年齢や弱さに関する主観的な判断を組み込む治療は,口腔状細胞癌の高齢患者にとって有益ではありません.
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PubMedで要約を見る
まとめ
この要約は機械生成です。口腔状細胞癌 (OCSCC) の高齢患者では,推奨された手術治療から逸脱すると,生存率が低下し,術後の罹患率が上昇しました. ガイドラインを遵守すると,高齢のOCSCC患者の治療結果が改善されます.
科学分野
- 腫瘍学
- 手術腫瘍学
- 高齢者医療
背景
- 口腔状細胞癌 (OCSCC) の高齢患者の治療決定には,年齢と弱さの主観的な評価がしばしば含まれます.
- 公式の治療ガイドラインは存在しますが,高齢のOCSCC患者の実際の実践における遵守と偏差はよく確立されていません.
研究 の 目的
- p16陰性OCSCCの高齢患者 (> 70歳) は,フランスのガイドラインに基づいて推奨される外科的治療法に従うか,それから逸脱するかを評価する.
- 推奨治療からの偏差と術後の罹患率,再発率,および死亡率との関連を分析する.
主な方法
- 2007年から2017年の間にp16陰性OCSCCと診断された70歳以上の185人の患者の遡及評価.
- 多変数ロジスティック回帰を用いた術後の罹患率の分析
- コックス比例リスクの回帰を用いた再発と死亡リスクの評価
主要な成果
- 推奨された治療から逸脱した患者 (21%) は,リクリエーションフリー生存率 (p=0. 005) と全生存率 (p=0. 008) が著しく低下した.
- 偏差は,手術後3ヶ月の罹患率増加 (aOR2. 63) と5年以内に再発するリスクの増加 (aHR1. 79) と独立して関連していました.
- 5年後の死亡率の上昇と有意な関連性はなかった (aHR1. 35).
結論
- OCSCCの高齢患者の推奨外科治療からの偏差は,より悪い腫瘍学的および臨床的結果と関連しています.
- 治療計画における主観的な意思決定のバイアスは,患者の結果に悪影響を及ぼす可能性があります.
- 高齢のOCSCC患者の治療戦略を最適化するために,手術前リスクモデルのさらなる検証が必要である.
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