Department of Clinical Neuroscience, Karolinska Hospital, 171 76, Stockholm, Sweden.
Acta Neurochir (Wien). 2011 Mar;153(3):467-71. doi: 10.1007/s00701-010-0894-0. Epub 2010 Dec 15.
Swedish health care legislation requires equal, high-quality health care for all inhabitants, while regional differences of medical availability and treatment potentially allow for different outcomes. This study was undertaken to evaluate whether glioma survival differed between the Stockholm region and the other Swedish regions since the Stockholm region has easier mean access to regional care and had started a specialized neuro-oncology service for all inhabitants of the region.
The Swedish Cancer Registry was searched for all gliomas in the neuroepithelial tissue, aged 16-79 years, and diagnosed between 1996 and the end of 2001. Survival analysis was performed using the Kaplan-Meier method. Survival rates from the Stockholm Regional Cancer Registry area was compared to the other areas in Sweden combined.
For high-grade glioma, the 2-year survival was 25% in Stockholm and 14% in the other areas. For low-grade glioma, the 2-year survival was 82% and 72%, respectively. The largest 2-year survival difference was detected for glioblastoma patients aged 16-54 years, with 27% survival in the Stockholm area compared to 12% in the other areas.
We cannot rule out all possible bias in our study, but results indicated higher 2-year survival for patients with glioma in the Stockholm region than in other regions of Sweden. These data are incompatible with the legislation of equal health care.
瑞典的医疗保健立法要求为所有居民提供平等、高质量的医疗保健，而医疗资源的可得性和治疗方法的地区差异可能会导致不同的结果。本研究旨在评估自斯德哥尔摩地区更容易获得区域性医疗服务以来，以及该地区开始为所有居民提供专门的神经肿瘤服务以来，胶质母细胞瘤的生存率是否在斯德哥尔摩地区和瑞典其他地区存在差异。
在瑞典神经上皮组织中搜索了所有年龄在 16-79 岁之间、1996 年至 2001 年底诊断出的胶质母细胞瘤病例。使用 Kaplan-Meier 方法进行生存分析。将斯德哥尔摩区域癌症登记处的生存率与瑞典其他地区进行比较。
对于高级别胶质瘤，斯德哥尔摩地区的 2 年生存率为 25%，瑞典其他地区为 14%。对于低级别胶质瘤，2 年生存率分别为 82%和 72%。在 16-54 岁的胶质母细胞瘤患者中，2 年生存率的差异最大，斯德哥尔摩地区的生存率为 27%，而瑞典其他地区为 12%。
我们不能排除我们研究中的所有可能偏见，但结果表明，斯德哥尔摩地区胶质母细胞瘤患者的 2 年生存率高于瑞典其他地区。这些数据与平等医疗保健的立法相矛盾。
