背景:局部晚期或转移性尿路上皮癌(la/mUC)的全身抗癌治疗与疗效相关,包括更长的总生存期(OS),但许多患者仍未治疗。这个观测,真实世界,国家研究旨在调查与在英格兰接受la/mUC全身抗癌治疗相关的因素。
方法:在国家癌症登记数据集中确定了2013年至2019年间诊断为la/mUC的成年人,并随访至2021年3月。医疗保健和合并症数据来自医院事件统计所接纳的患者护理和门诊数据集。从系统性抗癌治疗数据集获得治疗数据。使用多变量逻辑回归确定与治疗相关的因素。使用Kaplan-Meier方法估计来自la/mUC诊断的OS。
结果:在16,610名诊断为la/mUC的患者中,5,191(31%)接受了全身抗癌治疗;4,700(91%)接受了基于铂的化疗。只有18%的患者不合格。如果是女性,患者接受治疗的可能性大大降低,顺铂不合格,年长的,或在2018年之前被诊断出;患有LUC,东部肿瘤协作组表现状态>1,或更高的合并症;或居住在伦敦以外或收入匮乏的地区。治疗组的中位OS(95%CI)未经治疗的患者为19.9(19.4-20.6)5.8(5.6-6.0)个月,分别。局限性包括对最初未出于研究目的收集的数据进行回顾性分析。
结论:从2013年到2019年,英格兰约70%的la/mUC患者未经治疗,考虑到有效治疗的可用性,这是非常高的。应解决治疗不足的原因。鉴于不断发展的治疗环境,对最新数据的分析将是有益的。
结论:这项研究调查了2013年至2019年间英格兰诊断为晚期尿路上皮癌患者的全身抗癌治疗。16610名患者中,31%接受治疗。各种因素与未接受治疗有关,包括女性,年龄较大,较差的性能状态,更大的合并症,和收入匮乏地区的居民。治疗后的中位总生存期与未经治疗的患者为19.9vs.5.8个月。
BACKGROUND: Systemic anticancer therapy for locally advanced or metastatic urothelial carcinoma (la/mUC) is associated with efficacy benefits, including longer overall survival (OS), but many patients remain untreated. This observational, real-world, national
study aimed to investigate factors associated with receiving systemic anticancer therapy for la/mUC in England.
METHODS: Adults diagnosed with la/mUC between 2013 and 2019 were identified in the National Cancer Registration Dataset and followed until March 2021. Healthcare and comorbidity data were obtained from Hospital Episode Statistics Admitted Patient Care and Outpatient datasets. Treatment data were obtained from the Systemic Anti-Cancer Therapy dataset. Factors associated with treatment were identified using multivariable logistic regression. OS from la/mUC diagnosis was estimated using Kaplan-Meier methodology.
RESULTS: Of 16,610 patients diagnosed with la/mUC, 5,191 (31%) received systemic anticancer therapy; 4,700 (91%) received platinum-based chemotherapy. Only 18% of patients were cisplatin ineligible. Patients were significantly less likely to receive treatment if they were female, cisplatin ineligible, older, or diagnosed before 2018; had laUC, an Eastern Cooperative Oncology Group performance status >1, or greater comorbidity; or resided outside London or in income-deprived areas. Median OS (95% CI) from diagnosis in treated vs. untreated patients was 19.9 (19.4-20.6) vs. 5.8 (5.6-6.0) months, respectively. Limitations include retrospective analysis of data not initially collected for research purposes.
CONCLUSIONS: From 2013 to 2019, ≈70% of patients with la/mUC in England were untreated, which is high given the availability of effective treatments. Reasons for
undertreatment should be addressed. Given the evolving treatment landscape, analysis of more recent data would be informative.
CONCLUSIONS: This
study investigated systemic anticancer treatment for patients diagnosed with advanced urothelial carcinoma in England between 2013 and 2019. Of 16,610 patients, 31% received treatment. Various factors were associated with not receiving treatment, including female sex, older age, worse performance status, greater comorbidity, and resident in income-deprived areas. Median overall survival in treated vs. untreated patients was 19.9 vs. 5.8 months.