指南一致的治疗可改善高级别子宫内膜癌患者的生存。
Guideline concordant therapy improves survival in high-grade endometrial cancer patients.
机构信息
Department of Radiation Oncology, University Hospital Ulm, Ulm, Germany.
Tumor Center, Institute for Quality Management and Health Services Research, University of Regensburg, Regensburg, Germany.
出版信息
J Cancer Res Clin Oncol. 2023 Jul;149(8):4761-4769. doi: 10.1007/s00432-022-04318-1. Epub 2022 Oct 14.
PURPOSE
Data from randomized controlled trials in high-grade endometrial cancer are scarce due to its low prevalence. Therefore, guideline recommendations in this cancer subtype rely on relatively few randomized trials and data from retrospective studies. The aim of this study was to evaluate the benefits from guideline-concordant therapy in high-grade endometrial cancer in a real-world patient group.
METHODS
The effect of treatment according to German S3 guidelines and the former S2k guideline on overall survival (OS) and recurrence-free survival (RFS) was evaluated in a cohort of 293 high-grade endometrial cancer patients.
RESULTS
Treatment concordant with the S3 guideline significantly improved OS (HR 0.623, CI 0.420-0.923, p = 0.018) and RFS (HR 0.578, CI 0.387-0.863, p = 0.007). Treatment concordant with the S2k guideline did not result in a significantly higher OS (HR 0.783, CI 0.465-1.316, p = 0.335) or RFS (HR 0.741, CI 0.347-1.740, p = 0.242).
CONCLUSION
Therapy according to the German S3 guideline improved OS and RFS in univariate as well as multivariate analysis in this cohort of high-grade endometrial cancer patients.
目的
由于高级别子宫内膜癌的发病率较低，因此其随机对照试验数据稀缺。因此，该癌症亚型的指南建议主要依赖于相对较少的随机试验和回顾性研究的数据。本研究旨在评估在真实患者群体中，遵循指南的治疗方案对高级别子宫内膜癌的获益。
方法
本研究评估了 293 名高级别子宫内膜癌患者中，根据德国 S3 指南和前 S2k 指南进行治疗对总生存期（OS）和无复发生存期（RFS）的影响。
结果
与 S3 指南一致的治疗显著改善了 OS（HR 0.623，CI 0.420-0.923，p=0.018）和 RFS（HR 0.578，CI 0.387-0.863，p=0.007）。与 S2k 指南一致的治疗并未显著提高 OS（HR 0.783，CI 0.465-1.316，p=0.335）或 RFS（HR 0.741，CI 0.347-1.740，p=0.242）。
结论
在本高级别子宫内膜癌患者队列中，S3 指南指导的治疗在单变量和多变量分析中均提高了 OS 和 RFS。
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