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2 周候诊制转诊对头颈部癌症患者生存的影响。

The impact of 2 weeks wait referral on survival of head and neck cancer patients.

机构信息

Division of Surgical Oncology, Head and Neck Surgery, Guy's and St Thomas' NHS Foundation Trust, London, UK.

Cancer Epidemiology, King's College London, London, UK.

出版信息

Eur Arch Otorhinolaryngol. 2023 Dec;280(12):5557-5564. doi: 10.1007/s00405-023-08152-0. Epub 2023 Aug 1.

Abstract

PURPOSE

This study aims to evaluate the association between 2 weeks wait referral and survival in the head and neck cancer.

METHODS

Retrospective cohort study of consecutively discussed new head and neck cancer patients at large United Kingdom Cancer Alliance including two tertiary referral hospitals and two district general hospital.

RESULTS

A total of 276 cancer patients were included for analysis. Patients referred under the 2 weeks wait had were seen and diagnosed sooner from referral (p < 0.0001 and p < 0.0001 respectively). However, this did not translate into better survival outcomes. No survival differences were seen between those patients that were managed within the proposed cancer targets and those that were not.

CONCLUSIONS

The 2 weeks wait head and neck cancer pathway did not offer a survival advantage. Targeting the delay in referral as well as delay in treatment to prevent late-stage cancer presentation is paramount. Fulfilment of cancer time targets do not translate into better outcomes and should not be prioritised to clinical judgement.

摘要

目的

本研究旨在评估 2 周等待转诊与头颈部癌症患者生存之间的关系。

方法

对英国大型癌症联盟中连续讨论的新头颈部癌症患者进行回顾性队列研究,包括两家三级转诊医院和两家地区综合医院。

结果

共纳入 276 例癌症患者进行分析。在 2 周等待期内转诊的患者从转诊到就诊的时间更早(p<0.0001 和 p<0.0001)。然而,这并没有转化为更好的生存结果。那些在拟议的癌症治疗目标内得到管理的患者与未得到管理的患者之间,生存情况没有差异。

结论

2 周等待期的头颈部癌症通路并没有带来生存优势。靶向治疗转诊和治疗延迟,以预防晚期癌症发生,这一点至关重要。满足癌症时间目标并不能转化为更好的结果,不应优先考虑临床判断。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/426a/10620249/2cb4157be02b/405_2023_8152_Fig1_HTML.jpg

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