Long-term, adverse genitourinary outcomes among endometrial cancer survivors in a large, population-based cohort study
Long-term, adverse genitourinary outcomes among endometrial cancer survivors in a large, population-based cohort study
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DOI：
10.1016/j.ygyno.2017.12.025
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发表时间：
2018-03-01
影响因子：
4.7
通讯作者：
Hashibe, Mia
中科院分区：
文献类型：
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作者：
Soisson, Sean;Ganz, Patricia A.;Hashibe, Mia
Objective.随着子宫内膜癌发病率的增加、高生存率和大量的子宫内膜癌幸存者，研究长期泌尿生殖系统结局对于子宫内膜癌幸存者的这些结局的管理非常重要。确定了1997年至2012年期间在犹他州诊断的2648名子宫内膜癌幸存者和10，503名普通人群女性的队列。所有ICD-9诊断代码都是从该州两个最大的医疗保健系统和全州数据库中收集的。采用多因素考克斯回归模型估计子宫内膜癌诊断后1- 5年和>5- 10年泌尿生殖系统结局的风险比。子宫内膜癌幸存者在1 - 5年内发生泌尿系统疾病的风险增加（HR：1.64，95% CI：1.50-1.78）和>5- 10年（HR：1.40，95% CI：1.26-1.56）和1 - 5年的生殖器官疾病（HR：1.71，95%CI：1.58-2.03）和>5- 10年（HR：1.33，95%CI：1.19-1.49）。在子宫内膜癌幸存者中观察到肾衰竭、慢性肾病、尿路感染和非恶性乳腺疾病的风险显着升高，持续时间>5- 10年。在确诊后1 ~ 5年内，分期越高、分级越高、年龄越大、接受过放疗或化疗的患者发生泌尿系统疾病的风险越高。与一般人群相比，子宫内膜癌幸存者在许多泌尿生殖系统结局方面的风险更高。这项研究提供的证据表明，有必要增加监测和咨询的泌尿生殖系统疾病的子宫内膜癌患者立即停止治疗后，并在数年后。(C)2018爱思唯尔公司All rights reserved.
Objective. With the increasing incidence of endometrial cancer, the high survival rate, and the large number of endometrial cancer survivors, investigations of long-term genitourinary outcomes are important for the management of these outcomes among endometrial cancer survivors.Methods. Cohorts of 2648 endometrial cancer survivors diagnosed in the state of Utah between 1997 and 2012 and 10,503 general population women were identified. All ICD-9 diagnosis codes were collected from the state's two largest healthcare systems and statewide databases. Multivariate Cox regression models were used to estimate hazard ratios at 1-5years and >5-10years after endometrial cancer diagnosis for genitourinary outcomes.Results. Endometrial cancer survivors were at elevated risk for urinary system disorders between 1 and 5years (HR: 1.64, 95% CI: 1.50-1.78) and >5-10years (HR: 1.40, 95% CI: 1.26-1.56) and genital organ disorders between 1 and 5years (HR: 1.71, 95% CI: 1.58-2.03) and >5-10years (HR: 1.33, 95% CI: 1.19-1.49). Significantly elevated risk was observed among endometrial cancer survivors for renal failure, chronic kidney disease, urinary tract infections, and nonmalignant breast conditions, persisting between >5-10years. Between 1 and 5years after cancer diagnosis, those with higher stage, higher grade, older age and treated with radiation or chemotherapy were at higher risk for urinary disorders.Conclusions. Endometrial cancer survivors were at higher risk for many genitourinary outcomes compared to women from the general population. This study presents evidence suggesting the necessity of increased monitoring and counseling for genitourinary disorders for endometrial cancer patients both immediately after treatment cessation and for years afterwards. (C) 2018 Elsevier Inc. All rights reserved.