[乳腺癌治疗的延误：巴黎公立医院集团（AP-HP）一家专家中心的经验]
[Delays in treatment of breast cancer: experience of an expert center of the Assistance Publique-Hôpitaux de Paris (AP-HP)].
作者信息
Revaux A, Laas E, Chopier J, Thomassin-Naggara I, Touboul E, Antoine M, Gligorov J, Darai E
机构信息
Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service de gynécologie obstétrique et médecine de la reproduction, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
Centre expert de cancérologie mammaire, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France; Université Pierre-et-Marie-Curie, Sorbonne Université, institut universitaire de cancérologie, 4, place Jussieu, 75005 Paris, France; Service de gynécologie obstétrique et médecine de la reproduction, hôpital Tenon, HUEP, Assistance Publique-Hôpitaux de Paris, 4, rue de la Chine, 75020 Paris, France.
出版信息
Gynecol Obstet Fertil. 2014 Sep;42(9):585-90. doi: 10.1016/j.gyobfe.2014.05.005. Epub 2014 Jun 30.
OBJECTIVES
The National Institute of the Cancer (INCA) recently published a study over the deadlines of medical care of breast cancers. We compared our delay within the framework of our expert center with their results.
PATIENTS AND METHODS
Our work is a retrospective unicentric non-interventional study. We included all the patients taken care for a breast cancer to the hospital Tenon in Paris. The criteria of inclusion were a primitive breast cancer, having accepted a care for a first cancer operated over a period of three months. We recovered 9 key deadlines to study the care of our patients.
RESULTS
Sixty-six patients were included. The mean age was of 55.6 years. The deadline of access to the hospital Tenon was 8.7 ± 7.7 days for the meetings of gynecology and 4.3 ± 4 days for those of radiology. The deadline of access to the diagnosis was 31.8 ± 26 days. The deadlines of access to the meeting of multidisciplinary dialogue pre-therapeutic was 13 ± 11 days. The access to the first management time was 18.5 days for the neoadjuvant chemotherapy and 13.5 days for surgery. The deadline of access to the postoperative therapeutic proposal was on average 20 ± 8 days. The deadline of access to the postoperative radiotherapy was of 197 days in case of postoperative chemotherapy vs 47.5 days without chemotherapy. The global deadline mammography-radiotherapy was of 188 days.
DISCUSSION AND CONCLUSION
The deadline of access to the diagnosis, to the postoperative therapeutic proposal and the global deadline mammography-radiotherapy with adjuvant chemotherapy or neoadjuvant were longer in our center compared with the results of the INCA. The deadlines of access to the surgery and access to the radiotherapy without postoperative chemotherapy were shorter on the other hand. The contribution of the diagnosis in one day for breast cancer is probably going to allow us to improve the deadlines of care in our structure.
目的
国立癌症研究所（INCA）最近发表了一项关于乳腺癌医疗期限的研究。我们将我们专家中心框架内的延迟情况与他们的结果进行了比较。
患者与方法
我们的研究是一项回顾性单中心非干预性研究。我们纳入了所有在巴黎特农医院接受乳腺癌治疗的患者。纳入标准为原发性乳腺癌，接受过首次癌症治疗且手术时间在三个月内。我们收集了9个关键期限来研究患者的治疗情况。
结果
共纳入66例患者。平均年龄为55.6岁。特农医院的妇科会诊就诊期限为8.7±7.7天，放射科会诊为4.3±4天。诊断就诊期限为31.8±26天。术前多学科对话会诊就诊期限为13±11天。新辅助化疗的首次治疗时间为18.5天，手术为13.5天。术后治疗方案的就诊期限平均为20±8天。术后化疗患者的术后放疗就诊期限为197天，未化疗患者为47.5天。乳腺钼靶检查至放疗的总期限为188天。
讨论与结论
与INCA的结果相比，我们中心的诊断就诊期限、术后治疗方案就诊期限以及辅助化疗或新辅助化疗后的乳腺钼靶检查至放疗的总期限更长。另一方面，手术就诊期限和未进行术后化疗的放疗就诊期限较短。乳腺癌一天内确诊可能有助于我们改善本机构的治疗期限。
Zotero 插件