病院のがん登録簿における併発性の予測的重要性
Jay F Piccirillo1, Ryan M Tierney, Irene Costas
1Department of Otolaryngology-Head and Neck Surgery, Washington University, St Louis, Mo 63110, USA. piccirij@msnotes.wustl.edu
JAMA
|May 27, 2004
まとめ
併発症は,がんのステージに関係なく,がん患者の生存率に大きな影響を与えます. 併発症の重度の高さは,より悪い生存結果と相関しており,その予後的価値を強調しています.
科学分野:
- 腫瘍学 腫瘍学
- エピデミオロジー エピデミオロジー
- バイオ統計学 バイオ統計学
背景:
- がん患者は,しばしば併存する疾患 (共病性) を抱えている.
- 併発症は,がん治療の決定,患者の予後,およびケア品質の評価に影響を与える可能性があります.
研究 の 目的:
- 併合性疾患のデータが,病院ベースのがん登録簿内で有意な予後的な洞察を提供しているかどうかを判断する.
- さまざまなタイプの癌における共疾患の予後値を評価する.
主な方法:
- 観察的な前向きなコホート研究デザインが採用されました.
- 併発性データは,訓練を受けたがん登録者によって,Adult Comorbidity Evaluation 27というツールを用いて体系的に収集されました.
- データには,1995年から2001年の間に前立腺,肺,乳房,消化器系,婦人科,泌尿器系,頭頸部がんと診断された1万7712人の患者が含まれていた.
主要な成果:
- 併発症の重症度は,がんのステージに関係なく,全生存期に対する用量依存の悪影響を示した.
- 重度の併発性疾患を有する患者は,併発性疾患のない患者と比較して,死亡率の調整されたリスク比 (2.56) が著しく高かった.
- 調整された生存分析は,併発症の重度の増加が,生存の悪影響と関連していることを確認した (P<.001).
結論:
- 併発症は,がん患者のために重要な,独立した予後要因です.
- 併発症データをがん登録簿に統合することで,観察的がん研究の有用性と価値が向上します.
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