导管原位癌 (DCIS) 主动监测 (AS) 的临床试验正在进行中。我们试图了解生物学上有利的 DCIS 的历史处理情况，并确定未立即手术的患者的结果。使用 NCDB 2004 年至 2017 年的数据，选定的队列包括 40 岁以上、患有低度或中度且激素受体 (HR) 阳性 DCIS 的女性。 AS 被定义为不进行手术或诊断后 12 个月以上进行手术。将 AS 组的女性与立即接受手术的女性进行比较。 Cochran-Armitage 检验用于评估诊断一年内 AS 的趋势。估计 Kaplan-Meier 曲线以比较总生存期 (OS)，按年龄分层（<50、50-64、≥65），并使用 Cox 比例风险模型确定预后因素对生存分布的影响。 74,367 名女性符合研究纳入标准； 2384 人（3.2%）接受了 AS 治疗。 AS 队列中的患者比例逐年增加，2017 年达到峰值，达到 4.2%（p<0.01）。在多变量分析中，年龄增加（OR 1.02，p<0.01）、黑人种族（OR 1.7，p<0.001）和没有保险（OR 2.2，p<0.001）与 AS 可能性增加相关。在 50 岁以下的女性中，OS 结果相似，立即手术队列的 10 年 OS 为 97.4%，而 AS 队列为 99.1% (p = 0.43)。接受 AS 治疗的 DCIS 患者比例仍然很小，但随着时间的推移而增加。对于年轻、健康的女性来说，生物学上有利的 DCIS 与不良生存无关。© 2024。作者。

Clinical trials of active surveillance (AS) for Ductal Carcinoma in Situ (DCIS) are underway. We sought to understand the historical management of biologically favorable DCIS and to determine the outcomes of patients who did not have immediate surgery. Using data from the NCDB from 2004 to 2017, the selected cohort included women >40 years of age, with low or intermediate grade and hormone receptor (HR) positive DCIS. AS was defined as either no surgery or surgery >12 months from diagnosis. Women in the AS group were compared to women who had immediate surgery. A Cochran-Armitage test was used to assess the trend of AS over year of diagnosis. Kaplan-Meier curves were estimated to compare overall survival (OS), stratified by age (<50, 50-64, ≥65), and Cox proportional hazard models were used to determine the effects of prognostic factors on survival distributions. 74,367 women met study inclusion criteria; 2384 (3.2%) were treated with AS. The proportion of patients in the AS cohort increased yearly, peaking in 2017 at 4.2% (p < 0.01). On multivariable analysis, increasing age (OR 1.02, p < 0.01), black race (OR 1.7, p < 0.001), and being uninsured (OR 2.2, p < 0.001) were associated with increased likelihood of AS. In women <50 years of age, OS outcomes were similar, with 10-year OS of 97.4% in the immediate surgery cohort versus 99.1% in AS cohort (p = 0.43). The proportion of patients with DCIS treated with AS has remained small but is increasing over time. AS of biologically favorable DCIS in younger, healthier women is not associated with adverse survival.© 2024. The Author(s).