无症状第四阶段结肠癌患者的护理模式:基于人口的分析
Lauren Weaver1, Catherine G Tran2, Amanda R Kahl3
1Division of Colon & Rectal Surgery, Department of Surgery, University of Minnesota, Minneapolis, MN. Electronic address: https://twitter.com/LWeaver_MD.
Surgery
|May 21, 2025
概括
近四分之一的无症状第四期结肠癌患者没有接受治疗. 系统治疗和手术的结合提供了最好的生存结果,突出了结肠癌护理干预的关键领域.
科学领域:
- 在瘤学瘤学.
- 胃肠病学 胃肠病学
- 公共卫生 公共卫生
背景情况:
- 目前的指导方针建议对无症状的第四阶段结肠癌进行化疗,对有症状的病例保留手术.
- 这一患者群的美国治疗模式仍未得到充分研究.
研究的目的:
- 为了研究美国无症状转移性结肠癌的现实世界治疗模式.
- 分析影响治疗方式选择的因素及其对生存的影响.
主要方法:
- 2014年监测,流行病学和最终结果护理模式数据库的分析.
- 将患者分为六个治疗组:化疗+/-生物药物,化疗+/-生物药物与切除/转移切除,化疗+/-生物药物仅进行初级切除,仅进行初级切除,不接受治疗,或其他.
- 使用多项逻辑回归和Cox比例危险模型来评估治疗与生存的关联.
主要成果:
- 28%接受化疗+/-生物药物;23%接受化疗+/-生物药物与原发性瘤切除;12%接受化疗+/-生物药物与原发性瘤切除和转移切除;12%仅接受原发性瘤切除;23%没有接受治疗.
- 年轻的患者更有可能接受积极的治疗 (化学疗法与切除/转移切除) 并不太可能接受任何治疗.
- 化学疗法与原发性瘤切除和转移切除的组合产生了最长的中位生存期 (61个月),而没有治疗时为1个月.
结论:
- 在无症状的第四阶段结肠癌患者中,很大一部分 (近25%) 没有接受任何治疗.
- 治愈性全身和外科治疗给了12%的患者,与5年平均存活率相关联.
- 这些发现为未来的研究和针对无症状第四阶段结肠癌的干预措施奠定了关键的基准.
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