术后辅助疗法利用率的差异以及影响甲状腺癌患者生存率的因素
Teagan E Marshall1, Rahma Ibrahim1, Yeon J Lee-Saxton1
1Department of Surgery, 1300 York Avenue, Weill Cornell Medicine, New York, NY, 10065, USA.
American journal of surgery
|September 28, 2024
概括
甲状腺癌患者在手术后受益于辅助疗法. 然而,老年患者和少数群体接受这一关键治疗的可能性较低,这表明存在显著的差异.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 癌症治疗方法 癌症治疗方法
背景情况:
- 无塑性甲状腺癌 (ATC) 是一种具有不良预后的高度侵袭性恶性瘤.
- 目前的指导方针建议ATC的辅助系统治疗和外科手术后的放射治疗.
- 确定影响辅助治疗坚持和生存的因素至关重要.
研究的目的:
- 确定与放弃ATC的术后辅助治疗相关的患者人口统计和临床因素.
- 为了确定经过甲状腺切除术的ATC患者的生存预测因素.
主要方法:
- 利用国家癌症数据库 (NCDB) 来识别经过前期甲状腺切除术 (2010-2017) 的ATC患者.
- 在接受辅助治疗的患者和没有接受辅助治疗的患者之间比较结果.
- 采用后勤回归来确定辅助疗法接收的预测因素和生存因素的考克斯回归.
主要成果:
- 在563名ATC患者中,有160人没有接受辅助治疗;大多数排除来自治疗计划,而不是患者拒绝.
- 高龄和非白人种族/种族是不接受辅助治疗的重要预测因素.
- 整体甲状腺切除术,R0/R1切除,辅助放射或组合疗法与改善的生存率有关.
结论:
- 整体甲状腺切除术,完全切除 (R0/R1) 和辅助疗法与ATC的死亡率降低有关.
- 存在显著的差异,老年患者和少数群体接受辅助治疗的可能性较低.
- 解决这些差异对于改善治疗坚持和ATC的结果至关重要.
相关概念视频
01:21Cancer Survival Analysis
329
Cancer survival analysis focuses on quantifying and interpreting the time from a key starting point, such as diagnosis or the initiation of treatment, to a specific endpoint, such as remission or death. This analysis provides critical insights into treatment effectiveness and factors that influence patient outcomes, helping to shape clinical decisions and guide prognostic evaluations. A cornerstone of oncology research, survival analysis tackles the challenges of skewed, non-normally...
329
01:20Comparing the Survival Analysis of Two or More Groups
156
Survival analysis is a cornerstone of medical research, used to evaluate the time until an event of interest occurs, such as death, disease recurrence, or recovery. Unlike standard statistical methods, survival analysis is particularly adept at handling censored data—instances where the event has not occurred for some participants by the end of the study or remains unobserved. To address these unique challenges, specialized techniques like the Kaplan-Meier estimator, log-rank test, and...
156