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在先进的上皮卵巢癌中降低细胞还原性手术的相关因素:基于人口的研究
Lei Zhao1, Gang Cheng2, Xin Zhou1
1Department of Gynecology, Kunshan Hospital of Traditional Chinese Medicine, Jiangsu, Kunshan, 215300, China.
World journal of surgical oncology
|April 4, 2025
概括
患有晚期上皮卵巢癌 (EOC) 的患者拒绝细胞还原手术,其生存率明显降低. 社会人口统计学因素影响了这一决定,突出了EOC治疗机会的差异.
科学领域:
- 妇科瘤学 妇科瘤学
- 癌症流行病学 癌症流行病学
- 医疗保健服务研究 医疗服务研究
背景情况:
- 细胞还原性手术是晚期上皮卵巢癌 (EOC) 的关键治疗方法.
- 一部分患有晚期EOC的患者拒绝接受推的手术,影响治疗结果.
- 了解影响手术拒绝的因素对于改善患者护理至关重要.
研究的目的:
- 为了评估晚期EOC患者的生存结果,这些患者拒绝了细胞还原手术.
- 确定与拒绝在先进EOC手术的决定相关的社会人口和临床因素.
主要方法:
- 来自SEER数据库 (2004-2021) 的21,988名晚期EOC患者的回顾性分析.
- 使用倾向分数匹配 (PSM) 进行手术与非手术队列的比较.
- 后勤回归用于识别手术下降的预测因素.
主要成果:
- 1.7%的患者 (363) 拒绝了手术,显示出明显较低的整体存活率 (17.8 vs 45.8 个月).
- 拒绝手术增加了PSM后的死亡风险 (HR,1.87).
- 手术拒绝与非西班牙裔黑人种族,年龄较大,收入较低,农村居住和未婚状况有关.
结论:
- 细胞还原手术的下降与高级EOC的生存率下降密切相关.
- 社会人口统计学因素显著影响手术决策,表明治疗差异.
- 需要有针对性的干预措施,以提高手术护理的准入,并减少EOC结果差异.
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