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治疗延迟对卵巢癌患者预后的影响:一项基于监测、流行病学和最终结果数据库的人群研究。

Impact of Treatment Delay on the Prognosis of Patients with Ovarian Cancer: A Population-based Study Using the Surveillance, Epidemiology, and End Results Database.

作者信息

Zhao Jing, Chen Ruiying, Zhang Yanli, Wang Yu, Zhu Haiyan

机构信息

Department of Shanghai Key Laboratory of Maternal Fetal Medicine, Shanghai Institute of Maternal-Fetal Medicine and Gynecologic Oncology, Shanghai First Maternity and Infant Hospital, School of Medicine, Tongji University, Shanghai, China.

出版信息

J Cancer. 2024 Jan 1;15(2):473-483. doi: 10.7150/jca.87881. eCollection 2024.

Abstract

This study aimed to assess the impact of treatment delay on prognosis in patients with ovarian cancer. A retrospective analysis of patients with ovarian cancer in the Surveillance, Epidemiology, and End Results (SEER) database between 2010 and 2015 was performed. Chi-square tests were used to assess baseline differences. The Kaplan-Meier method was used to evaluate the effect of different treatment intervals on survival outcomes in patients. Cox regression analyses were used to identify independent factors associated with ovarian cancer prognosis. Of the 21,590 patients included, 15,675 (72.6%), 5,582 (25.9%), and 333 (1.54%) were classified into the immediate-treatment (<1 month after diagnosis), intermediate-delay (1-2 month delayed), and long-delay groups (≥3 months delayed), respectively. The 5-year probability of overall survival (OS) was 61.4% in the immediate-treatment group, decreasing to 36.4% and 34.8% in the intermediate- and long-delay groups, respectively. Similar survival differences were also reflected in cancer-specific survival (CSS), with 5-year CSS probabilities of 66.7%, 42.6%, and 41.8% in the aforementioned groups, respectively. Patients in the intermediate-delay group showed poorer OS (adjusted hazard ratio [HR], 1.06; 95% confidence interval [CI], 1.02-1.11; p=0.006) and CSS (adjusted HR, 1.06; 95% CI, 1.01-1.11; p=0.012) than immediate-treatment group. Patients with delayed treatment had poorer OS and CSS. The patient's waiting time from diagnosis to initial treatment should be within 1 month.

摘要

本研究旨在评估治疗延迟对卵巢癌患者预后的影响。对2010年至2015年间监测、流行病学和最终结果(SEER)数据库中的卵巢癌患者进行了回顾性分析。采用卡方检验评估基线差异。采用Kaplan-Meier方法评估不同治疗间隔对患者生存结局的影响。采用Cox回归分析确定与卵巢癌预后相关的独立因素。在纳入的21590例患者中,15675例(72.6%)、5582例(25.9%)和333例(1.54%)分别被分为立即治疗组(诊断后<1个月)、中度延迟组(延迟1-2个月)和长期延迟组(延迟≥3个月)。立即治疗组的5年总生存率(OS)为61.4%,中度延迟组和长期延迟组分别降至36.4%和34.8%。癌症特异性生存率(CSS)也有类似的生存差异,上述三组的5年CSS概率分别为66.7%、42.6%和41.8%。中度延迟组患者的OS(调整后风险比[HR],1.06;95%置信区间[CI],1.02-1.11;p=0.006)和CSS(调整后HR,1.06;95%CI,1.01-1.11;p=0.012)均比立即治疗组差。治疗延迟的患者OS和CSS较差。患者从诊断到初始治疗的等待时间应在1个月内。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8aff/10758034/d4004bbc074a/jcav15p0473g001.jpg

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