医院体积对儿童威尔姆斯瘤生存率的影响
Charbel Chidiac1, Olivia Liu2, Paul Phan2
1Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
Pediatric blood & cancer
|January 2, 2025
概括
高容量医院 (HVH) 改善了威尔姆斯瘤 (WT) 的儿童的生存率. 在HVH的治疗,定义为每年超过三个病例,显示出更好的结果和遵守护理指南.
科学领域:
- 儿科瘤学 儿科瘤学
- 手术结果研究研究.
背景情况:
- 威尔姆斯瘤 (WT) 治疗是多学科的,涉及手术,化疗和放射治疗.
- 高容量医院 (HVH) 与更好的癌症护理结果有关.
- 医院体积对儿科WT存活率的影响需要评估.
研究的目的:
- 评估儿科威尔姆斯瘤管理中医院体积和生存结果之间的关联.
- 确定一个最佳的医院体积值,以改善儿科WT患者的存活率.
主要方法:
- 利用国家癌症数据库 (2004-2020年) 对接受WT手术的年龄在18岁以下的患者.
- 采用受限立方斜线模型来分析医院体积和5年生存率.
- 通过使用卡普兰-梅尔曲线和考克斯回归验证了医院体积切线.
主要成果:
- 较高的住院人数与改善的生存率相关,但没有超过3例/年的额外好处.
- 治疗每年≥3例WT病例 (HVH) 的机构显示5年生存率更高 (95.5%与93.1%相比).
- 治疗HVH与降低死亡率 (aHR 0.71) 和增加淋巴结采样有关.
结论:
- 在HVH的儿科WT治疗与更高的存活率和更好的淋巴结采样坚持有关.
- 低容量医院 (LVH) 在患者人口统计和治疗方案方面存在差异.
- 加强培训和整合HVH实践可能会改善LVH的结果.
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