一个国家数据库分析门黑色素瘤手术结果的演变
Sameh H Emile1,2, Nir Horesh1,3, Zoe Garoufalia1
1Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA.
Journal of surgical oncology
|March 27, 2024
概括
门黑色素瘤的治疗已经转向了不那么侵入性的手术和增加了免疫治疗的使用,从而改善了整体存活率 (OS). 高龄和较高的并发症分数预测了更糟糕的结果,而私人保险与更好的生存率有关.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 癌症流行病学 癌症流行病学
背景情况:
- 门黑色素瘤是一种罕见且具有攻击性的恶性瘤.
- 了解治疗趋势和生存结果对于改善患者护理至关重要.
研究的目的:
- 评估门黑色素瘤治疗和治疗结果的时间趋势.
- 确定影响门黑色素瘤患者整体存活时间 (OS) 的因素.
主要方法:
- 分析国家癌症数据库 (NCDB) 对2004-2020年门黑色素瘤患者的分析.
- 使用接收器操作特征 (ROC) 曲线分析来定义研究周期.
- 在两个不同的时间段之间比较患者的特征,治疗方法和生存结果.
主要成果:
- 从2013年至2020年,与2004年至2012年相比,观察到治疗的转变,腹腔切除的数量减少,瘤切除的数量增加.
- 在后期,免疫疗法使用显著增加 (OR:3.41),而化疗使用减少 (OR:0.516).
- 晚期的平均整体存活时间 (OS) 从19.8个月提高到25.2个月 (p=0.006).
- 更糟糕的OS的独立预测因素包括年龄较大,查尔森并发症得分较高,淋巴结较为阳性.
- 私人保险独立地与增加的OS相关 (HR:0.385).
结论:
- 门黑色素瘤的治疗模式已经发展,有利于减少广泛的手术和增加免疫治疗的使用.
- 这些治疗转换与改善的整体存活率相关.
- 年龄,并发症负担,淋巴结状况和保险状况仍然是门黑色素瘤生存的重要预后因素.
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