cancer survival

癌症生存率
  • 文章类型: Journal Article
    背景:癌症患者的总体生存率一直在提高。然而,在不同的社会经济地位中,生存率的提高并不一致。因此,我们调查了癌症患者5年生存率(5YSR)的收入差异和时间趋势.
    方法:这项研究使用了2002年至2018年的国家癌症队列,该队列是通过连接韩国中央癌症登记处和国家健康保险服务(NHIS)索赔数据库来计算大韩民国的癌症生存率。生存数据从2002年开始,分析基于精算方法。我们比较了2002-2006年最早可用的5年生存率和2014-2018年最新可用的5年生存率,观察到2021年12月31日。根据保险费,收入水平分为六类:医疗援助受益人和五种NHIS亚型。不平等的斜率指数(SII)和不平等的相对指数被用来衡量5YSR的绝对和相对差异,分别。
    结果:所有癌症在2002-2006年和2014-2018年期间的5YSR改善。在研究期间,观察到肺的5年生存率(5YSR)显着改善,肝脏,还有胃癌.肺生存率的SII(17.5,95%置信区间(CI)7.0-28.1),肝脏(15.1,95%CI10.9-19.2),胃(13.9,95%CI3.2-24.7),结直肠(11.4,95%CI0.9-22.0),前列腺癌(10.7,95%CI2.5-18.8)明显升高,这意味着随着收入水平的提高,存活率更高。肺的SII,肝脏,胃癌增加了,而甲状腺,乳房,子宫颈,前列腺,结直肠癌在研究期间有所下降。
    结论:尽管从2002年到2018年,在癌症类型和收入水平中观察到5YSR的显着改善,但这种增加并没有在收入水平中均匀分布。我们的研究揭示了癌症患者生存的持续收入差距,特别是肺癌和肝癌。
    BACKGROUND: The overall survival rates among cancer patients have been improving. However, the increase in survival is not uniform across socioeconomic status. Thus, we investigated income disparities in the 5-year survival rate (5YSR) in cancer patients and the temporal trends.
    METHODS: This study used a national cancer cohort from 2002 to 2018 that was established by linking the Korea Central Cancer Registry and the National Health Insurance Service (NHIS) claim database to calculate the cancer survival rate by income level in the Republic of Korea. Survival data were available from 2002 onward, and the analysis was based on the actuarial method. We compared the survival of the earliest available 5-year period of 2002-2006 and the latest available 5-year period of 2014-2018, observing until 31 December 2021. Income level was classified into six categories: Medical Aid beneficiaries and five NHIS subtypes according to insurance premium. The slope index of inequality (SII) and relative index of inequality were used to measure absolute and relative differences in 5YSR by income, respectively.
    RESULTS: The 5YSR between the 2002-2006 and 2014-2018 periods for all cancers improved. A significant improvement in 5-year survival rates (5YSR) over the study period was observed in lung, liver, and stomach cancer. The SII of survival rates for lung (17.5, 95% confidence interval (CI) 7.0-28.1), liver (15.1, 95% CI 10.9-19.2), stomach (13.9, 95% CI 3.2-24.7), colorectal (11.4, 95% CI 0.9-22.0), and prostate (10.7, 95% CI 2.5-18.8) cancer was significantly higher, implying higher survival rates as income levels increased. The SII for lung, liver, and stomach cancer increased, while that of thyroid, breast, cervical, prostate, and colorectal cancer decreased over the study period.
    CONCLUSIONS: Although substantial improvement in the 5YSR was observed across cancer types and income levels from 2002 to 2018, this increase was not uniformly distributed across income levels. Our study revealed persistent income disparities in the survival of cancer patients, particularly for lung and liver cancer.
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  • 文章类型: Journal Article
    这篇综述探讨了饮食因素与乳腺癌预后之间的多方面关系。关注不饱和脂肪,地中海饮食(MD),和其他营养成分。乳腺癌仍然是一个重要的全球健康问题,饮食等生活方式因素在预防和管理中起着关键作用。审查遵循了2020年系统审查和荟萃分析(PRISMA)指南的首选报告项目。2019年至2024年间发布的英文文章是可以接受的。我们使用了相关的搜索词,如“不饱和脂肪”,“地中海饮食”,“乳腺癌”,和“营养”在PubMed中执行搜索,PubMedCentral(PMC),EBSCOhost,和灰色文献,如谷歌学者。筛选后,选择了479篇原始论文中的11篇,并将其包含在最终审查中。其中包括横断面分析和系统回顾,队列研究,叙事回顾,系统回顾和荟萃分析,病例对照研究,随机对照试验(RCT),和横断面研究。主要研究结果表明,坚持MD与改善乳腺癌女性的生活质量和降低死亡率相关。特别是在老年群体中。饮食强调富含抗氧化剂的食物,抗炎化合物,和健康的脂肪有助于这些观察到的好处。特定的不饱和脂肪,特别是omega-3多不饱和脂肪酸(PUFA),如二十二碳六烯酸(DHA)和二十碳五烯酸(EPA),通过调节癌细胞行为和增强治疗反应来证明抗癌特性。与MD相关的生物标志物,如β-胡萝卜素和番茄红素,作为饮食依从性和潜在风险降低的指标。此外,在橄榄油中发现的成分,包括多酚和单不饱和脂肪酸,通过发挥抗氧化和抗增殖作用,在预防乳腺癌方面表现出有希望的效果。其他饮食因素如钙,豆类,水果,蔬菜也在降低乳腺癌风险和提高生存率方面发挥作用。这篇综述强调了饮食干预在优化乳腺癌患者预后中的重要性,并强调了进一步研究以阐明潜在机制和完善饮食建议的必要性。
    This review explores the multifaceted relationship between dietary factors and breast cancer outcomes, focusing on unsaturated fats, the Mediterranean diet (MD), and other nutritional components. Breast cancer remains a significant global health concern, with lifestyle factors like diet playing a pivotal role in prevention and management. The review adhered to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines. Articles written in English and released between 2019 and 2024 were acceptable. We used pertinent search terms such as \"unsaturated fats\", \"Mediterranean diet\", \"breast cancer\", and \"nutrition\" to perform searches in PubMed, PubMed Central (PMC), EBSCOhost, and grey literature such as Google Scholar. After screening, 11 of the 479 original papers were chosen and included in the final review. These include cross-sectional analysis and systematic review, cohort study, narrative review, systematic review and meta-analysis, case-control study, randomized controlled trials (RCTs), and cross-sectional study. Key findings suggest that adherence to the MD correlates with improved quality of life measures and reduced mortality rates among women with breast cancer, particularly in older age groups. The diet\'s emphasis on antioxidant-rich foods, anti-inflammatory compounds, and healthy fats contributes to these observed benefits. Specific unsaturated fats, notably omega-3 polyunsaturated fatty acids (PUFAs) like docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), demonstrate anti-cancer properties by modulating cancer cell behavior and enhancing treatment responses. Biomarkers associated with the MD, such as β-carotene and lycopene, serve as indicators of dietary compliance and potential risk reduction. Furthermore, components found in olive oil, including polyphenols and monounsaturated fatty acids, exhibit promising effects in preventing breast cancer by exerting antioxidant and anti-proliferative actions. Other dietary factors like calcium, legumes, fruits, and vegetables also play a role in reducing breast cancer risk and improving survival rates. This review underscores the importance of dietary interventions in optimizing outcomes for breast cancer patients and highlights the need for further research to elucidate underlying mechanisms and refine dietary recommendations.
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  • 文章类型: Journal Article
    目的:这项研究旨在检查癌症发病率的差异,诊断阶段,奥斯陆教育水平不同的地区的生存率,挪威。
    方法:使用挪威癌症登记处2013-2021年的汇总数据来描述奥斯陆15个行政区的癌症发病率和生存率的分布,随后根据人口的教育水平分为三个地区。计算结肠癌的年龄标准化发病率和五年相对生存率,直肠,肺,黑色素瘤,乳房,和前列腺癌。诊断时的阶段被归类为局部的,区域,遥远,除了乳腺癌,所有癌症类型都未知,这被归类为I-IV阶段和未知。
    结果:中、高学历地区的乳腺癌发病率较高,黑色素瘤,前列腺癌,而低教育地区的肺癌发病率较高。在所有研究的癌症类型中,低教育地区在遥远阶段被诊断出的比例高于其他组。除了乳腺癌.中、高学历地区的总体五年相对生存率较高。
    结论:发病率,诊断阶段,和生存不同的教育区域。这种变化表明了医疗保健服务的差距,护理质量,和健康行为。解决这些差距有助于改善整体健康结果,促进健康公平。
    OBJECTIVE: This study aimed to examine disparities in cancer incidence, stage at diagnosis, and survival rates across districts with differences in education levels in Oslo, Norway.
    METHODS: Aggregated data from the Cancer Registry of Norway in the period 2013-2021 were used to describe the distribution of cancer incidence and survival across Oslo\'s 15 administrative districts, subsequently grouped into three areas based on the population\'s level of education. Age-standardised incidence rates and five-year relative survival were calculated for colon, rectal, lung, melanoma, breast, and prostate cancer. The stage at the time of diagnosis was categorised as localised, regional, distant, and unknown for all cancer types except breast cancer, which was categorised into stage I-IV and unknown.
    RESULTS: Mid- and high-education areas had higher incidences of breast, melanoma, and prostate cancer, while the low-education area had higher incidence rates for lung cancer. The low-education area had a higher proportion diagnosed at a distant stage than the other groups for all cancer types studied, except breast cancer. The mid- and high-education areas had higher five-year relative survival rates overall.
    CONCLUSIONS: Incidence, stage at diagnosis, and survival varied between education areas. The variation indicates disparities in healthcare access, quality of care, and health behaviours. Addressing these disparities can help improve overall health outcomes and promote health equity.
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  • 文章类型: Published Erratum
    [这更正了文章DOI:10.3389/fpubh.2023.1310823。].
    [This corrects the article DOI: 10.3389/fpubh.2023.1310823.].
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  • 文章类型: Journal Article
    在韩国,从2001年到2021年,癌症发病率增加了56.5%。然而,与2001年至2005年相比,2017年至2021年的5年癌症生存率增加了17.9%。癌症生存率随着社会经济地位的降低而下降,不同癌症类型之间的存活率存在差异。分析癌症患者生存的社会经济模式可以帮助识别高危人群,并确保他们从干预措施中受益。
    本研究的目的是分析被诊断为六种类型胃癌的患者的生存率差异,结直肠,肝脏,乳房,子宫颈,和肺癌-基于韩国全国数据的社会经济地位。
    这项研究使用与国家健康信息数据库链接的韩国中央癌症登记数据库,对2014年至2018年12月31日期间诊断为癌症的患者进行随访。生成了按收入状况分层的Kaplan-Meier曲线,并对每种癌症类型进行对数秩检验,以评估统计学显著性.使用Cox比例风险回归模型计算任何原因的总生存期的95%CI的风险比。
    六种不同类型癌症的存活率如下:胃癌,69.6%(96,404/138,462);结直肠癌,66.6%(83,406/125,156);肝癌,33.7%(23,860/70,712);肺癌,30.4%(33,203/109,116);乳腺癌,91.5%(90,730/99,159);和宫颈癌,78%(12,930/16,580)。在将医疗援助组与最高收入组进行比较时,胃癌的风险比为1.72(95%CI1.66-1.79),结直肠癌1.60(95%CI1.54-1.56),肝癌1.51(95%CI1.45-1.56),肺癌为1.56(95%CI1.51-1.59),2.19(95%CI2.01-2.38)用于乳腺癌,宫颈癌为1.65(95%CI1.46-1.87)。较高的剥夺指数和晚期诊断阶段与死亡风险增加相关。
    社会经济地位在几种癌症类型中显著调节癌症生存率的差异。这种效应在不太致命的癌症如乳腺癌中尤其明显。因此,考虑到癌症的类型和社会经济因素,社会和医疗干预措施,如早期癌症检测和适当的治疗对于弱势群体是必要的。
    UNASSIGNED: In South Korea, the cancer incidence rate has increased by 56.5% from 2001 to 2021. Nevertheless, the 5-year cancer survival rate from 2017 to 2021 increased by 17.9% compared with that from 2001 to 2005. Cancer survival rates tend to decline with lower socioeconomic status, and variations exist in the survival rates among different cancer types. Analyzing socioeconomic patterns in the survival of patients with cancer can help identify high-risk groups and ensure that they benefit from interventions.
    UNASSIGNED: The aim of this study was to analyze differences in survival rates among patients diagnosed with six types of cancer-stomach, colorectal, liver, breast, cervical, and lung cancers-based on socioeconomic status using Korean nationwide data.
    UNASSIGNED: This study used the Korea Central Cancer Registry database linked to the National Health Information Database to follow up with patients diagnosed with cancer between 2014 and 2018 until December 31, 2021. Kaplan-Meier curves stratified by income status were generated, and log-rank tests were conducted for each cancer type to assess statistical significance. Hazard ratios with 95% CIs for any cause of overall survival were calculated using Cox proportional hazards regression models with the time since diagnosis.
    UNASSIGNED: The survival rates for the six different types of cancer were as follows: stomach cancer, 69.6% (96,404/138,462); colorectal cancer, 66.6% (83,406/125,156); liver cancer, 33.7% (23,860/70,712); lung cancer, 30.4% (33,203/109,116); breast cancer, 91.5% (90,730/99,159); and cervical cancer, 78% (12,930/16,580). When comparing the medical aid group to the highest income group, the hazard ratios were 1.72 (95% CI 1.66-1.79) for stomach cancer, 1.60 (95% CI 1.54-1.56) for colorectal cancer, 1.51 (95% CI 1.45-1.56) for liver cancer, 1.56 (95% CI 1.51-1.59) for lung cancer, 2.19 (95% CI 2.01-2.38) for breast cancer, and 1.65 (95% CI 1.46-1.87) for cervical cancer. A higher deprivation index and advanced diagnostic stage were associated with an increased risk of mortality.
    UNASSIGNED: Socioeconomic status significantly mediates disparities in cancer survival in several cancer types. This effect is particularly pronounced in less fatal cancers such as breast cancer. Therefore, considering the type of cancer and socioeconomic factors, social and medical interventions such as early cancer detection and appropriate treatment are necessary for vulnerable populations.
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  • 文章类型: Journal Article
    这是浙江省癌症长期生存的全面概述,中国。混合分析,队列和周期分析的结合,已被提议得出最新的癌症生存率估计。使用这种方法,我们的目的是及时准确地分析浙江省癌症登记的5年相对生存率(RS)和净生存率(NS),中国。
    浙江省14个癌症登记处共纳入了2013-2017年诊断的255,725例新癌症病例。中国,随访至2019年底。混合分析用于计算2018-2019年按性别划分的总体和分层的5年RS和5年NS,癌症类型,区域,和诊断时的年龄。
    在2018-2019年期间,浙江整体癌症的年龄标准化5年RS和NS分别为47.5%和48.6%,分别。女性癌症的年龄标准化5年RS(55.4%)高于男性(40.0%),城市地区的比率(49.7%)高于农村地区的比率(43.1%)。5年RS随着年龄的增长而下降,从<45岁的84.4%到>74岁的23.7%。我们的RS和NS的结果显示出相似的趋势,没有显着差异。年龄标准化5年RS最高的前五名癌症是甲状腺癌(96.0%),乳腺癌(84.3%),睾丸癌(79.9%),前列腺癌(77.2%),膀胱癌(70.6%),年龄标准化5年RS最低的五种癌症是胰腺癌(6.0%),肝癌(15.6%),胆囊癌(17.1%),食管癌(22.7%),和白血病(31.0%)。
    我们报告了浙江省最新的5年癌症RS和NS,中国第一次,并发现2018-2019年浙江省癌症患者的5年生存率相对较高。基于人群的癌症登记处被认为是可用于评估癌症预防战略的影响和卫生系统有效性的关键政策工具。
    UNASSIGNED: This is a comprehensive overview of long-term cancer survival in Zhejiang Province, China. Hybrid analysis, a combination of cohort and period analysis, has been proposed to derive up-to-date cancer survival estimates. Using this approach, we aimed to timely and accurately analyze the 5-year relative survival (RS) and net survival (NS) in cancer registries of Zhejiang Province, China.
    UNASSIGNED: A total of 255,725 new cancer cases diagnosed during 2013-2017 were included in 14 cancer registries in Zhejiang Province, China, with a follow-up on vital status until the end of 2019. The hybrid analysis was used to calculate the 5-year RS and 5-year NS during 2018-2019 for overall and stratifications by sex, cancer type, region, and age at diagnosis.
    UNASSIGNED: During 2018-2019, the age-standardized 5-year RS and NS for overall cancer in Zhejiang was 47.5% and 48.6%, respectively. The age-standardized 5-year RS for cancers of women (55.4%) was higher than that of men (40.0%), and the rate of urban areas (49.7%) was higher than that of rural areas (43.1%). The 5-year RS declined along with age, from 84.4% for ages <45 years to 23.7% for ages >74 years. Our results of the RS and NS showed the similar trend and no significant difference. The top five cancers with top age-standardized 5-year RS were thyroid cancer (96.0%), breast cancer (84.3%), testicular cancer (79.9%), prostate cancer (77.2%), and bladder cancer (70.6%), and the five cancers with the lowest age-standardized 5-year RS were pancreatic cancer (6.0%), liver cancer (15.6%), gallbladder cancer (17.1%), esophageal cancer (22.7%), and leukemia (31.0%).
    UNASSIGNED: We reported the most up-to-date 5-year cancer RS and NS in Zhejiang Province, China for the first time, and found that the 5-year survival for cancer patients in Zhejiang during 2018-2019 was relatively high. The population-based cancer registries are recognized as key policy tools that can be used to evaluate both the impact of cancer prevention strategies and the effectiveness of health systems.
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  • 文章类型: Journal Article
    肺癌是癌症相关死亡率的主要原因,非小细胞肺癌(NSCLC)占所有肺癌病例的85%。这种恶性肿瘤的特点是多因素的危险因素,预后不良,和可悲的临床结果。大量证据表明,由于个体之间遗传多态性引入的遗传变异,肺癌易感性和生存率存在个体差异。间接影响肺癌易感性和患者生存率。在过去的几十年里,肿瘤环境中的免疫景观和宿主免疫反应一直被认为是NSCLC发展和患者生存的决定因素。随着非小细胞肺癌治疗模式向免疫治疗的转变,人们越来越认识到免疫系统在癌症发展和生存中的作用,检测与NSCLC风险和预后相关的免疫调节标志物中的单核苷酸多态性(SNPs)至关重要.尽管广泛的研究报道了SNP在预测NSCLC的风险和生存率中的意义。之前尚未对调节NSCLC免疫应答的基因中的SNP进行综述。因此,这篇综述揭示了免疫调节标记的遗传多态性的证据,包括免疫检查点,免疫检查点抑制剂,趋化因子,白细胞介素,人类白细胞抗原及其受体,和抗原呈递机制基因,以及它们在易感性中的意义,NSCLC的预后和生存。与NSCLC风险和生存相关的遗传因素的鉴定为更深入地理解疾病的发病机制和进展提供了宝贵的信息。还可以改善早期和晚期疾病的预后和个性化临床护理。
    Lung cancer is the leading cause of cancer-associated mortality and non-small cell lung carcinoma (NSCLC) constitutes 85 % of all lung cancer cases. This malignancy is characterized by multifactorial risk factors, poor prognosis, and deplorable clinical outcome. Considerable evidence indicates that there is inter-individual variability in the lung cancer predisposition and survival due to genetic variations introduced by genetic polymorphisms between individuals, indirectly affecting the lung cancer susceptibility and the patient survival. In the past decades, immune landscape in the tumour environment and host immune response are constantly implicated as determining factor in NSCLC development and patients\' survival. With the change of paradigm in NSCLC treatment to immunotherapy and increasing recognition of the role of the immune system in cancer development and survival, the inspection of single nucleotide polymorphisms (SNPs) in immunomodulated markers associated with the risk and prognosis for NSCLC is crucial. Despite extensive studies reported the implication of SNPs in predicting the risk and survival of NSCLC. SNPs in the genes that modulate immune response in NSCLC have not been reviewed before. Hence, this review uncovers the evidence on the genetic polymorphisms of immunomodulatory markers which include immune checkpoints, immune checkpoint inhibitors, chemokines, interleukins, human leukocyte antigen and its receptors, and antigen presenting machinery genes, and their significance in the susceptibility, prognosis and survival in NSCLC. The identification of genetic factors associated with NSCLC risk and survival provides invaluable information for a greater comprehension of the pathogenesis and progression of the disease, also to refine prognosis and personalize clinical care in early and advanced-stages disease.
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  • 文章类型: Journal Article
    背景:神经内分泌肿瘤(NENs)在全球范围内的发病率正在增加。先前对英国癌症数据库(国家癌症登记和分析服务(NCRAS))的分析显示,在大多数肿瘤部位,女性的生存优势显着。本研究旨在将NCRAS与监测进行比较,流行病学,和最终结果程序(SEER),以使用相同的统计方法验证这些结果。
    方法:从NCRAS和SEER中提取了14,834和108,399例NENs患者,分别。使用限制平均生存时间(RMST)和Kaplan-Meier生存估计值计算NEN每个解剖部位的男性和女性的60个月生存率。计算60个月RMST女性生存优势(FSA)。
    结果:FSA在NCRAS和SEER中相似。FSA最高发生在肺和胃NENs。
    结论:来自SEER的数据证实了NCRAS发表的研究结果。女性生存优势仍然无法解释。
    BACKGROUND: Neuroendocrine neoplasms (NENs) are increasing in incidence globally. Previous analysis of the UK cancer database (National Cancer Registration and Analysis Service (NCRAS)) showed a notable female survival advantage in most tumour sites. This study aims to compare NCRAS to the Surveillance, Epidemiology, and End Results Program (SEER) to validate these results using the same statistical methods.
    METHODS: A total of 14,834 and 108,399 patients with NENs were extracted from NCRAS and SEER, respectively. Sixty-months survival for both males and females for each anatomical site of NENs were calculated using restricted mean survival time (RMST) and Kaplan-Meier Survival estimates. The sixty-month RMST female survival advantage (FSA) was calculated.
    RESULTS: FSA was similar in NCRAS and SEER. The highest FSA occurred in lung and stomach NENs.
    CONCLUSIONS: The data from SEER confirm the findings published by NCRAS. Female survival advantage remains unexplained.
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  • 文章类型: Journal Article
    胃癌(GC)是全球癌症相关死亡的第四大原因,治疗选择有限。这项研究的目的是分析在寡转移GC(OGC)患者的一线治疗中增加手术的价值。
    这项回顾性研究包括OGC患者,这些患者在2012年4月至2022年4月期间接受了原发肿瘤和同步转移的诱导化疗。终点是通过Kaplan-Meier方法分析的总生存期(OS)和无复发生存期(RFS)。用Cox模型评估预后因素。
    收集39例患者的数据。所有病例均提交我们的多学科肿瘤委员会(MTB),以评估根治性手术的可行性。中位随访33.6个月(mo。),中位OS为26.6个月。(95%CI23.8-29.4),中位RFS为10.6个月。(95%可信区间6.3-14.8)。根据Mandard标准(TRG1-3,未达到20.5个月。对于TRG4-5;HR0.23,p=0.019),PSECOG≤1(26.7个月。对于PS≤1和11.2mo。PS>1;HR0.3,p=0.022)和低转移负担(26.7个月。单个站点与12.9个月相比。≥2个部位;HR0.34,p=0.039)与良好预后相关。在我们的系列中,没有发生重大的术中并发症或手术相关的死亡。
    术前化疗和根治性手术切除原发肿瘤和转移瘤的序贯策略被证明能显著改善OS和RFS。多学科评估是强制性的,以确定可以从该策略中受益的患者。
    UNASSIGNED: Gastric cancer (GC) is the fourth leading cause of cancer-related death worldwide with limited therapeutic options. The aim of this study was to analyze the value of adding surgery to the first-line treatment in patients with oligometastatic GC (OGC).
    UNASSIGNED: This retrospective study included patients with OGC who underwent induction chemotherapy followed by surgery of both primary tumor and synchronous metastasis between April 2012 and April 2022. Endpoints were overall survival (OS) and relapse-free survival (RFS) analyzed by the Kaplan-Meier method. Prognostic factors were assessed with the Cox model.
    UNASSIGNED: Data from 39 patients were collected. All cases were referred to our multidisciplinary tumor board (MTB) to evaluate the feasibility of radical surgery. After a median follow-up of 33.6 months (mo.), median OS was 26.6 mo. (95% CI 23.8-29.4) and median RFS was 10.6 mo. (95% CI 6.3-14.8). Pathologic response according to the Mandard criteria (TRG 1-3, not reached versus 20.5 mo. for TRG 4-5; HR 0.23, p=0.019), PS ECOG ≤ 1 (26.7 mo. for PS ≤ 1 versus 11.2 mo. for PS >1; HR 0.3, p=0.022) and a low metastatic burden (26.7 mo. for single site versus 12.9 mo. for ≥2 sites; HR 0.34, p=0.039) were related to good prognosis. No major intraoperative complications nor surgery-related deaths occurred in our series.
    UNASSIGNED: A sequential strategy of preoperative chemotherapy and radical surgical excision of both primary tumor and metastases was demonstrated to significantly improve OS and RFS. Multidisciplinary evaluation is mandatory to identify patients who could benefit from this strategy.
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  • 文章类型: Journal Article
    背景:Covid-19大流行极大地改变了获取和提供癌症护理服务的方式,包括结直肠癌(CRC)。在英国,不鼓励患者在初级保健中就诊,许多磋商都是远程进行的,调查程序和筛查程序暂停,和较少的手术和治疗交付。人们不得不面对在大流行期间患癌症的实际后果,并导航从未见过的途径,经常独自一人。我们检查了在大流行期间被诊断和治疗CRC的经验,以及这对人们癌症之旅的影响。
    方法:在Covid-19大流行期间(2020年1月至2021年5月),对被诊断为CRC的人进行了半结构化访谈,在英格兰东北部。在面试中使用了一个迭代的主题指南,远程发生(电话或缩放),录音,伪匿名和转录。最初的转录本由两名研究人员独立编码,以及为跨成绩单应用而开发的代码“bank”。研究团队合作开发了主题和总体分析结构。
    结果:对19名参与者进行了访谈,分析并确定了四个关键主题:(1)新冠肺炎和癌症的相对威胁不可比拟,与Covid-19相比,癌症的风险要大得多;(2)远程咨询存在问题,影响患者与临床医生建立融洽和信任的能力,评估非语言交流,感觉能够披露,理解并保留信息;(3)Stoma缺乏随访护理,一些人经历了造口逆转的漫长等待时间;最后,(4)在协商中独处对一些人吸收信息的能力产生负面影响,在情感脆弱的时候让他们没有亲人的支持。然而,一些参与者更喜欢在他们路径的某些点上独处,包括接受诊断,最常见的是在接受住院治疗时。
    结论:独处带来意想不到的好处,让人们免于承担情感为他人工作,而是专注于他们的康复,然而,远程咨询对患者体验产生负面影响。这项研究强调了大流行癌症之旅的复杂益处和负担,包括这些是如何在癌症通路的不同点转移的。
    洛林·安吉尔,癌症幸存者,从概念概念出发一直是这项研究的核心,有助于:研究重点和设计的发展;确保资金;制作面向患者的材料;制定面试主题指南;数据的分析和解释;以及关键发现和手稿的起草。
    BACKGROUND: The Covid-19 pandemic dramatically altered the way cancer care services were accessed and delivered, including for colorectal cancer (CRC). In the United Kingdom, patients were discouraged from presenting in primary care, many consultations took place remotely, investigative procedures and screening programmes were temporarily suspended, and fewer operations and treatments were delivered. People had to face the practical consequences of having cancer during a pandemic and navigate never before seen pathways, often alone. We examined the experience of being diagnosed and treated for CRC during the pandemic, and the implications of this on people\'s cancer journeys.
    METHODS: Semi-structured interviews were undertaken with people diagnosed with CRC during the Covid-19 pandemic (January 2020-May 2021), in the North East of England. An iterative topic guide was used during interviews, which took place remotely (telephone or Zoom), were audio recorded, pseudo-anonymised and transcribed. Initial transcripts were independently coded by two researchers, and a code \'bank\' developed for application across transcripts. Development of themes and overarching analytical constructs was undertaken collaboratively by the research team.
    RESULTS: Interviews were conducted with 19 participants, analysed and four key themes identified: (1) The relative threats of Covid-19 and Cancer were not comparable, with cancer seen as posing a far greater risk than Covid-19; (2) Remote consultations were problematic, affecting patients\' abilities to build rapport and trust with clinicians, assess nonverbal communication, and feel able to disclose, comprehend and retain information; (3) Stoma follow-up care was seen to be lacking, with long wait times for stoma reversal experienced by some; Finally, (4) Being alone during consultations negatively impacted some peoples\' abilities to absorb information, and left them without the support of loved ones at an emotionally vulnerable time. However, some participants preferred being alone at certain points in their pathways, including receiving a diagnosis, and most frequently when receiving in-patient treatment.
    CONCLUSIONS: Being alone brought unexpected benefits, absolving people from undertaking emotions work for others, and instead focus on their recovery, however, remote consultations negatively impacted patients\' experiences. This study highlights the complex benefits and burdens of pandemic-located cancer journeys, including how these shifted at different points across cancer pathways.
    UNASSIGNED: Lorraine Angell, a cancer survivor, has been central to this study from idea conception, contributing to: development of study focus and design; securing funding; production of patient-facing materials; development of interview topic guides; analysis and interpretation of data; and drafting of key findings and manuscripts.
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