Gill Amitoj, Gosain Rohit, Bhandari Shruti, Gosain Rahul, Gill Gurkirat, Abraham Joseph, Miller Kenneth
James Graham Brown Cancer Center, University of Louisville, Louisville, KY.
Division of Hematology and Oncology, Roswell Park Cancer Institute, Buffalo, NY.
Am J Clin Oncol. 2018 Oct;41(10):1024-1027. doi: 10.1097/COC.0000000000000408.
Follow-up cancer care is important for patients who have received IV chemotherapy but some patients discontinue their care and are lost to follow-up (LFU) at the cancer center where they were treated. The purpose of this study was to determine what proportion of cancer survivors are LFU at 5 years after treatment, the timing of LFU, and the characteristics of those who do not continue survivorship care.
Adult patients with cancer who were treated with chemotherapy at a large community teaching hospital in 2006 and 2007 were identified and linked with State tumor registry data. Hospital medical records were reviewed to obtain information on demographics, diagnosis, treatment, and date of last follow-up visit. Characteristics of patients with ≥5 years of follow-up care were compared with those who were LFU.
In total, 487 patients received chemotherapy and 304 died (62%) during the 5-year follow-up period. Among the 183 cancer patients who were known to be alive at 5 years, 92 (50%) were LFU and 50% (46/92) of this LFU group were LFU within 1 year of diagnosis. At 5 years, follow-up care was continuing for 55% of women, compared with 39% of men. The highest proportion of follow-up was observed among lung cancer patients (84%), followed by patients with breast cancers (63%) and gastrointestinal cancers (40%). Patients with hematological cancers had the lowest follow-up proportion at 5 years (29%) (P<0.05). Follow-up was not significantly associated with age (P=0.48), insurance status(P=0.29), and race(P=0.06).
It is estimated that 65% of the cancer survivors in the United States are ≥5 years beyond their diagnosis but there is little data on oncology follow-up rates. In our retrospective study of 183 patients who were treated with chemotherapy only 49.7% continue to follow-up at their treatment center. LFU has important implications in planning long-term care strategies for cancer survivors and in survivorship research.
后续癌症护理对于接受过静脉化疗的患者很重要，但一些患者会中断护理，并在接受治疗的癌症中心失去随访（LFU）。本研究的目的是确定癌症幸存者在治疗后5年时失去随访的比例、失去随访的时间，以及那些不再继续接受生存护理的患者的特征。
确定2006年和2007年在一家大型社区教学医院接受化疗的成年癌症患者，并将其与州肿瘤登记数据相关联。查阅医院病历以获取有关人口统计学、诊断、治疗和最后一次随访日期的信息。将接受≥5年随访护理的患者特征与失去随访的患者特征进行比较。
在5年随访期内，共有487例患者接受了化疗，304例（62%）死亡。在已知5年时仍存活的183例癌症患者中，92例（50%）失去随访，且该失去随访组中有50%（46/92）在诊断后1年内失去随访。在5年时，55%的女性继续接受随访护理，而男性为39%。肺癌患者的随访比例最高（84%），其次是乳腺癌患者（63%）和胃肠道癌症患者（40%）。血液系统癌症患者在5年时的随访比例最低（29%）（P<0.05）。随访与年龄（P=0.48）、保险状况（P=0.29）和种族（P=0.06）无显著关联。
据估计，美国65%的癌症幸存者已确诊超过5年，但关于肿瘤学随访率的数据很少。在我们对183例仅接受化疗的患者的回顾性研究中，只有49.7%的患者继续在其治疗中心接受随访。失去随访对癌症幸存者长期护理策略的规划和生存研究具有重要意义。
