教科书肿瘤学结果是一种易于使用的综合质量指标，与晚期卵巢癌的生存密切相关
Textbook oncologic outcome is an easy-to-use composite quality measure that is strongly associated with survival in advanced-stage ovarian cancer
影响因子:4.10000
分区:医学2区 Top / 妇产科学1区 肿瘤学2区
发表日期:2024 Dec
作者:
Giuseppe Caruso, Carrie L Langstraat, Amanika Kumar, Michaela E McGree, Angela J Fought, Dimitrios Nasioudis, Giovanni D Aletti, Nicoletta Colombo, Robert L Giuntoli, William A Cliby
摘要
教科书肿瘤结果（也是）在手术肿瘤学中已被验证，这是一种与肿瘤学结果相关的复合质量措施。我们的目的是评估接受晚期上皮性脂肪癌症（AEOC）接受初级治疗的患者（AEOC）的总体生存期（OS）的关联。分别分析了原发性延迟手术（PDS）和间隔伪造手术（IDS）队列。也被定义为实现完整的延伸，住院时间<10天，没有30天的再入院，90天内没有死亡以及在42天内开始辅助化学疗法。 Kaplan-Meier方法用于估计5年OS的状态和COX回归，以评估5年内Too与死亡之间的关系。总共包括21,657名患者：PDS队列中的51.4％和IDS队列中的48.6％。在PDS队列的20.5％和IDS队列的39.2％中也实现了（Too+）。对于PDS队列，达到的5年OS也与59.0％的OS相关，而39.5％也是如此 - （HR 0.53，95％CI 0.49-0.57）。对于IDS队列，对于5年OS：43.9％也可以看到类似的益处，而31.2％也是如此 - （HR 0.67，95％CI 0.63-0.70）。多变量分析表明，在PDS队列（HR 0.58，95％CI 0.54-0.62）和IDS队列中，在5年内达到的患者的死亡风险较低，并且在长期进行了质量的质量质量质量质量时，对长期的评估工具相关联（HR 0.69，95％CI 0.65-0.73）。手术时机。该工具反映了使用多学科方法提供基于风险的个性化决策的能力。
Abstract
Textbook oncologic outcome (TOO) has been validated in surgical oncology as a composite quality measure correlated with oncologic outcomes. We aimed to assess the association between TOO and overall survival (OS) in patients undergoing primary treatment for advanced epithelial tubo-ovarian cancer (AEOC).Patients undergoing surgery for AEOC between 2008 and 2019 were identified in the National Cancer Database (NCDB). Primary debulking surgery (PDS) and interval debulking surgery (IDS) cohorts were analyzed separately. TOO was defined as achieving complete debulking, length of hospital stay <10 days, no 30-day readmission, no death within 90 days, and initiation of adjuvant chemotherapy within 42 days. The Kaplan-Meier method was used to estimate 5-year OS by TOO status and Cox regression to evaluate the relationship between TOO and death within 5 years.A total of 21,657 patients were included: 51.4% in the PDS cohort and 48.6% in the IDS cohort. TOO was achieved (TOO+) in 20.5% of the PDS cohort and 39.2% of the IDS cohort. For the PDS cohort, achieving TOO was associated with improved 5-year OS: 59.0% TOO+ vs. 39.5% TOO- (HR 0.53, 95% CI 0.49-0.57). For the IDS cohort, a similar benefit was seen for 5-year OS: 43.9% TOO+ vs. 31.2% TOO- (HR 0.67, 95% CI 0.63-0.70). Multivariable analysis demonstrated that patients achieving TOO were at lower risk of death within 5 years in both the PDS cohort (HR 0.58, 95% CI 0.54-0.62) and the IDS cohort (HR 0.69, 95% CI 0.65-0.73).The TOO composite measure is associated with improved long-term survival and could be a useful quality assessment tool for patients undergoing primary treatment for AEOC, irrespective of surgical timing. This tool reflects the ability to deliver risk-based individualized decision-making using a multidisciplinary approach.