到达三级肉瘤中心的旅行距离不会影响瘤表现或结果
Aaron Gazendam1, Liuzhe Zhang1, David Clever1
1Division of Orthopaedic Surgery, Department of Surgery, University of Toronto Musculoskeletal Oncology Unit, Sinai Health System, Toronto, Canada.
The bone & joint journal
|February 28, 2025
概括
对于加拿大的软组织肉瘤 (STS) 患者来说,前往中心化癌症中心的旅行距离没有影响疾病呈现或生存结果. 集中式护理模式即使在大型地理区域也很有效.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 公共卫生 公共卫生
背景情况:
- 软组织肉瘤 (STS) 是一种罕见的癌症,需要专门的集中治疗.
- 加拿大等国家的地理障碍可以显著增加患者前往这些中心的距离.
- 旅行距离对癌症呈现和中心化模型的结果的影响尚不清楚,特别是在单一付款者系统中.
研究的目的:
- 调查在加拿大第三级转诊中心治疗软组织肉瘤患者的旅行距离和临床结果之间的关联.
- 为了确定增加的旅行距离是否会影响疾病的呈现,治疗时间表或集中护理环境中的生存率.
主要方法:
- 在2010年至2021年间接受手术切除的1570名软组织肉瘤患者的回顾性队列分析.
- 患者根据距离转诊中心的距离 (≤50公里与>50公里) 进行了分层.
- 考克斯回归分析被用来确定包括旅行距离在内的整体生存预测因素.
主要成果:
- 生活在更远的地方 (>50公里) 的患者比居住在更近的地方 (平均24.8公里) 的患者旅行的时间显著多 (平均176公里).
- 两组之间在疾病表现,治疗时间,全身疗法使用或功能结果方面没有发现显著差异.
- 两年和五年总生存率在距离组之间是可比的,而旅行距离不是生存的独立预测因素.
结论:
- 在这个加拿大集中中心的软组织肉瘤患者中,旅行距离没有对疾病呈现或生存结果产生负面影响.
- 这些发现挑战了关于旅行距离影响癌症结果的先前假设.
- 这项研究支持集中式癌症护理模式的有效性,即使在地理扩张的国家.
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