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癌症患者接受姑息治疗后长期生存的相关因素:一项探索性研究。

Factors Associated With Long Survival in Patients With Cancer Admitted to Palliative Care: An Exploratory Study.

机构信息

Faculty of Medicine, Porto University, Porto, Portugal.

Department of Palliative Care, Portuguese Oncology Institute of Porto, Porto, Portugal.

出版信息

J Palliat Care. 2024 Jul;39(3):244-252. doi: 10.1177/08258597241231005. Epub 2024 Feb 19.

Abstract

Some patients with cancer admitted to palliative care have relatively long survivals of 1 year or more. The objective of this study was to find out factors associated with prolonged survival. Retrospective case-control study comparing the available data of patients with cancer who survived more than 1 year after admission in a palliative care service with patients with cancer who survived 6 months or less. The intended proportion was 4 controls for each case. Patients were identified through electronic records from 2012 until 2018. And 1721 patients were identified. Of those patients, 111 (6.4%) survived for at least 1 year, and 363 (21.1%) were included as controls according to the established criteria. The intended proportion could not be reached; the proportion was only 3.3:1. The median survival of cases was 581 days (range: 371-2763), and the median survival of controls was 57 days (range: 1-182). In the multivariable analysis, patients with a hemoglobin ≥ 10.6 g/dL and a creatinine level >95 µmol/L had a higher probability of living more than 1 year. In contrast, patients with abnormal cognition, pain, anorexia, liver metastases, an Eastern Cooperative Oncology Group performance status >1, and a neutrophil/lymphocyte ratio ≥ 3.43 had a low probability of living more than 1 year. Several factors were statistically associated positively or negatively with prolonged survival. However, the data of this study should be confirmed in other studies.

摘要

一些接受姑息治疗的癌症患者的存活时间相对较长,有 1 年或更长时间。本研究的目的是找出与延长存活时间相关的因素。回顾性病例对照研究比较了在姑息治疗服务中存活超过 1 年的癌症患者和存活 6 个月或更短时间的癌症患者的可用数据。预期每个病例有 4 个对照。通过 2012 年至 2018 年的电子记录确定患者。共确定了 1721 名患者。在这些患者中,有 111 名(6.4%)至少存活 1 年,根据既定标准,有 363 名(21.1%)被纳入对照。未达到预期比例;比例仅为 3.3:1。病例的中位生存时间为 581 天(范围:371-2763),对照的中位生存时间为 57 天(范围:1-182)。多变量分析显示,血红蛋白≥10.6g/dL 和肌酐水平>95μmol/L 的患者存活超过 1 年的可能性更高。相比之下,认知功能异常、疼痛、厌食、肝转移、东部合作肿瘤学组表现状态>1 和中性粒细胞/淋巴细胞比值≥3.43 的患者存活超过 1 年的可能性较低。有几个因素与延长存活时间呈正相关或负相关。然而,本研究的数据应在其他研究中得到证实。

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