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美国妇科肿瘤学家手术实践的横断面调查。

Cross-sectional survey of surgical practices among gynecologic oncologists in the United States.

机构信息

Gynecology Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.

Department of Epidemiology and Biostatistics, Memorial Sloan Kettering Cancer Center, New York, NY, United States of America.

出版信息

Gynecol Oncol. 2023 May;172:36-40. doi: 10.1016/j.ygyno.2023.03.004. Epub 2023 Mar 16.

DOI:10.1016/j.ygyno.2023.03.004
PMID:36933401
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC10192122/
Abstract

OBJECTIVE

We sought to document current surgical practices among gynecologic oncologists in the United States.

METHODS

In March/April 2020, we conducted a cross-sectional survey among members of the Society of Gynecologic Oncology to identify gynecologic oncology practice trends in the United States. The survey collected demographic data and queried participants on types of surgical procedures performed and chemotherapy use. Univariant and multivariant analyses were used to evaluate the association between surgeon practice type, region of practice, working with gynecologic oncology fellows, time in practice, and dominant surgical modality of practice on performance of specific procedures.

RESULTS

Among 1199 gynecologic oncology surgeons who were emailed the survey, 724 completed the survey (60.4% response rate). Of these respondents, 170 (23.5%) were within 6 years of fellowship graduation, 368 (50.8%) identified as female; and 479 (66.2%) worked in an academic setting. Surgeons who worked with gynecologic oncology fellows were more likely to perform bowel surgery, upper abdominal surgery, complex upper abdominal surgery, and prescribe chemotherapy. Surgeons who were ≥ 13 years out from fellowship graduation were more likely to perform bowel surgery and complex abdominal surgery and less likely to prescribe chemotherapy and perform sentinel lymph node dissections (P < 0.05).

CONCLUSIONS

These findings highlight the variation in surgical procedures performed by gynecologic oncologists in the United States. These data support that there are practice variations that would benefit from further investigation.

摘要

目的

我们旨在记录美国妇科肿瘤学家当前的手术实践情况。

方法

2020 年 3 月/4 月,我们对妇科肿瘤学会的成员进行了横断面调查,以确定美国妇科肿瘤学实践中的趋势。该调查收集了人口统计学数据,并询问了参与者所进行的手术类型和化疗使用情况。单变量和多变量分析用于评估外科医生实践类型、实践地区、与妇科肿瘤学研究员合作、实践时间以及主要手术方式与特定手术操作之间的关联。

结果

在向 1199 名发送电子邮件的妇科肿瘤外科医生中,有 724 名完成了调查(60.4%的回复率)。在这些应答者中,有 170 名(23.5%)在 fellowship毕业后 6 年内,368 名(50.8%)为女性;479 名(66.2%)在学术环境中工作。与妇科肿瘤学研究员合作的外科医生更有可能进行肠道手术、上腹部手术、复杂的上腹部手术和开具化疗药物。毕业后≥13 年的外科医生更有可能进行肠道手术和复杂的腹部手术,不太可能开具化疗药物和进行前哨淋巴结解剖(P<0.05)。

结论

这些发现突出了美国妇科肿瘤医生所进行的手术程序的差异。这些数据表明存在需要进一步调查的实践差异。

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本文引用的文献

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Doubling down on the future of gynecologic oncology: The SGO future of the profession summit report.加倍关注妇科肿瘤学的未来:妇科肿瘤学会专业未来峰会报告
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Trends in ureteral surgery on an academic gynecologic oncology service.妇科肿瘤学学术服务中的输尿管手术趋势。
Gynecol Oncol. 2021 Dec;163(3):552-556. doi: 10.1016/j.ygyno.2021.10.009. Epub 2021 Oct 19.
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National trends in bowel and upper abdominal procedures in ovarian cancer surgery.卵巢癌手术中肠道和上腹部手术的全国趋势。
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Gynecol Oncol. 2020 Jul;158(1):188-193. doi: 10.1016/j.ygyno.2020.05.006. Epub 2020 May 23.
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Twenty-year surgical trends in a gynecologic oncology fellowship training program: Implications for practice.妇科肿瘤学奖学金培训计划中 20 年的手术趋势:对实践的影响。
Gynecol Oncol. 2019 Nov;155(2):359-364. doi: 10.1016/j.ygyno.2019.09.013. Epub 2019 Sep 28.
6
Trends in surgical complexity and treatment modalities utilized in the management of ovarian cancer in an era of neoadjuvant chemotherapy.新辅助化疗时代卵巢癌治疗中手术复杂性和治疗方式的变化趋势。
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Continuous improvement in primary Debulking surgery for advanced ovarian cancer: Do increased complete gross resection rates independently lead to increased progression-free and overall survival?在晚期卵巢癌的初级减瘤术中不断改进:更高的完全大体切除率是否能独立提高无进展生存期和总生存期?
Gynecol Oncol. 2018 Oct;151(1):24-31. doi: 10.1016/j.ygyno.2018.08.014. Epub 2018 Aug 17.
8
Effect of Total Laparoscopic Hysterectomy vs Total Abdominal Hysterectomy on Disease-Free Survival Among Women With Stage I Endometrial Cancer: A Randomized Clinical Trial.腹腔镜全子宫切除术与经腹全子宫切除术治疗Ⅰ期子宫内膜癌无病生存的效果比较:一项随机临床试验。
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A comparison of sentinel lymph node biopsy to lymphadenectomy for endometrial cancer staging (FIRES trial): a multicentre, prospective, cohort study.比较前哨淋巴结活检与淋巴结切除术用于子宫内膜癌分期的研究(FIRES 试验):一项多中心、前瞻性、队列研究。
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