多学科团队会议可以改善食道癌患者的生存率
Mats Lindblad1, Christine Jestin2, Jan Johansson3
1Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden.
概括
多学科团队会议 (MDTs) 改善食道癌症患者的生存率. 尽管有好处,老年患者和晚期疾病患者不太可能在MDT中讨论.
科学领域:
- 在瘤学瘤学.
- 临床医学 临床医学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 多学科团队会议 (MDT) 是食道癌症护理的标准.
- 虽然MDT与更好的分期和准则遵守有关,但它们对生存的影响仍未得到充分研究.
研究的目的:
- 调查MDT讨论与食道癌患者的生存结果之间的关联.
- 确定影响MDT参与食道癌症管理的因素.
主要方法:
- 在6837名瑞典食道癌患者 (2006-2018) 的回顾性队列研究中.
- 多变量逻辑回归分析了影响MDT分配的因素.
- 考克斯回归和卡普兰-梅尔估计器评估了MDT对生存的影响.
主要成果:
- 20%的患者 (1338) 在MDT上没有讨论.
- 降低MDT概率的因素包括晚年和IVb期疾病.
- 增加MDT概率的因素包括高等教育,婚姻,状组织学和晚年诊断.
- MDT讨论与改善的生存率相关 (HR 0.72,95% CI 0.66-0.78).
- 在MDTs讨论的患者中,中位生存时间从4.5个月增加到10.7个月.
结论:
- MDT讨论显著改善食道癌症患者的生存率.
- 某些患者群体,包括老年人和患有晚期疾病或较低社会经济地位的患者,不太可能从MDTs中受益.
- 应该努力确保所有食道癌症患者平等地获得MDT讨论.
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