈΠΈ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΏΡΠ΅Π΄ΡΡΠ°Π²Π»ΡΠ΅ΡΡΡ ΡΠ΅Π»Π΅ΡΠΎΠΎΠ±ΡΠ°Π·Π½ΡΠΌ ΠΈΠ·ΡΡΠΈΡΡ ΡΠΏΠΈΠ΄Π΅ΠΌΠΈΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΈΠ΅ Ρ
Π°ΡΠ°ΠΊΡΠ΅ΡΠΈΡΡΠΈΠΊΠΈ Π½Π΅ΠΌΠ΅Π»ΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΠΎΠ³ΠΎ ΡΠ°ΠΊΠ° Π»Π΅Π³ΠΊΠΎΠ³ΠΎ (ΠΠΠΠ Π) Ρ ΡΡΠ΅ΡΠΎΠΌ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΈΠΏΠ°.
Π¦Π΅Π»Ρ ΠΏΡΠΎΠ²Π΅ΡΡΠΈ Π°Π½Π°Π»ΠΈΠ· Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΏΠ»ΠΎΡΠΊΠΎΠΊΠ»Π΅ΡΠΎΡΠ½ΡΠΌ ΡΠ°ΠΊΠΎΠΌ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ (ΠΠΠ Π) ΠΈ Π°Π΄Π΅Π½ΠΎΠΊΠ°ΡΡΠΈΠ½ΠΎΠΌΠΎΠΉ Π»Π΅Π³ΠΊΠΎΠ³ΠΎ (ΠΠΠ) Π² Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΠΈ ΠΎΡ Π²ΠΎΠ·ΡΠ°ΡΡΠ°, ΠΏΠΎΠ»Π° ΠΈ ΡΡΠ°Π΄ΠΈΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ.
ΠΠ°ΡΠ΅ΡΠΈΠ°Π» ΠΈ ΠΌΠ΅ΡΠΎΠ΄Ρ. ΠΡΠΎΠ°Π½Π°Π»ΠΈΠ·ΠΈΡΠΎΠ²Π°Π½Ρ ΠΈΡΡΠΎΡΠΈΠΈ Π±ΠΎΠ»Π΅Π·Π½ΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π°ΠΌΠΈ ΠΠΠ Π (n = 3007) ΠΈ ΠΠΠ (n = 3049), ΠΏΡΠΎΡ
ΠΎΠ΄ΠΈΠ²ΡΠΈΡ
Π»Π΅ΡΠ΅Π½ΠΈΠ΅ Π² ΠΎΠ½ΠΊΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠΌ Π΄ΠΈΡΠΏΠ°Π½ΡΠ΅ΡΠ΅ ΠΠΎΠ²ΠΎΡΠΈΠ±ΠΈΡΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ Π² 20152019 Π³Π³. Π ΠΈΡΡΠ»Π΅Π΄ΠΎΠ²Π°Π½ΠΈΠ΅ Π²ΠΎΡΠ»ΠΈ 4758 ΠΌΡΠΆΡΠΈΠ½ ΠΈ 1298 ΠΆΠ΅Π½ΡΠΈΠ½, ΡΡΠ΅Π΄Π½ΠΈΠΉ Π²ΠΎΠ·ΡΠ°ΡΡ Π²ΡΠ±ΠΎΡΠΎΠΊ ΡΠΎΡΡΠ°Π²ΠΈΠ» 68 Π»Π΅Ρ (ΠΌΡΠΆΡΠΈΠ½Ρ 66,8, ΠΆΠ΅Π½ΡΠΈΠ½Ρ 69,1 Π³ΠΎΠ΄Π°).
Π Π΅Π·ΡΠ»ΡΡΠ°ΡΡ. ΠΠΎΠ»ΡΡΠΈΠ½ΡΡΠ²ΠΎ (96%) Π·Π°Π±ΠΎΠ»Π΅Π²ΡΠΈΡ
ΠΠΠΠ Π Π±ΡΠ»ΠΈ ΡΡΠ°ΡΡΠ΅ 50 Π»Π΅Ρ. ΠΡΡΠΈΠ»Π΅ΡΠ½ΡΡ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠ Π ΠΈ ΠΠΠ Π±ΡΠ»Π° ΠΌΠ΅Π½Π΅Π΅ 20%. ΠΠ΅Π΄ΠΈΠ°Π½Π° Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ ΠΠΠ Π ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 443 Π΄Π½Ρ (25-ΠΉ 75-ΠΉ ΠΏΠ΅ΡΡΠ΅Π½ΡΠΈΠ»ΠΈ: [1381241]), Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ ΠΠΠ 552 [1071511] Π΄Π½Ρ.
Π 67% ΡΠ»ΡΡΠ°Π΅Π² Π΄ΠΈΠ°Π³Π½ΠΎΠ· ΠΠΠΠ Π Π²ΠΏΠ΅ΡΠ²ΡΠ΅ ΡΡΡΠ°Π½ΠΎΠ²Π»Π΅Π½ Π½Π° III/IV ΡΡΠ°Π΄ΠΈΠΈ. ΠΠ°ΠΊΡΠΈΠΌΠ°Π»ΡΠ½ΡΠ΅ Π·Π½Π°ΡΠ΅Π½ΠΈΡ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ (1015 Π»Π΅Ρ) ΠΎΡΠΌΠ΅ΡΠ΅Π½Ρ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ ΠΠΠΠ Π Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ 61 Π³ΠΎΠ΄ ΠΈ ΡΡΠ°ΡΡΠ΅, Ρ ΠΊΠΎΡΠΎΡΡΡ
Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΠ΅ Π΄ΠΈΠ°Π³Π½ΠΎΡΡΠΈΡΠΎΠ²Π°Π½ΠΎ Π½Π° III ΡΡΠ°Π΄ΠΈΡΡ
. ΠΡΠΎΠ²Π΅ΡΠΊΠ° Π³ΠΈΠΏΠΎΡΠ΅Π·Ρ ΠΎ Π²Π»ΠΈΡΠ½ΠΈΠΈ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΈΠΏΠ° ΠΠΠΠ Π Π½Π° Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΡ ΠΏΡΠΈ ΠΎΠΏΡΠ΅Π΄Π΅Π»Π΅Π½Π½ΠΎΠΉ ΡΡΠ°Π΄ΠΈΠΈ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ (Π΄Π²ΡΠ²ΡΠ±ΠΎΡΠΎΡΠ½ΡΠΉ ΠΊΡΠΈΡΠ΅ΡΠΈΠΉ Π£ΠΈΠ»ΠΊΠΎΠΊΡΠΎΠ½Π° ΠΠ΅Ρ
Π°Π½Π°) Π²ΡΡΠ²ΠΈΠ»Π° Π·Π°Π²ΠΈΡΠΈΠΌΠΎΡΡΡ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΎΡ Π³ΠΈΡΡΠΎΠ»ΠΎΠ³ΠΈΡΠ΅ΡΠΊΠΎΠ³ΠΎ ΡΠΈΠΏΠ° ΡΠΎΠ»ΡΠΊΠΎ Π½Π° IV ΡΡΠ°Π΄ΠΈΠΈ (p = 0,000001); ΠΌΠ΅Π΄ΠΈΠ°Π½Π° Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΏΡΠΈ ΠΠΠ IV ΡΡΠ°Π΄ΠΈΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π° 80 Π΄Π½Π΅ΠΉ, ΠΏΡΠΈ ΠΠΠ Π IV ΡΡΠ°Π΄ΠΈΠΈ 104 Π΄Π½Ρ.
Π Π³ΡΡΠΏΠΏΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ Π ΠΌΡΠΆΡΠΈΠ½ Π±ΡΠ»ΠΎ 87%, Π² Π³ΡΡΠΏΠΏΠ΅ Π±ΠΎΠ»ΡΠ½ΡΡ
ΠΠΠ 73%. ΠΡΠΈ Π΄ΠΈΠ°Π³Π½ΠΎΠ·Π΅ ΠΠΠ Π Π²Π»ΠΈΡΠ½ΠΈΡ Π³Π΅Π½Π΄Π΅ΡΠ½ΠΎΠ³ΠΎ ΠΏΡΠΈΠ·Π½Π°ΠΊΠ° Π½Π° ΠΌΠ΅Π΄ΠΈΠ°Π½Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ Π½Π΅ Π²ΡΡΠ²Π»Π΅Π½ΠΎ (Π»ΠΎΠ³Π°ΡΠΈΡΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ°Π½Π³ΠΎΠ²ΡΠΉ ΠΊΡΠΈΡΠ΅ΡΠΈΠΉ; p = 0,48). ΠΠ΅Π΄ΠΈΠ°Π½Π° Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΆΠ΅Π½ΡΠΈΠ½ Ρ ΠΠΠ ΠΎΠΊΠ°Π·Π°Π»Π°ΡΡ Π²ΡΡΠ΅, ΡΠ΅ΠΌ Π°Π½Π°Π»ΠΎΠ³ΠΈΡΠ½ΡΠΉ ΠΏΠΎΠΊΠ°Π·Π°ΡΠ΅Π»Ρ Ρ ΠΌΡΠΆΡΠΈΠ½: 329 Π΄Π½Π΅ΠΉ ΠΏΡΠΎΡΠΈΠ² 169 Π΄Π½Π΅ΠΉ (Π»ΠΎΠ³Π°ΡΠΈΡΠΌΠΈΡΠ΅ΡΠΊΠΈΠΉ ΡΠ°Π½Π³ΠΎΠ²ΡΠΉ ΠΊΡΠΈΡΠ΅ΡΠΈΠΉ; p = 0,000001).
ΠΡΠ½ΠΎΠ²Π½Π°Ρ Π΄ΠΎΠ»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΊΠ°ΠΊ Ρ ΠΠΠ Π, ΡΠ°ΠΊ ΠΈ Ρ ΠΠΠ Π±ΡΠ»Π° Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ 6175 Π»Π΅Ρ 59 ΠΈ 50% ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ. ΠΠ°ΠΈΠΌΠ΅Π½Π΅Π΅ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΉ ΠΏΡΠΎΠ³Π½ΠΎΠ· ΠΎΡΠΌΠ΅ΡΠ΅Π½ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΠΌΠ»Π°Π΄ΡΠ΅ 50 Π»Π΅Ρ, Π½Π°ΠΈΠ±ΠΎΠ»Π΅Π΅ Π±Π»Π°Π³ΠΎΠΏΡΠΈΡΡΠ½ΡΠΉ Π΄Π»Ρ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² ΡΡΠ°ΡΡΠ΅ 75 Π»Π΅Ρ. ΠΡΠΈ ΠΠΠ Π ΠΌΠ΅Π΄ΠΈΠ°Π½Π° Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΡΠΎΡΡΠ°Π²ΠΈΠ»Π°: Π² Π²ΠΎΠ·ΡΠ°ΡΡΠ½ΠΎΠΉ Π³ΡΡΠΏΠΏΠ΅ Π΄ΠΎ 50 Π»Π΅Ρ 156 Π΄Π½Π΅ΠΉ, 5160 Π»Π΅Ρ 238,5 Π΄Π½Ρ, 6175 Π»Π΅Ρ 300 Π΄Π½Π΅ΠΉ, Π±ΠΎΠ»Π΅Π΅ 75 Π»Π΅Ρ 487 Π΄Π½Π΅ΠΉ (Ρ
ΠΈ-ΠΊΠ²Π°Π΄ΡΠ°Ρ 98,77097; df = 3; p = 0,000001); ΠΏΡΠΈ ΠΠΠ 143, 201, 210,5 ΠΈ 230 Π΄Π½Π΅ΠΉ ΡΠΎΠΎΡΠ²Π΅ΡΡΡΠ²Π΅Π½Π½ΠΎ (Ρ
ΠΈ-ΠΊΠ²Π°Π΄ΡΠ°Ρ 23,93492; df = 3; p = 0,00003).
ΠΠ°ΠΊΠ»ΡΡΠ΅Π½ΠΈΠ΅. ΠΠ½Π°Π»ΠΈΠ· Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΏΠ°ΡΠΈΠ΅Π½ΡΠΎΠ² Ρ Π΄ΠΈΠ°Π³Π½ΠΎΠ·ΠΎΠΌ ΠΠΠ Π ΠΈ ΠΠΠ ΠΏΠΎΠΊΠ°Π·Π°Π», ΡΡΠΎ ΡΡΠ°Π΄ΠΈΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π½ΠΈΡ ΠΈ Π²ΠΎΠ·ΡΠ°ΡΡ ΡΡΠ°ΡΠΈΡΡΠΈΡΠ΅ΡΠΊΠΈ Π·Π½Π°ΡΠΈΠΌΠΎ Π²Π»ΠΈΡΡΡ Π½Π° ΠΌΠ΅Π΄ΠΈΠ°Π½Ρ Π²ΡΠΆΠΈΠ²Π°Π΅ΠΌΠΎΡΡΠΈ, ΡΠΎΡΠΌΠΈΡΡΡ ΠΎΡΠΎΠ±Π΅Π½Π½ΠΎΡΡΠΈ ΠΎΠ±ΡΠ΅ΠΉ ΡΡΡΡΠΊΡΡΡΡ Π·Π°Π±ΠΎΠ»Π΅Π²Π°Π΅ΠΌΠΎΡΡΠΈ ΠΈ ΡΠΌΠ΅ΡΡΠ½ΠΎΡΡΠΈ ΠΎΡ ΠΠΠΠ Π Π² ΠΠΎΠ²ΠΎΡΠΈΠ±ΠΈΡΡΠΊΠΎΠΉ ΠΎΠ±Π»Π°ΡΡΠΈ