بررسی میزان عود و بقای بیماران مبتلا به سرطان دهانه رحم در بیمارستان شهدای تجریش طی بررسی 11 ساله

نوع مقاله : اصیل پژوهشی

نویسندگان

1 استادیار گروه زنان و زایمان، مرکز تحقیقات سرطان، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

2 استاد گروه عفونی، دانشکده بهداشت، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

3 رزیدنت چشم پزشکی، کمیته تحقیقات دانشجویی، مرکز تحقیقات سرطان، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

4 استاد گروه جراحی عمومی، فلوشیپ جراحی سرطان، مرکز تحقیقات سرطان، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

5 استادیار گروه زنان و زایمان، فلوشیپ پریناتولوژی، مرکز تحقیقات سرطان، دانشکده پزشکی، دانشگاه علوم پزشکی شهید بهشتی، تهران، ایران.

6 دانشجوی پزشکی عمومی، دانشکده پزشکی، دانشگاه علوم پزشکی اراک، اراک، ایران.

10.22038/ijogi.2025.86263.6388

چکیده

مقدمه: سرطان دهانه رحم، هفتمین سرطان شایع جهانی و ششمین عامل مرگ ناشی از بدخیمی در زنان است. با توجه به کمبود مطالعات جامع در ایران درباره عود و بقای این سرطان و تفاوت بارِ بیماری در گروه‌های قومی مختلف، مطالعه حاضر با هدف بررسی میزان عود و بقای بیماران مبتلا به سرطان دهانه رحم انجام شد.
روش‌کار: این مطالعه توصیفی- تحلیلی و مقطعی بر روی 211 بیمار بستری در بیمارستان شهدای تجریش طی سال‌های 1403-1393 انجام شد. داده‌های دموگرافیک، پاتولوژی تومور (درجه، نوع)، وضعیت HPV، متاستاز، سایز تومور، درگیری لنف نود، نوع درمان و اطلاعات عود و بقاء از پرونده‌ها و از طریق تماس تلفنی استخراج شد. تحلیل بقاء با روش کاپلان- مایر و مقایسه عوامل تأثیرگذار با آزمون رگرسیون کاکس انجام شد. تجزیه و تحلیل داده‌ها با استفاده از نرم‌افزار آماری SPSS (نسخه 26) انجام گرفت. میزان p کمتر از 05/0 معنی‌دار در نظر گرفته شد.
یافته ­ها: میزان زمان بقای کلی مشاهده شده 1 ساله، 3 ساله و 5 ساله به‌ترتیب 3/97، 3/85 و 6/57 درصد بود. در آنالیز مدل چندگانه، مرحله پیشرفته بیماری (209/0=HR)، متاستاز (25/0=HR) و سن بالا (616/0=HR) قوی‌ترین پیش‌بین‌کننده‌های کاهش بقاء بودند.
نتیجه­ گیری: سن بالا، درجه پاتولوژی پیشرفته، عود بیماری و متاستاز، از عوامل کاهنده بقاء در بیماران مبتلا به سرطان دهانه رحم هستند. تشخیص زودهنگام در مراحل IA و IB و درمان ترکیبی جراحی- رادیوتراپی، پیامدهای بهتری دارد. افزایش آگاهی جامعه درباره غربالگری منظم، پاپ‌اسمیر و غربالگری تست HPV جهت بهبود بقای بیماران و تشخیص زودهنگام برای کاهش مرگ‌ومیر ناشی از این سرطان در جمعیت‌های پرخطر ضروری است.

کلیدواژه‌ها

موضوعات

عنوان مقاله [English]

Recurrence and Survival Rate of Patients with Cervical Cancer in Shohada Tajrish Hospital during 10 years

نویسندگان [English]

  • Atieh Akbari 1
  • Hossein Hatami 2
  • Navid Mokhtari 3
  • Mohammad Esmaeil Akbari 4
  • Taraneh Arbabzadeh 5
  • Nahal Mokhtari 6
1 Assistant Professor, Department of Obstetrics and Gynecology, Cancer Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
2 Professor, Department of Infection, School of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
3 Resident, Department of Ophthalmology, Student Research Committee, Cancer Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
4 Professor, Department of General Surgery, Cancer Surgery Fellowship, Cancer Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
5 Assistant Professor, Department of Obstetrics and Gynecology, Fellowship of Perinatology, Cancer Research Center, Faculty of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
6 General Physician Student, Faculty of Medicine, Arak University of Medical Sciences, Arak, Iran.
چکیده [English]

Introduction: Cervical cancer is the seventh most common cancer worldwide and the sixth leading cause of death from malignancy in women. Given the lack of comprehensive studies in Iran on the recurrence and survival of this cancer, and the differences in the burden of the disease in different ethnic groups, this study was conducted with aim to investigate the recurrence and survival rates of patients with cervical cancer.
Methods: This cross-sectional descriptive-analytical study was conducted on 211 patients hospitalized at Shohada Tajrish Hospital during 2014 to 2024. Demographic data, tumor pathology (grade, type), HPV status, metastasis, tumor size, lymph node involvement, type of treatment, and recurrence and survival information were extracted from records and telephone calls. Survival analysis was performed using the Kaplan-Meier method and comparison of influential factors was performed using the Cox regression test. Data analysis was performed using SPSS software (version 26). P<0.05 was considered significant.
Results: The observed overall survival rates for one year, three years, and five years were 97.3, 85.3, and 57.6 percent, respectively. In the multivariate model analysis, advanced stage of disease (HR=0.209), metastasis (HR=0.25), and old age (HR=0.616) were the strongest predictors of decreased survival.
Conclusion: Old age, advanced pathological grade, disease recurrence, and metastasis are the factors that reduce survival in patients with cervical cancer. Early diagnosis in stages IA and IB and combined surgery-radiotherapy treatment have better outcomes. Increasing public awareness about regular screening, Pap smear and HPV test screening is essential to improve patient survival and early detection to reduce mortality from this cancer in high-risk populations.

کلیدواژه‌ها [English]

  • Cervical Cancer
  • Human Papillomavirus (HPV)
  • Recurrence
  • Survival

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مجله زنان، مامایی و نازایی ایران
دوره 28، شماره 10
دی 1404
صفحه 24-35

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