结合高体积的常见复杂癌症手术在低体积的个人癌症手术环境中保证了长期生存
Kelsey S Romatoski1,2, Sophie H Chung1, Susanna W L de Geus1,2
1Department of Surgery, Boston Medical Center, Chobanian & Avedisian School of Medicine, Boston University, Boston, MA, USA.
Annals of surgical oncology
|June 13, 2023
概括
有复杂癌症手术混合体积的医院的长期存活率与高体积医院相似. 这表明混合体积的医院可以保持复杂的癌症手术的质量和准入.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 之前的研究强调了高复杂的外科手术体积与高风险癌症手术中改善的短期结果之间的联系.
- 本研究研究了在癌症特定个体手术数量较低的医院中,综合常见复杂癌症手术数量的长期影响.
研究的目的:
- 调查医院外科手术容量与重大癌症手术的长期生存结果之间的关联.
- 为了比较低容量医院 (LVH),混合容量医院 (MVH) 和高容量医院 (HVH) 的结果.
主要方法:
- 对国家癌症数据库 (2004-2019) 进行了回顾性分析.
- 包括为肝细胞癌,非小细胞肺癌,胰腺癌,胃癌,食道癌或直肠腺癌接受手术的患者.
- 医院被分为LVH,MVH (低个体,高总复合体积) 和HVH.
主要成果:
- 在大多数手术中,与LVH相比,MVH和HVH的五年生存率显著更好,除了晚期肝切除手术外,HVH的表现都优于两者.
- 胃切除术,食道切除术和直肠切除术的生存结果在MVH和HVH之间是可比的.
- 虽然HVH在胰腺切除术和MVH在叶叶切除术/肺切除术中显示出好处,但这些差异在临床上并不显著,除了肝切除术外,HVH在肝切除术中显示出更高的5年生存率.
结论:
- 具有在常见复杂癌症手术 (MVH) 中丰富经验的医院实现了与高容量医院 (HVH) 相比的长期存活率.
- 混合体积医院提供了一个可行的模型,以补充复杂的癌症手术的集中化,确保护理质量和患者获取.
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