设施类型和体积对局部晚期食道癌的影响
Zaid Muslim1, Stephanie Stroever2, Kostantinos Poulikidis3
1Division of Thoracic Surgery, Rudy L. Ruggles Biomedical Research Institute, Danbury, CT, USA.
Asian cardiovascular & thoracic annals
|November 23, 2023
概括
学术和高容量癌症设施改善食道癌症患者的生存率. 与社区医院相比,这些中心进行了更多的手术,并提供了更好的结果,这凸显了癌症护理中设施类型和体积的重要性.
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:
- 局部晚期食道癌治疗结果受医疗机构特征的影响.
- 假设学术和大体积设施会影响生存率和手术干预率.
研究的目的:
- 调查学术与社区以及高体积与低体积设施与当地晚期食道癌患者的手术选择和生存之间的独立关联.
主要方法:
- 利用国家癌症数据库 (2004-2016) 对患有IB-III期食道癌症的患者.
- 根据类型 (学术/社区) 和数量 (高/低,截止20种癌症/年) 分类设施.
- 应用多变量回归模型来分析基于设施特征的手术率和生存率的差异.
主要成果:
- 与大量的社区设施相比,在大量的学术设施的患者更有可能接受手术 (OR: 1.865) 和死亡率更低 (OR: 0.784).
- 高体积设施 (学术和社区) 与低体积设施 (p <0.05) 相比,与手术率的增加有关.
- 高容量学术设施与低容量学术设施相比,显示出更好的生存率 (OR:0.858),社区医院的生存率没有显著差异.
结论:
- 设施类型和患者病例量显著影响局部晚期食道癌的手术决策和生存结果.
- 与社区医院相比,学术机构的手术可能性更高,并且与患者生存率的提高有关.
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