华中地区乳腺癌患者术后随访评估的依从性及其与社会人口学和疾病特征的关系。
Adherence to post-surgery follow-up assessment and its association with sociodemographic and disease characteristics in patients with breast cancer in Central China.
机构信息
Department of Breast Surgery, The Affiliated Shanxi Bethune Hospital of Shanxi Medical University, 99 Longcheng Street, Taiyuan, 030032, Xiaodian District, China.
Cancer Research Institute, University of South Australia, Adelaide, 5000, Australia.
出版信息
BMC Cancer. 2020 Nov 12;20(1):1098. doi: 10.1186/s12885-020-07600-y.
BACKGROUND
Follow-up after curative surgery is increasingly recognized as an important component of breast cancer care. Although current guideline regulates the follow-ups, there are no relevant studies on the adherence to it in China. This study investigated the post-surgery follow-up and explored its association with patients, tumor and treatment characteristics.
METHODS
A total of 711 patients underwent surgical treatment in Shanxi Bethune Hospital from March 2012 to May 2018 were included in this study. Baseline sociodemographic, tumor, and treatment characteristics were obtained from the hospital electronic medical records. The post-surgery follow-up was reviewed and assessed from the patient's follow-up examination record. Factors associated with the first three-year follow up was evaluated using logistic regression analysis.
RESULTS
The annual follow-up rate after surgery decreased gradually from 67.1% at the 1st year, 60.2% at the 3rd year to 51.9% at the 4th year, and 43.5% at the 5th year. Loss of follow-up during the first 3 years after surgery was significantly associated with older age (> 65 years), lower medical insurance coverage, axillary lymph node dissection, and less intensity of systemic treatment.
CONCLUSION
A significant downtrend of annual follow-up rate for breast cancer survivors was confirmed in this study. Loss of follow-up within the first 3 years after surgery was associated with both patient's characteristics and treatment. These results will provide evidence to help clinicians to develop tailored patient management after curative surgery.
背景
根治性手术后的随访越来越被认为是乳腺癌治疗的重要组成部分。尽管目前的指南规定了随访，但中国尚未有相关研究关注其依从性。本研究调查了手术后的随访情况，并探讨了其与患者、肿瘤和治疗特征的关系。
方法
本研究纳入了 2012 年 3 月至 2018 年 5 月在山西白求恩医院接受手术治疗的 711 例患者。从医院电子病历中获取患者的基本社会人口学、肿瘤和治疗特征。从患者的随访检查记录中回顾和评估手术后的随访情况。使用逻辑回归分析评估与前三年随访相关的因素。
结果
术后随访率逐年下降，第 1 年为 67.1%，第 3 年为 60.2%，第 4 年为 51.9%，第 5 年为 43.5%。术后 3 年内失访与年龄较大（>65 岁）、医疗保险覆盖率较低、腋窝淋巴结清扫和全身治疗强度较低显著相关。
结论
本研究证实了乳腺癌幸存者术后年度随访率呈显著下降趋势。术后 3 年内的失访与患者特征和治疗均有关。这些结果将为临床医生制定根治性手术后的个体化患者管理提供证据。
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