导航选择:使用SEER数据的甲状腺癌患者手术拒绝的决定因素和结果
Mohammad H Hussein1, Eman A Toraih1,2, Ifidon E Ohiomah3
1Division of Endocrine and Oncologic Surgery, Department of Surgery, School of Medicine, Tulane University, New Orleans, LA 70112, USA.
Cancers
|July 29, 2023
概括
拒绝或推迟手术的甲状腺癌患者面临的死亡率增加. 诸如年龄,性别和种族等社会人口统计学因素影响手术拒绝,强调了患者教育和癌症护理共享决策的必要性.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 公共卫生 公共卫生
背景情况:
- 甲状腺癌的治疗通常包括手术干预.
- 患者拒绝或推迟推的手术可能会对结果产生负面影响.
- 了解影响外科决定的因素对于改善患者护理至关重要.
研究的目的:
- 确定与甲状腺癌患者的手术拒绝相关的社会人口学因素.
- 分析手术延迟或拒绝对癌症特异性和整体死亡率的影响.
- 为优化甲状腺癌治疗坚持和结果的战略提供信息.
主要方法:
- 利用了来自监测,流行病学和最终结果 (SEER) 数据库 (2000-2019) 的数据.
- 包括176,472名患有乳头或卵泡甲状腺癌的患者,建议进行手术.
- 采用卡普兰-梅尔方法和考克斯比例危险回归来进行死亡率分析.
主要成果:
- 手术延迟 (≥4个月) 或拒绝与整体死亡率增加有关.
- 手术拒绝显著增加了甲状腺癌特异性死亡率.
- 高龄 (≥55岁),男性性别,未婚状态,亚洲/太平洋岛民种族,以及晚期瘤阶段预测了手术拒绝.
结论:
- 手术拒绝和延迟与甲状腺癌的生存结果较差有关.
- 社会人口统计学因素在患者对手术干预的决定中起着重要作用.
- 加强患者教育,共享决策和改善对护理的准入对于优化甲状腺癌管理至关重要.
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