Kaitlyn C. Dykes, Jiling Chou, Allison O. Taylor, Albert C. Shu, Sarah E. Mudra, Xiaoyang Ma, Jaeil Ahn, Catherine E. Lai
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引用次数: 0
Abstract
Bakground
It is important to understand the outcomes of adult acute lymphoblastic leukemia (ALL) patients at different facilities as treatment paradigms change.
Aims
Our primary objective was to determine adult ALL overall survival (OS) by facility volume and type. Secondary objectives included identifying sociodemographic factors that may have impacted outcomes and analyzing treatment patterns by facility volume and type.
Methods
This was a retrospective analysis of the National Cancer Database (NCDB) that included patients ≥40 years diagnosed with ALL between 2004 and 2016.
Results
A total of 14 593 patients were included in this study. Univariate OS was greatest at low volume (LV) and community programs (CPs) and the least at high volume (HV) and academic programs (AP). This difference was lost after multivariable Cox proportional hazards model analysis, which found no difference in survival by facility volume or type, however, survival was significantly influenced by age, race, Hispanic ethnicity, insurance, and residence location (p < 0.05). Patients treated at HV and APs compared to LV and CP received more anti-neoplastic directed therapy.
Conclusion
Our results suggest treatment facility volume and type do not impact older adult ALL patient (≥40 years) survival, however confounding sociodemographic differences do impact survival outcomes, despite more aggressive and novel treatment approaches provided at HV and APs.
背景：随着治疗模式的改变，了解成人急性淋巴细胞白血病（ALL）患者在不同医疗机构的治疗效果非常重要。目的：我们的首要目标是根据医疗机构的规模和类型确定成人ALL的总生存率（OS）。次要目标包括确定可能影响疗效的社会人口学因素，并根据医疗机构的规模和类型分析治疗模式：这是一项对国家癌症数据库（NCDB）的回顾性分析，其中包括2004年至2016年间确诊为ALL的年龄≥40岁的患者：本研究共纳入14 593名患者。单变量OS在低容量（LV）和社区项目（CPs）中最大，在高容量（HV）和学术项目（AP）中最小。多变量考克斯比例危险模型分析发现，设施数量或类型对存活率没有影响，但年龄、种族、西班牙裔、保险和居住地对存活率有显著影响（P 结论：我们的研究结果表明，治疗设施数量和类型对存活率没有影响：我们的研究结果表明，治疗机构的数量和类型不会影响老年 ALL 患者（≥40 岁）的存活率，但是，尽管 HV 和 AP 提供了更积极、更新颖的治疗方法，社会人口统计学差异仍会影响存活率。
期刊介绍：
Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance.
Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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