妇科肿瘤学家参与卵巢癌治疗标准的接受和生存。

World journal of obstetrics and gynecology Pub Date : 2016-01-01 Epub Date: 2016-05-10 DOI:10.5317/wjog.v5.i2.187
Sun Hee Rim, Shawn Hirsch, Cheryll C Thomas, Wendy R Brewster, Darryl Cooney, Trevor D Thompson, Sherri L Stewart
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引用次数: 17

摘要

目的:研究美国妇科肿瘤学家(GO)对手术/化疗标准护理(SOC)的影响,以及这如何转化为卵巢癌(OC)女性生存率的提高。方法:监测、流行病学和最终结果(SEER)-Medicare数据用于鉴定11688例OC患者(1992-2006)。仅纳入具有初始外科手术代码的医疗保险接受者(n = 6714)。医师专业是通过将SEER-Medicare与美国医学协会主文件相连接来确定的。SOC由一组go定义。采用多变量logistic回归来确定接受手术/化疗SOC的预测因素,并采用比例风险模型来估计SOC治疗和医生专业对生存率的影响。结果:约34%的患者接受了GO手术,25%的患者接受了整体SOC。三分之一的女性在护理过程中有过GO。接受GO手术的女性与非GO手术的女性相比,接受手术SOC的几率是2.35倍,接受化疗SOC的几率是1.25倍(P < 0.01)。未接受手术SOC的女性的死亡风险高于接受手术SOC的女性[风险比= 1.22 (95%CI: 1.12-1.33), P < 0.01],并且在调整协变量后,未接受手术SOC的女性与接受手术SOC的女性的死亡率也更高。接受联合SOC的妇女的中位生存时间延长了14个月。结论:接受手术SOC和GO的整体治疗具有生存优势。持续的生存差异,特别是未接受SOC的患者,需要进一步调查。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Gynecologic oncologists involvement on ovarian cancer standard of care receipt and survival.

Gynecologic oncologists involvement on ovarian cancer standard of care receipt and survival.

Gynecologic oncologists involvement on ovarian cancer standard of care receipt and survival.

Aim: To examine the influence of gynecologic oncologists (GO) in the United States on surgical/chemotherapeutic standard of care (SOC), and how this translates into improved survival among women with ovarian cancer (OC).

Methods: Surveillance, Epidemiology, and End Result (SEER)-Medicare data were used to identify 11688 OC patients (1992-2006). Only Medicare recipients with an initial surgical procedure code (n = 6714) were included. Physician specialty was identified by linking SEER-Medicare to the American Medical Association Masterfile. SOC was defined by a panel of GOs. Multivariate logistic regression was used to determine predictors of receiving surgical/chemotherapeutic SOC and proportional hazards modeling to estimate the effect of SOC treatment and physician specialty on survival.

Results: About 34% received surgery from a GO and 25% received the overall SOC. One-third of women had a GO involved sometime during their care. Women receiving surgery from a GO vs non-GO had 2.35 times the odds of receiving the surgical SOC and 1.25 times the odds of receiving chemotherapeutic SOC (P < 0.01). Risk of mortality was greater among women not receiving surgical SOC compared to those who did [hazard ratio = 1.22 (95%CI: 1.12-1.33), P < 0.01], and also was higher among women seen by non-GOs vs GOs (for surgical treatment) after adjusting for covariates. Median survival time was 14 mo longer for women receiving combined SOC.

Conclusion: A survival advantage associated with receiving surgical SOC and overall treatment by a GO is supported. Persistent survival differences, particularly among those not receiving the SOC, require further investigation.

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