Does delaying surgery following induction chemotherapy compromise survival in patients with mesothelioma?

IF 1.4 Q4 ONCOLOGY
Lye-Yeng Wong, Ioana Baiu, Matthew Leipzig, Ashley Titan, Douglas Z. Liou, Natalie Lui, Mark Berry, Joseph B. Shrager, Leah Backhus
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Abstract

Objective: The ideal time interval between induction chemotherapy and surgery and the impact on cancer mortality in patients with mesothelioma remains unclear. Methods: We queried the National Cancer Database (2004-2017) for patients with favorable prognostic factors considered for surgery. Immediate surgery was performed within 3 months following the start of induction chemotherapy, while delayed surgery was defined as surgery performed later than 3 months. We compared both groups to those who did not have an operation despite being surgical candidates, as well as to those who were treated with surgery only. Overall mortality was assessed using Cox proportional hazard models adjusting for covariates. Results: A total of 4,294 patients were included, with the majority of patients undergoing induction chemotherapy followed by no surgery (3,370, 78%). The proportion of patients undergoing both immediate and delayed surgery increased over the last decade, but delayed surgery continued to be more common. There were no significant differences in baseline characteristics between the immediate and delayed surgery groups. Higher comorbidity scores were significantly associated with an increased risk of death on multivariable analysis, but the timing of surgery was not. This held true with a sensitivity analysis using 6 months as the definition of delayed surgery. Conclusions: This study shows that delaying surgery following induction chemotherapy does not compromise overall survival in patients with mesothelioma.
诱导化疗后延迟手术是否会影响间皮瘤患者的生存?
目的:间皮瘤患者诱导化疗与手术之间的理想时间间隔及其对肿瘤死亡率的影响尚不清楚。方法:我们查询了国家癌症数据库(2004-2017)中考虑手术的预后因素良好的患者。诱导化疗开始后3个月内立即手术,延迟手术定义为3个月后手术。我们将两组患者与未接受手术的患者以及仅接受手术治疗的患者进行了比较。采用Cox比例风险模型对协变量进行校正,评估总死亡率。结果:共纳入4294例患者,大多数患者接受诱导化疗后未手术(3370例,78%)。在过去十年中,接受即时手术和延迟手术的患者比例有所增加,但延迟手术仍然更为常见。在立即手术组和延迟手术组之间,基线特征没有显著差异。多变量分析显示,较高的合并症评分与死亡风险增加显著相关,但与手术时间无关。在使用6个月作为延迟手术定义的敏感性分析中,这一结论成立。结论:本研究表明,诱导化疗后延迟手术并不影响间皮瘤患者的总生存率。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
3.20
自引率
5.30%
发文量
460
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