等待时间和乳腺癌存活率:使用CanIMPACT数据进行基于人口的回顾性队列研究
Rachel Walsh1,2, Aisha Lofters3,4, Patti Groome5
1Department of Family and Community Medicine, University of Toronto, Toronto, ON, Canada. rachel.walsh@sunnybrook.ca.
Cancer causes & control : CCC
|May 15, 2024
概括
乳腺癌手术和化疗之间的较短间隔与更好的生存结果有关. 在这项研究中,初始接触到咨询或接触到化疗的延迟没有显著影响生存率.
科学领域:
- 在瘤学瘤学.
- 医疗保健服务研究 医疗服务研究
- 流行病学 流行病学
背景情况:
- 与乳腺癌手术相比,辅助化疗的时间是已知的预后因素.
- 早期治疗途径间隔,例如初始医疗保健接触到专家咨询或化疗对生存的影响仍然不太清楚.
研究的目的:
- 调查各种治疗等待时间和I-III期乳腺癌妇女的整体存活率之间的关联.
- 具体地检查从第一次与乳腺癌相关的医疗保健接触到专家咨询 (接触到咨询) 和辅助化疗 (接触到化疗) 的间隔,以及手术到化疗的间隔.
主要方法:
- 一项基于人口的回顾性队列研究,对12,782名在加拿大安大略省被诊断患有I-III阶段乳腺癌的妇女进行了研究 (2007-2011).
- 利用Cox比例危险回归来分析时间间隔与整体存活时间之间的关联.
- 根据关键预后因素进行调整,包括癌症阶段,年龄,并发症,社会经济地位和治疗细节.
主要成果:
- 手术和辅助化疗开始之间的较长间隔与总生存时间的减少显著相关 (HR 1.13每30天增加).
- 在接触到咨询的间隔 (HR 0.979每30天增加) 和整体存活率之间没有发现显著的关联.
- 综合接触到化疗间隔也没有显著影响整体存活率 (HR 1.00每30天增加).
结论:
- 缩短手术至化疗间隔对于改善乳腺癌患者的整体生存率至关重要.
- 与手术后的化疗延迟相比,初始医疗接触到专家咨询或化疗的时间似乎对生存结果的影响不那么明显.
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