Temporal trends in outcome of XXXX in a resource-limited setting.

@entity1 @entity5 @entity957 @entity1544 @entity204
AIMS AND BACKGROUND: Improving survival has been documented for @entity957 in recent years. It is a common malignancy in Pakistan but survival outcomes have not been reported. The objective of this study was to determine survival and identify independent predictors in @entity1 with @entity1544 in 2 different time periods. METHODS: A retrospective review of @entity1 who received treatment between 2003 and 2012 was performed. @entity1 were divided into two 5 year groups: group 1 (2003-2007) (n = 628) and group 2 (2008-2012) (n = 920). Demographics, risk factors, treatment approaches, and outcomes were compared. Disease-free and overall survival were calculated. Cox proportional hazard model was used to determine independent predictors of survival. RESULTS: A significant difference was present for ethnicity and grade and clinical T and N stage of @entity5 , with earlier presentation in group 2. More @entity1 underwent surgery (p = 0.001) and had radical treatment intent (p<0.0001) in recent years. Induction chemotherapy (p<0.0001) and palliative chemotherapy (p<0.0001) were used more frequently. No significant difference in disease-free survival was observed but overall 5-year survival improved significantly (23% vs 42%) (p<0.0001). Use of palliative chemotherapy reduced risk of @entity204 significantly (hazard ratio [HR] 0.1, confidence interval [CI] 0.02-0.4, p = 0.003), while pathologic nodal positivity significantly increased the risk (HR 2.5, CI 1-5.9, p = 0.03). CONCLUSIONS: These results from a single @entity5 hospital demonstrate improvement in overall survival secondary to early detection, better @entity1 selection, and use of palliative chemotherapy in the later period.
