Comprehensive Analysis of management and survival of patient with solid tumor and, patient Outcomes in Adults: A 5-Year Survival Analysis Study
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Date
2023-09
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Addis Ababa University
Abstract
Background
Cancer, a non-communicable disease, has surged globally in last two decades due to various factors, including racial, biological, socio-economic status and socio-cultural influences. Solid tumor accounts the highest number of cancer cases across worldwide. Africa faces the greatest challenges, marked by the worst outcomes and the shortest survival rate. This adversity exacerbated by lack of awareness, limited preventive strategies, and the prevalence of unhealthy lifestyles across the continent. Additionally, there is a notable dearth of comprehensive studies conducted in Ethiopia that delve into the disease spectrum, treatment modalities, drug utilization patterns, and patient survival trends over a five-year timeframe.
Objective: This study seeks to elucidate the spectrum of cancer, treatment modalities, patterns of drug utilization, and the myriad factors that influence patient survival within the Tikur Anbesa specialized hospital solid tumor oncology center for solid tumor.
Methods: Employing a convenient sampling technique, a retrospective observational follow-up study was carried out at TASH oncology facility from July to February 2022. Adult patient data spanning from January 2016 to February 2017 was meticulously extracted from medical records and phone addresses. An organized checklist, pre-tested in English and complete with contact information, was crafted for this purpose. Data analysis was performed using SPSS, with the Cox regression model being employed to identify variables impacting survival. Median and overall survivals were assessed through Kaplan-Meier analysis, and statistical significance was declared at a p-value ≤ 0.05.
Results: Majority of patients with cancer were under 65 year of age .71.1% were from rural areas .over all cervical cancer accounts the highest incidence with 24.5% of the case, while colorectal cancer was the commonest one among males. At the 5-year mark, the overall survival rate of 10 months (8.956-11.044) with 73.8% of the study population having passed away. Notably, overall survival was significantly influenced by factors such as marital status, exposure to agricultural pests treatment methods, cancer stage, recurrence, complications, and the administration of specific drugs such as paclitaxel, doxorubicin, and hormonal agents. Patients with advanced cancer stage (Adjusted Hazard Ratio [AHR] 2.02, 95% Confidence Interval [CI] 1.525-2.676), complications (AHR 1.233, 95% CI 1.525-2.676), and those who did not receive chemotherapy (AHR 1.817, 95% CI 1.382-2.389) exhibited poorer survival outcomes, while patients treated with paclitaxel and hormonal therapy demonstrated improved survival.
Conclusion: Our findings indicate suboptimal overall survival across all cancer types when compared to high-income nations with lower mortality rates. Particularly noteworthy is the persistently high incidence of cervical cancer, coupled with limited access to advanced radiation therapy within our center. We advocate for collaborative efforts aimed at addressing cancer prevention and treatment challenges, with a specific emphasis on immunization and the early detection of infectious malignancies.
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Keywords
Treatment modalities, cancer stage, disease spectrum, drug utilization