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实施个性化监测方案后,结肠癌监测质量得到提高。

Improved quality of colon cancer surveillance after implementation of a personalized surveillance schedule.

机构信息

Department of Surgery, Cantonal Hospital Olten, Olten, Switzerland.

Department of General, Visceral and Vascular Surgery, Campus Benjamin Franklin, Charité University of Medicine, Berlin, Germany.

出版信息

J Surg Oncol. 2020 Sep;122(3):529-537. doi: 10.1002/jso.25973. Epub 2020 May 14.

Abstract

BACKGROUND

Early detection of recurrence through surveillance after curative surgery for primary colon cancer is recommended. We previously reported inadequate quality of surveillance among patients operated for colon cancer. These poor results led to the introduction of a personalized surveillance schedule. This study reassesses the quality of surveillance after the introduction of the personalized schedule.

PATIENTS AND METHODS

A total of 93 patients undergoing curative surgery for colon cancer between January 2009 and December 2014 (prospective data registration) were included in this retrospective single-center cohort study. Written informed consent was given by all patients. Compliance with surveillance was compared with national guidelines, as well as with the previous results and analyzed depending on where surveillance was conducted (general practitioner or outpatient clinic).

RESULTS

Adherence to surveillance was higher when performed by oncologists compared to general practitioners with an odds ratio (OR), 6.03 (95%CI: 3.41-10.67, P = .001). Compared with the previous study, adherence to surveillance was significantly higher in the later cohort with an OR = 4.55 (95%CI: 2.50-8.33, P < 0.001).

CONCLUSION

This study demonstrates that the implementation of a personalized surveillance schedule improves adherence to recommendations and that awareness can be increased with this simple measure.

摘要

背景

建议对原发性结肠癌根治术后进行监测以早期发现复发。我们之前报告过结肠癌手术后监测质量不足。这些不良结果导致引入了个性化监测计划。本研究在引入个性化计划后重新评估了监测质量。

患者和方法

本回顾性单中心队列研究共纳入 93 例 2009 年 1 月至 2014 年 12 月期间接受结肠癌根治术的患者(前瞻性数据登记)。所有患者均签署了书面知情同意书。将监测的依从性与国家指南进行了比较,并根据监测地点(全科医生或门诊)进行了分析。

结果

与全科医生相比,由肿瘤医生进行监测时,依从性更高,优势比(OR)为 6.03(95%CI:3.41-10.67,P=0.001)。与之前的研究相比,后期队列的监测依从性显著更高,OR=4.55(95%CI:2.50-8.33,P<0.001)。

结论

本研究表明,实施个性化监测计划可提高建议的依从性,并且通过这一简单措施可以提高认识。

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