Epidemiologické charakteristiky nádorov testis v Slovenskej republike – retrospektívna štúdia
Authors:
M. Ondrusova 1,2; D. Ondrus 3,4
Authors‘ workplace:
Department of Cancer Epidemiology, Cancer Research Institute, Slovak Academy of Sciences, Bratislava, Slovak Republic 2Institute of Biostatistics and Analyses, Masaryk University, Brno, Czech Republic 3Department of Oncology, Comenius University Medical S
1
Published in:
Klin Onkol 2009; 22(2): 52-57
Category:
Original Articles
Overview
Východiská:
Nádory testis (NT) sú zriedkavou malignitou, ich medicínska závažnosť však spočíva v prudkom náraste hodnôt incidencie v posledných troch desaťročiach. Mortalita má v posledných 20-tich rokoch klesajúci trend.
Pacienti a metódy:
V celonárodnej restrospektívnej deskriptívnej štúdii sa hodnotilo 1 805 pacientov zo Slovenska, u ktorých sa diagnostikovalo 1 832 NT v rokoch 1993–2002. U chorých sa analyzovali údaje v zdravotnej dokumentácii a medicínske dotazníky, klinické príznaky a objektívne parametre pri klinickom vyšetrení.
Výsledky:
V rokoch 1993–2002 bola priemerná štandardizovaná incidencia (prepočítaná priamou metódou na svetovú štandardnú populáciu) 6,2/100 000; štandardizovaná mortalita dosiahla 0,5/100 000 mužov. Pri porovnávaní rizikových faktorov medzi skupinou pacientov s bilaterálnymi a unilaterálnymi NT bola najčastejšie sa vyskytujúcim rizikovým faktorom ingvinálna hernia (8,6%, p = 0,0026). V 3% prípadov chorých sa zistil bilaterálny NT. Z tohto počtu sa metachrónny výskyt zistil u 70,4% pacientov. Priemerný vek pacientov v čase diagnózy prvého NT u pacientov s bilaterálnym ochorením bol 27,5 rokov (p = 0,001); väčšina z nich (55%) mala NT diagnostikovaný vo veku 20–29 rokov. Priemerný vek pacientov s jednostranným NT bol 34 rokov. Osem pacientov malo synchrónny výskyt bilaterálneho nádoru, u 47 pacientov sa druhý NT diagnostikoval v rozpätí 2–302 mesiacov od prvej orchiektómie. V prípade seminómov bol časový interval medzi manifestáciou prvého a druhého NT v priemere 85 mesiacov, u neseminomatóznych nádorov bol tento interval 72 mesiacov (štatisticky nevýznamný rozdiel). Medián sledovania pacientov s NT bol 112,5 mesiacov (rozpätie 7–342 mesiacov), 5-ročné prežívanie bolo 96,2%.
Závery:
Ďalšie štúdium epidemiologických charakteristík NT je nevyhnutné pre definovanie rizikových faktorov ochorenia a možností včasnej liečebnej intervencie.
Kľúčové slová:
nádory testis – epidemiológia – rizikové faktory – prežívanie – onkologický register
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