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Yang S, Teng H, Wang Y, Ji K, Chen W, Zhou H. Risk factors on surgical compliance and its impact on survival outcomes in meningioma patients: a SEER-based retrospective propensity-score matched analysis. BMC Surg 2024; 24:39. [PMID: 38291417 PMCID: PMC10826196 DOI: 10.1186/s12893-024-02326-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2023] [Accepted: 01/17/2024] [Indexed: 02/01/2024] Open
Abstract
BACKGROUND This study aimed to analyze the effect of surgical compliance on the survival outcome of patients with meningioma and explore the factors affecting surgical compliance. METHODS We selected data from the Surveillance, Epidemiology, and End Results database for 122,632 meningioma patients diagnosed between 2004 and 2018. The effect of surgical compliance on patients' overall survival (OS) was analyzed through Cox regression and Kaplan-Meier curves. Independent risk factors for surgical compliance were identified through multifactorial logistic regression analyses to construct diagnostic nomograms, further assessed by receiver operating characteristic curves. Furthermore, we used univariate and multivariate logistic regression analyses to evaluate relevant variables linked to adherence with meningioma surgery. Moreover, 1:1 propensity score matching was applied to assess the validity of the results in patients with favorable and poor surgical compliance. RESULTS A total of 48,735 were eligible from the initial cohort of 122,632 patients with meningioma. Among them, 45,038 (92.40%) exhibited good surgical compliance, while 3697 (7.60%) had poor surgical compliance. The rate of patients with good surgical compliance was significantly higher than that of patients with inadequate surgical compliance (p < 0.001). Moreover, surgical compliance is an independent prognostic factor for OS in meningioma patients. Univariate Cox regression analysis indicated that individuals with poor surgical compliance demonstrated lower OS rates than those with good surgical compliance (hazard ratio [HR 2.404; 95% confidence interval [CI] 2.276-2.54, p < 0.001], consistent with the observation in the multivariate analysis (HR 1.564; 95% CI 1.471-1.663, p < 0.001). We developed a prediction model using seven variables: age, sex, race, tumor behavior recode, tumor size, family income, and residential setting (p < 0.05). Surgical compliance was associated with patient age, sex, race, tumor behavior recode, tumor size, family income, and residential setting by logistic regression analysis. CONCLUSIONS Surgical compliance emerged as an independent prognostic factor for survival in patients with meningioma. Poor surgical compliance was associated with older age, black and other races, females, advanced-stage tumors, larger tumor size, lower household income, and rural residence. When patients experienced these conditions, OS was shorter, requiring more aggressive treatment.
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Affiliation(s)
- Shengkai Yang
- Department of Neurosurgery, Binhai County People's Hospital, Yancheng, China
| | - Hongwei Teng
- Department of Neurosurgery, Binhai County People's Hospital, Yancheng, China
| | - Yingdan Wang
- Department of Pediatric, Binhai County People's Hospital, Yancheng, China
| | - Kangkang Ji
- Department of Central Laboratory, Binhai County People's Hospital, Yancheng, China
| | - Weihua Chen
- Department of Neurosurgery, Binhai County People's Hospital, Yancheng, China.
| | - Hai Zhou
- Department of Neurosurgery, Binhai County People's Hospital, Yancheng, China.
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Role of Pretreatment Hemoglobin-to-Platelet Ratio in Predicting Survival Outcome of Locally Advanced Nasopharyngeal Carcinoma Patients. J Cancer Epidemiol 2021; 2021:1103631. [PMID: 34751228 PMCID: PMC8572126 DOI: 10.1155/2021/1103631] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2021] [Accepted: 10/13/2021] [Indexed: 12/28/2022] Open
Abstract
Background The three-year survival rate of locally advanced nasopharyngeal carcinoma (NPC) patients in Indonesia is lower than in other Asian countries. Calculation of hemoglobin-to-platelet ratio (HPR) may become a more practical predictor than the ratios using leukocyte cell components. Yet, no study has been conducted to investigate the potential of HPR in predicting survival outcomes in locally advanced nasopharyngeal cancer patients. Objective To determine the role of pretreatment hemoglobin-to-platelet ratio in predicting the three-year overall survival (OS) of locally advanced NPC. Method A retrospective cohort study followed up on 289 locally advanced NPC patients who had undergone therapy at the Dr. Cipto Mangunkusumo National General Hospital between January 2012 and October 2016. HPR cut-off was determined using ROC. Subjects were classified into two groups according to the HPR value. Kaplan-Meier curve was utilized to illustrate patients' three-year survival, and Cox regression test analyzed confounding variables to yield an adjusted hazard ratio (HR). Results The optimal cut-off for HPR was 0.362 (AUC 0.6228, 95% CI: 0.56-0.69, sensitivity 61.27%, specificity 60.34%). Of the subjects, 48.44% had HPR ≤ 0.362, and they had a higher three-year mortality rate than those with HPR > 0.362 (50% vs. 31.54%). In bivariate analysis, HPR ≤ 0.362 and age ≥ 60 significantly showed a worse three-year OS (p value = 0.003 and 0.075, respectively). In multivariate analysis, we concluded that a pretreatment HPR ≤ 0.362 was an independent negative predictor of three-year OS in locally advanced NPC patients (adjusted HR 1.82; 95% CI: 1.25–2.65). Conclusion Pretreatment HPR ≤ 0.362 was a negative predictor of three-year OS in locally advanced nasopharyngeal cancer patients.
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Hutajulu SH, Howdon D, Taroeno-Hariadi KW, Hardianti MS, Purwanto I, Indrasari SR, Herdini C, Hariwiyanto B, Ghozali A, Kusumo H, Dhamiyati W, Dwidanarti SR, Tan IB, Kurnianda J, Allsop MJ. Survival outcome and prognostic factors of patients with nasopharyngeal cancer in Yogyakarta, Indonesia: A hospital-based retrospective study. PLoS One 2021; 16:e0246638. [PMID: 33577563 PMCID: PMC7880494 DOI: 10.1371/journal.pone.0246638] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Accepted: 01/22/2021] [Indexed: 12/24/2022] Open
Abstract
Purpose This study aimed to determine the survival outcome and prognostic factors of patients with nasopharyngeal cancer accessing treatment in Yogyakarta, Indonesia. Methods Data on 759 patients with NPC diagnosed from 2007 to 2016 at Dr Sardjito General Hospital were included. Potential prognostic variables included sociodemographic, clinicopathology and treatment parameters. Multivariable analyses were implemented using semi-parametric Cox proportional hazards modelling and fully parametric survival analysis. Results The median time of observation was 14.39 months. In the whole cohort the median observed survival was 31.08 months. In the univariable analysis, age, education status, insurance type, BMI, ECOG index, stage and treatment strategy had an impact on overall survival (OS) (p values <0.01). Semi-parametric multivariable analyses with stage stratification showed that education status, ECOG index, and treatment modality were independent prognostic factors for OS (p values <0.05). In the fully parametric models age, education status, ECOG index, stage, and treatment modality were independent prognostic factors for OS (p values <0.05). For both multivariable analyses, all treatment strategies were associated with a reduced hazard (semi-parametric models, p values <0.05) and a better OS (parametric models, p values <0.05) compared with no treatment. Furthermore, compared with radiation alone or chemotherapy alone, a combination of chemotherapy and radiation either in a form of concurrent chemoradiotherapy (CCRT), sequential chemotherapy and radiation, or induction chemotherapy followed by CCRT demonstrated a reduced hazard (hazard ratio/HR 0.226, 95% confidence interval/CI 0.089–0.363, and HR 0.390, 95%CI 0.260–0.519) and a better OS (time ratio/TR 3.108, 95%CI 1.274–4.942 and TR 2.531, 95%CI 1.829–3.233) (p values < 0.01). Conclusions Median OS for the cohort was low compared to those reported in both endemic and non-endemic regions. By combining the findings of multivariable analyses, we showed that age, education status, ECOG index, stage and first treatment modality were independent predictors for the OS.
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Affiliation(s)
- Susanna Hilda Hutajulu
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
- * E-mail:
| | - Daniel Howdon
- Leeds Institute of Health Sciences, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
| | - Kartika Widayati Taroeno-Hariadi
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Mardiah Suci Hardianti
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ibnu Purwanto
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Sagung Rai Indrasari
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Camelia Herdini
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Bambang Hariwiyanto
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Ahmad Ghozali
- Department of Anatomical Pathology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Henry Kusumo
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Wigati Dhamiyati
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Sri Retna Dwidanarti
- Department of Radiology, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - I. Bing Tan
- Department of Otorhinolaryngology, Head and Neck Surgery, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
- Department of Otorhinolaryngology, Head and Neck Surgery, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Johan Kurnianda
- Division of Hematology and Medical Oncology, Department of Internal Medicine, Faculty of Medicine, Public Health and Nursing, Universitas Gadjah Mada/ Dr Sardjito General Hospital, Yogyakarta, Indonesia
| | - Matthew John Allsop
- Leeds Institute of Health Sciences, School of Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom
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Othman MY, Blair S, Nah SA, Ariffin H, Assanasen C, Soh SY, Jacobsen AS, Lam C, Loh AHP. Pediatric Solid Tumor Care and Multidisciplinary Tumor Boards in Low- and Middle-Income Countries in Southeast Asia. JCO Glob Oncol 2020; 6:1328-1345. [PMID: 32886560 PMCID: PMC7529532 DOI: 10.1200/go.20.00284] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/30/2020] [Indexed: 11/20/2022] Open
Abstract
PURPOSE Pediatric solid tumors require coordinated multidisciplinary specialist care. However, expertise and resources to conduct multidisciplinary tumor boards (MDTBs) are lacking in low- and middle-income countries (LMICs). We aimed to profile the landscape of pediatric solid tumor care and practices and perceptions on MDTBs among pediatric solid tumor units (PSTUs) in Southeast Asian LMICs. METHODS Using online surveys, availability of specialty manpower and MDTBs among PSTUs was first determined. From the subset of PSTUs with MDTBs, one pediatric surgeon and one pediatric oncologist from each center were queried using 5-point Likert scale questions adapted from published questionnaires. RESULTS In 37 (80.4%) of 46 identified PSTUs, availability of pediatric-trained specialists was as follows: oncologists, 94.6%; surgeons, 91.9%; radiologists, 54.1%; pathologists, 40.5%; radiation oncologists, 29.7%; nuclear medicine physicians, 13.5%; and nurses, 81.1%. Availability of pediatric-trained surgeons, radiologists, and pathologists was significantly associated with the existence of MDTBs (P = .037, .005, and .022, respectively). Among 43 (89.6%) of 48 respondents from 24 PSTUs with MDTBs, 90.5% of oncologists reported > 50% oncology-dedicated workload versus 22.7% of surgeons. Views on benefits and barriers did not significantly differ between oncologists and surgeons. The majority agreed that MDTBs helped to improve accuracy of treatment recommendations and team competence. Complex cases, insufficient radiology and pathology preparation, and need for supplementary investigations were the top barriers. CONCLUSION This first known profile of pediatric solid tumor care in Southeast Asia found that availability of pediatric-trained subspecialists was a significant prerequisite for pediatric MDTBs in this region. Most PSTUs lacked pediatric-trained pathologists and radiologists. Correspondingly, gaps in radiographic and pathologic diagnoses were the most common limitations for MDTBs. Greater emphasis on holistic multidisciplinary subspecialty development is needed to advance pediatric solid tumor care in Southeast Asia.
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Affiliation(s)
- Mohd Yusran Othman
- Department of Pediatric Surgery, KK Women’s and Children’s Hospital, Singapore
- Department of Pediatric Surgery, Hospital Tunku Azizah (Women’s and Children’s Hospital), Kuala Lumpur, Malaysia
| | - Sally Blair
- Vietnam Pediatric Hematology Oncology Programme, Ho Chi Minh City, Vietnam
- Division of Pediatric Haematology and Oncology, Department of Pediatrics, National University of Singapore, Singapore
| | - Shireen A. Nah
- Division of Pediatric Surgery, Department of Surgery, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Hany Ariffin
- Department of Pediatrics, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Chatchawin Assanasen
- Vietnam Pediatric Hematology Oncology Programme, Ho Chi Minh City, Vietnam
- Southeast Asia Pediatric Hematology Oncology, Division of Hematology/Oncology Department of Pediatrics, UT Health San Antonio, San Antonio, TX
| | - Shui Yen Soh
- Haematology/Oncology Service, Department of Pediatric Subspecialties, KK Women’s and Children’s Hospital, Singapore
| | - Anette S. Jacobsen
- Department of Pediatric Surgery, KK Women’s and Children’s Hospital, Singapore
- SingHealth-Duke NUS Global Health Institute, Duke NUS Medical School, Singapore
| | - Catherine Lam
- St Jude Global, St Jude Children’s Research Hospital, Memphis, TN
| | - Amos H. P. Loh
- Department of Pediatric Surgery, KK Women’s and Children’s Hospital, Singapore
- SingHealth-Duke NUS Global Health Institute, Duke NUS Medical School, Singapore
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Wang S, Mao W, Wang Y, Shi X, Wang W, Dai L, Zhang W. Surgical Compliance and Survival Outcomes for Patients with Stage T1-2 Non-Small-Cell Lung Cancer. Cancer Manag Res 2020; 12:3597-3610. [PMID: 32547197 PMCID: PMC7245446 DOI: 10.2147/cmar.s238819] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Accepted: 04/27/2020] [Indexed: 12/13/2022] Open
Abstract
Introduction Our aim was to determine the relationship between surgical compliance and survival outcomes in patients with stage T1-2 non-small-cell lung cancer (NSCLC). Methods Patients with T1-2 NSCLC who were diagnosed between 2004 and 2015 were identified from the SEER database. Multivariate logistic regression was used to analyse factors associated with surgical compliance. Kaplan-Meier curves and Cox regression were used to analyse the effects of surgical compliance on overall survival (OS) and cancer-specific survival (CSS). Results Of the 221,704 eligible T1-2 NSCLC patients, 106,668 patients recommended surgery. Among them, 99,672 (93.4%) patients were surgical compliance group, and 6996 (6.6%) were surgical noncompliance group. Poor surgical compliance was associated with earlier diagnosis time, old age, male, black race, unmarried status, main bronchus site, poor grade/stage, and lower household income. Patients' compliance was an independent prognostic factor for OS and CSS of T1-2 NSCLC patients. Multivariate Cox regression showed that surgical noncompliance individuals showed lower OS (hazard ratio [HR] 2.494; 95% confidence interval [CI] 2.423-2.566, p < 0.001) and lower CSS (HR 2.877; 95% CI 2.782-2.974, p < 0.001) compared with surgical compliance patients. In addition, results in the non-surgical group were observed to be similar to those of the surgical noncompliance group. Conclusion We found that patients' compliance was an independent prognostic factor for survival in T1-2 NSCLC patients. Poor surgical compliance was associated with earlier diagnosis time, old age, male, black race, unmarried status, main bronchus site, poor grade/stage, and lower household income.
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Affiliation(s)
- Siben Wang
- Department of Thoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi Province 046000, People's Republic of China
| | - Weipu Mao
- Department of Urology, Affiliated Zhongda Hospital of Southeast University, Nanjing 210009, People's Republic of China
| | - Yi Wang
- Department of Respiratory Medicine, The Forth Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230022, People's Republic of China
| | - Xiuquan Shi
- Department of General Surgery, The People's Hospital of Yingshang, Fuyang, Anhui Province 236200, People's Republic of China
| | - Wei Wang
- Department of Respiratory Medicine, The Forth Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230022, People's Republic of China
| | - Lili Dai
- Department of Respiratory Medicine, The Forth Affiliated Hospital of Anhui Medical University, Hefei, Anhui Province 230022, People's Republic of China
| | - Wenping Zhang
- Department of Thoracic Surgery, Heping Hospital Affiliated to Changzhi Medical College, Changzhi, Shanxi Province 046000, People's Republic of China
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Faisal HH, Kubo N, Nuryadi E, Prihartono J, Atmakusuma TD, Rachmadi L, Oike T, Nakano T, Gondhowiardjo SA, Adham M. Patterns of Care and Outcome Analysis of Nasopharyngeal Carcinoma: An Indonesian Single Institution Study. Asian Pac J Cancer Prev 2020; 21:1481-1485. [PMID: 32458659 PMCID: PMC7541880 DOI: 10.31557/apjcp.2020.21.5.1481] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/25/2019] [Accepted: 05/10/2020] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND Nasopharyngeal cancer is endemic to Southeast Asia. However, there is limited clinical evidence of nasopharyngeal cancer in Indonesia, which has the largest population in Southeast Asia. METHODS Patterns of care and treatment outcomes in 428 patients with newly-diagnosed and pathologically-confirmed nasopharyngeal cancer were retrospectively analyzed. RESULTS Concurrent chemo-radiotherapy (CCRT) was the first-line treatment for stages I-IVB diseases. The 2-year overall survival (OS) of all patients were 100.0%, 100.0%, 93.8%, 86.2%, 82.9%, and 62.4% for stages I, II, III, IVA, IVB, and IVC, respectively. The 2-year OS of CCRT-treated patients were 100.0%, 100.0%, 92.6%, 82.4%, and 78.3% for stages I, II, III, IVA, and IVB, respectively. CONCLUSION The patterns of care and treatment outcomes were potentially consistent with world standards, needing future validation. This is the largest study of newly diagnosed nasopharyngeal cancer in Indonesia, a huge disease burden, providing an important basis for the clinical management of this disease.
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Affiliation(s)
- Hamida Hayati Faisal
- Department of Ear, Nose and Throat, Head and Neck Surgery, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Nobuteru Kubo
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
| | - Endang Nuryadi
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
- Department of Radiation Oncology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Joedo Prihartono
- Department of Community Medicine, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Tubagus Djumhana Atmakusuma
- Department of Internal Medicine, Hematology and Medical Oncology Division, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Lisnawati Rachmadi
- Department of Pathological Anatomy, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Takahiro Oike
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
| | - Takashi Nakano
- Department of Radiation Oncology, Gunma University Graduate School of Medicine, Gunma, Japan.
| | - Soehartati A Gondhowiardjo
- Department of Radiation Oncology, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
| | - Marlinda Adham
- Department of Ear, Nose and Throat, Head and Neck Surgery, Dr. Cipto Mangunkusumo National General Hospital, Faculty of Medicine Universitas Indonesia, Jakarta, Indonesia.
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Huang L, Hu C, Chao H, Wang R, Lu H, Li H, Chen H. miR-29c regulates resistance to paclitaxel in nasopharyngeal cancer by targeting ITGB1. Exp Cell Res 2019; 378:1-10. [DOI: 10.1016/j.yexcr.2019.02.012] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 02/14/2019] [Accepted: 02/15/2019] [Indexed: 01/20/2023]
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Schröders J, Wall S, Hakimi M, Dewi FST, Weinehall L, Nichter M, Nilsson M, Kusnanto H, Rahajeng E, Ng N. How is Indonesia coping with its epidemic of chronic noncommunicable diseases? A systematic review with meta-analysis. PLoS One 2017; 12:e0179186. [PMID: 28632767 PMCID: PMC5478110 DOI: 10.1371/journal.pone.0179186] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2016] [Accepted: 05/07/2017] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND Chronic noncommunicable diseases (NCDs) have emerged as a huge global health problem in low- and middle-income countries. The magnitude of the rise of NCDs is particularly visible in Southeast Asia where limited resources have been used to address this rising epidemic, as in the case of Indonesia. Robust evidence to measure growing NCD-related burdens at national and local levels and to aid national discussion on social determinants of health and intra-country inequalities is needed. The aim of this review is (i) to illustrate the burden of risk factors, morbidity, disability, and mortality related to NCDs; (ii) to identify existing policy and community interventions, including disease prevention and management strategies; and (iii) to investigate how and why an inequitable distribution of this burden can be explained in terms of the social determinants of health. METHODS Our review followed the PRISMA guidelines for identifying, screening, and checking the eligibility and quality of relevant literature. We systematically searched electronic databases and gray literature for English- and Indonesian-language studies published between Jan 1, 2000 and October 1, 2015. We synthesized included studies in the form of a narrative synthesis and where possible meta-analyzed their data. RESULTS On the basis of deductive qualitative content analysis, 130 included citations were grouped into seven topic areas: risk factors; morbidity; disability; mortality; disease management; interventions and prevention; and social determinants of health. A quantitative synthesis meta-analyzed a subset of studies related to the risk factors smoking, obesity, and hypertension. CONCLUSIONS Our findings echo the urgent need to expand routine risk factor surveillance and outcome monitoring and to integrate these into one national health information system. There is a stringent necessity to reorient and enhance health system responses to offer effective, realistic, and affordable ways to prevent and control NCDs through cost-effective interventions and a more structured approach to the delivery of high-quality primary care and equitable prevention and treatment strategies. Research on social determinants of health and policy-relevant research need to be expanded and strengthened to the extent that a reduction of the total NCD burden and inequalities therein should be treated as related and mutually reinforcing priorities.
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Affiliation(s)
- Julia Schröders
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Stig Wall
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Mohammad Hakimi
- Centre for Reproductive Health, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Fatwa Sari Tetra Dewi
- Department of Health Behaviour, Environment and Social Medicine, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Lars Weinehall
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
| | - Mark Nichter
- School of Anthropology, College of Social and Behavioral Sciences, The University of Arizona, Tucson, United States of America
| | - Maria Nilsson
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
| | - Hari Kusnanto
- Department of Family Medicine, Community Medicine and Bioethics, Faculty of Medicine, Universitas Gadjah Mada, Yogyakarta, Indonesia
| | - Ekowati Rahajeng
- Center for Public Health Research and Development, National Institute of Health Research and Development (NIHRD), Ministry of Health, Jakarta, Republic of Indonesia
| | - Nawi Ng
- Unit of Epidemiology and Global Health, Department of Public Health and Clinical Medicine, Umeå University, Umeå, Sweden
- Centre for Demographic and Ageing Research, Umeå University, Umeå, Sweden
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Mahdavifar N, Towhidi F, Makhsosi BR, Pakzad R, Moini A, Ahmadi A, Lotfi S, Salehiniya H. Incidence and Mortality of Nasopharynx Cancer and Its Relationship With Human Development Index in the World in 2012. World J Oncol 2016; 7:109-118. [PMID: 28983375 PMCID: PMC5624652 DOI: 10.14740/wjon980w] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2016] [Indexed: 12/29/2022] Open
Abstract
BACKGROUND One of the most common cancers in head and neck is nasopharynx. Knowledge about the incidence and mortality of this disease and its distribution in terms of geographical areas is necessary for further study, better planning and prevention. Therefore, this study aimed to determine the incidence and mortality of nasopharynx cancer and its relationship with human development index (HDI) in the world in 2012. METHODS This study was an ecological study conducted based on GLOBOCAN project of World Health Organization (WHO) for the countries in world. The correlation between standardized incidence rates (SIRs) and standardized mortality rates (SMRs) of nasopharynx cancer with HDI and its components was assessed with correlation coefficient by using SPSS 15. RESULTS In 2012, 86,691 nasopharynx cancer cases occurred in the world, so that 60,896 new cases were seen in men and 25,795 new cases in women (sex ratio = 2.36). SIR of the cancer was 1.2 per 100,000 (1.7 in men and 0.7 in women per 100,000) in the world. In 2012, 50,831 nasopharynx death cases occurred in the world, so that 35,756 death cases were seen in men and 15,075 death cases in women (sex ratio = 2.37). SIR of mortality from the cancer was 0.7 per 100,000 (0.7 in women and 1 in men per 100,000) in the world. The results of correlation analysis showed a negative correlation between the SIR and HDI (r = -0.037, P = 0.629), and also the results of correlation analysis showed a negative correlation between the SMR and HDI (r = -0.237, P = 0.002). CONCLUSION Nasopharyngeal cancer is native to Southeast Asia and the highest incidence and mortality were seen in countries with moderate and low HDI. It is suggested that studies are conducted on determining the causes of the cancer incidence and mortality in the world and the differences between various regions.
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Affiliation(s)
- Neda Mahdavifar
- Health Promotion Research Center, Department of Epidemiology and Biostatistics, School of Public Health, Zahedan University of Medical Sciences, Zahedan, Iran
| | - Farhad Towhidi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | | | - Reza Pakzad
- Student Research Committee, Ilam University of Medical Sciences, Ilam, Iran
| | - Ali Moini
- Department of Internal Medicine, Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Abbas Ahmadi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Sarah Lotfi
- Imam Reza Hospital, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Hamid Salehiniya
- Zabol University of Medical Sciences, Zabol, Iran
- Department of Epidemiology and Biostatistics, School of Public Health, Tehran University of Medical Sciences, Tehran, Iran
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Epidemiology and Inequality in the Incidence and Mortality of Nasopharynx Cancer in Asia. Osong Public Health Res Perspect 2016; 7:360-372. [PMID: 28053841 PMCID: PMC5194228 DOI: 10.1016/j.phrp.2016.11.002] [Citation(s) in RCA: 50] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2016] [Revised: 09/21/2016] [Accepted: 11/07/2016] [Indexed: 12/30/2022] Open
Abstract
OBJECTIVES One of the most common head and neck cancers is nasopharynx cancer. Knowledge about the incidence and mortality of this disease and its distribution in terms of geographical areas is necessary for further study and better planning. Therefore, this study was conducted with the aim of determining the incidence and mortality rates of nasopharynx cancer and its relationship with the Human Development Index (HDI) in Asia in 2012. METHODS The aim of this ecologic study was to assess the correlation between age-specific incidence rate (ASIR) and age-specific mortality rate (ASMR) with HDI and its components, which include the following: life expectancy at birth, mean years of schooling, and gross national income per capita. Data about SIR and SMR for every Asian country for 2012 were obtained from the global cancer project. We used the correlation bivariate method for the assessment. Statistical significance was assumed if p < 0.05. All reported p values are two-sided. Statistical analyses were performed using SPSS (Version 15.0, SPSS Inc.). RESULTS A total of 68,272 cases (males, 71.02%; females, 28.97%; sex ratio, 2.45) and 40,530 mortalities (males, 71.63%; females, 28.36%; sex ratio, 2.52) were recorded in Asian countries in 2012. The five countries with the highest ASIR of nasopharynx cancer were Malaysia, Singapore, Indonesia, Vietnam, and Brunei, and the five countries with the highest ASMR were Indonesia, Vietnam, Singapore, Malaysia, and Brunei. The correlation between HDI and ASIR was 0.097 (p = 0.520) [0.105 in men (p = 0.488) and 0.119 in women (p = 0.901)]. The correlation between HDI and ASMR was -0.102 (p = 0.502) [-0.072 in men (p = 0.633) and -0.224 in women (p = 0.134)]. CONCLUSION Nasopharynx cancer is native to Southeast Asia. The highest incidence and mortality rates are found in Malaysia, Singapore, Indonesia, Vietnam, and Brunei. No significant relation was found between the standardized incidence and mortality rates of nasopharynx cancer and the HDI components. Further studies are recommended in Southeast Asian countries in order to find the etiology of cancer, as well as its diagnosis and treatment.
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The Impact of the Overall Radiotherapy Time on Clinical Outcome of Patients with Nasopharyngeal Carcinoma; A Retrospective Study. PLoS One 2016; 11:e0151899. [PMID: 27030990 PMCID: PMC4816552 DOI: 10.1371/journal.pone.0151899] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2015] [Accepted: 02/26/2016] [Indexed: 11/19/2022] Open
Abstract
Purpose In Yogyakarta, nasopharyngeal carcinoma (NPC) shows a poor response to radiotherapy treatment. Previous study showed a prolonged overall treatment time (OTT), due to interruptions during treatment. This study explores the association between clinical outcome and OTT. Secondary, the relation between clinical outcome and disease stage, waiting time to radiation (WT) and chemotherapy schedule was explored. Methods In this retrospective cohort, 142 patients who started curative intent radiotherapy for NPC between March 2009 and May 2014, with or without chemotherapy, were included. The median follow up time was 1.9 years. Data was collected on WT, OTT, disease stage, and chemotherapy schedule. Time factors were log-transformed. Clinical outcome was defined as therapy response, loco-regional control (LRC), disease free survival (DFS) and overall survival (OS). Results The median WT was 117 days (range 12–581) and OTT was 58 days (43–142). OTT and disease stage were not associated to any of the clinical outcome parameters. The log- WT was associated to poor therapy outcome (HR 1.68; 95% ci: 1.09–2.61), LRC (HR 1.66; 95% ci: 1.15–2.39), and DFS (HR 1.4; 95% ci: 1.09–1.81). In the multivariable analysis, significant hazard risk for poor therapy response, LRC, DFS and OS were seen for patients who didn’t received concurrent chemotherapy. Conclusion Not receiving concurrent chemotherapy showed the strongest risk for poor outcome. Since the choice of chemotherapy is related to a variety of factors, like the WT and patient’s physical condition when radiation can start, careful interpretation is needed. Reason for not finding a relation between OTT and clinical outcome might be the low number of patients who finished radiotherapy within 7 weeks, or by a stronger detrimental effect of other factors.
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Epstein–Barr virus-targeted therapy in nasopharyngeal carcinoma. J Cancer Res Clin Oncol 2015; 141:1845-57. [DOI: 10.1007/s00432-015-1969-3] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Accepted: 03/30/2015] [Indexed: 01/28/2023]
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