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对于肌肉侵入性膀癌的新辅助化疗的推使用的遵守率较低

Lisa M C van Hoogstraten^1,2, Calvin C O Man³, J Alfred Witjes⁴

¹Netherlands Comprehensive Cancer Organisation, PO Box 1281, 6501 BG, Nijmegen, The Netherlands. l.vanhoogstraten@iknl.nl.

World journal of urology

|May 31, 2023

概括

在肌肉侵入性膀癌中,新辅助化疗 (NAC) 的指导方针遵守率较低,在医院有显著的差异. 虽然在统计学上不显著,但更高的NAC使用可能与改善的生存率相关,这需要进一步调查.

科学领域:

泌尿器科泌尿器科泌尿器科泌尿器科
在瘤学瘤学.
临床研究临床研究

背景情况:

肌肉侵入性膀癌 (MIBC) 治疗通常涉及新辅助化疗 (NAC) 以改善生存结果.
遵守NAC使用的既定准则和临床实践的变化是调查的关键领域.

研究的目的:

评估在非转移性肌肉侵入性膀癌 (MIBC) 中遵守新辅助化疗 (NAC) 指南.
为了评估NAC管理的医院间变化的程度.
为了确定NAC变异对患者存活率的影响.

主要方法:

基于荷兰癌症登记处的全国性研究,对1025名在2017-2019年间被诊断为非转移性MIBC患者进行了研究.
根据 ECOG 性能状态 0-1 和肌素清除率 ≥ 50 mL/min/1.73 m2 的定义,NAC 资格.
病例组合调整多层次分析用于医院间变异和Cox比例危险模型用于生存分析.

主要成果:

在809名符合条件的NAC患者中,只有34%的患者接受了NAC.
对NAC的准则遵守率在cT2中为26%,在cT3-4aMIBC中为55%.
医院间使用NAC的差异在7-57% (cT2) 和31-62% (cT3-4a) 之间.
较高的医院特异性NAC概率显示出对更好的生存率的非显著趋势 (HRcT2=0.59,HRcT3-4a=0.71).

结论:

在MIBC中使用NAC,特别是cT2疾病中,遵循指南的程度较低,并且存在显著的医院间变异.
研究结果表明,与较高的NAC利用相关的潜在生存益处,尽管在统计学上不显著.
建议改善NAC的准则遵守,特别是在cT3-4a疾病中确立了生存益处.

关键词:

膀癌是一种膀癌.坚持指导方针的坚持.在 MIBC 里面,你会看到 MIBC.肌肉侵入性膀癌是一种肌肉侵入性膀癌.新辅助化学疗法新辅助化学疗法进行激进的囊切除术.医疗保健中的变化.

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