| Abstract | Cilj istraživanja: Analizirati duljinu preživljenja ispitanika s karcinomom pluća dijagnosticiranim na Odjelu za patologiju KBC-a Split i usporediti sa sličnim studijama.
Ispitanici i metode: U uzorku je 1165 ispitanika kojima je susljedno od 01.01.2012, do 31.12.2016. dijagnosticiran karcinom pluća na Odjelu za patologiju Kliničkog zavoda za patologiju, sudsku medicinu i citologiju KBC-a Split. Iz računalne baze prikupljeni su podatci o dobi i spolu, vrsti bioptičkog uzorka i tipu karcinoma. Status ispitanika (živ ili mrtav) utvrđen je iz baze podataka bolničke mrtvozorničke službe i knjige umrlih Matičnog ureda Županije Splitsko-dalmatinske. Ispitanici su praćeni do 1. prosinca 2017. Preživljenje je izračunato u mjesecima od datuma uzimanja biopsije do dana smrti ili zadnjeg dana praćenja.
Rezultati: Od 1165 ispitanika, 74% je muškog, a 26% ženskog spola. Medijan dobi je 66 godina. Većina uzoraka je dobivena bronhoskopski (78,5%). Najviše je ispitanika s adenokarcinomom (42,9%), karcinomom pločastih stanica (32,7%) i karcinomom malih stanica (16,7%). U muškaraca adenokarcinom je neznatno češći od karcinoma pločastih stanica (38,6% prema 38%), a u žena značajno češći (55,3% prema 17,8%). U promatranom razdoblju vidi se blagi porast incidencije u muškaraca. Prosječna duljina preživljenja je 22,3 mjeseca, medijan 10 mjeseci, a petogodišnje preživljenje 16,5%. Stariji od 74 godine imaju značajno kraće preživljenje od mlađih od 74 godine (p<0,001). Nema razlike u duljini preživljenja između ispitanika s adenokarcinom i karcinomom pločastih stanica (p=0,708), kao ni između karcinoma malih stanica i ostalih neuroendokrinih karcinoma (p=0,820). Rizik smrtnog ishoda je veći 1,34 puta za muškarce u odnosu na žene (p<0,001) i 1,12 puta veći za karcinom malih stanica/ostale neuroendokrine karcinome nego za karcinom pločastih stanica i adenokarcinom zajedno (p=0,05). Rizik smrtnog ishoda karcinoma malih stanica je za 1,13 puta veći nego od adenokarcinoma, karcinoma pločastih stanica i ostalih neuroendokrinih karcinoma zajedno (95%CI: 1,04-1,24; p=0,005).
Zaključci: Trend incidencije karcinoma pluća u Splitsko-dalmatinskoj županiji je za muškarace u blagom porastu, a dob u kojoj se dijagnosticira nešto mlađa nego u svijetu. Žene žive prosječno 8 mjeseci duže od muškaraca. Petogodišnje preživljenje od 16,5% je veće od hrvatskog prosjeka. Spol, dob i tip karcinoma su nezavisni prognostički čimbenici, čime smo potvrdili rezultate drugih kliničkih i populacijskih studija. |
| Abstract (english) | Research Objective: To analyze survival rate of patients with lung cancer diagnosed at The Department of Pathology of University Hospital of Split and compare it with other studies.
Patients and Methods: The sample contains data of 1165 patients whom the lung cancer was pathohistologicaly diagnosed from January 1st, 2012 until December 31st 2016 at the Department of Pathology. Patient's sex and age, type of biopsy specimen and type of cancer were collected from the departmnts archive. An outcome (alive or dead) was determined from the database of Mortality Register of the Split-Dalmatia County. Follow-up was finished in December 1, 2017. Survival was measured in months, from the date of biopsy until the day of death, or the last day of follow-up.
Results: Out of 1165 patients, 74% were males and 26% females. Median of age was 66 years. Most of the samples were obtained by bronchoscopy (78.5%). Most common types were adenocarcinoma (42.9%), squamous cancer (32.7%) and small cell carcinoma (16.7%). In males, adenocarcinoma and squamous cancer occured equaly (38.6% versus 38%), and in females adenocarcinoma was more common (55.3% versus 17.8%). In the observed period, there was a slight increase in incidence among males. The average survival was 22.3 months, median 10 months, and five-year survival 16.5%. The patients older than 74 had shorter survival than younger ones (p<0.001). There was no difference in overall survival of patinets with adenocarcinoma and squamous carcinoma (p=0.708), as well as between small cell carcinoma and other neuroendocrine carcinomas (p = 0.820). The death rate was 1.34 times higher for men than women (p<0.001) and 1.12 times higher for small cell carcinoma/neuroendocrine carcinomas than for squamous cancer/adenocarcinoma (p = 0.05). Death rate for small cell carcinoma was 1.13 times higher than adenocarcinoma, squamous cell carcinoma and other neuroendocrine carcinoma together (95% CI: 1.04-1.24, p = 0.005).
Findings: In Split-Dalmatia County slight increase in incidence of lung cancer is observed. The age of diagnosis is slightly younger than in rest of the world. Women live on average 8 months longer than men. Five-year survival of 16.5% is higher than the country average, 10%. In concusion, in our study gender, age, and type of lung cancer are independent prognostic factors, thus confirming the results of other clinical and population studies. |
