Ovarian carcinoma: Care and survival in a community-based population
Ovarian carcinoma: Care and survival in a community-based population
复制标题
DOI：
10.1016/s0149-2918(01)80037-0
复制
发表时间：
2001-01-01
影响因子：
3.2
通讯作者：
Barrette, B
中科院分区：
文献类型：
--
作者：
Yawn, BP;Wollan, P;Barrette, B
背景：以前关于卵巢癌的治疗和费用的研究是基于肿瘤学实践的数据。这样的研究可能会排除那些不适合治疗的患者，并且可能不会考虑诊断或初级治疗期间发生的费用。目的：本研究的目的是描述地理上定义的人群中卵巢癌的流行病学，管理和护理费用，以更好地了解疾病及其护理的总谱。方法：我们对明尼苏达州奥姆斯特德县所有首次确诊为卵巢上皮癌的居民的病历进行了回顾性分析结果：107例卵巢癌患者中，42例（39%）在诊断时为I期或II期肿瘤。患者诊断时的平均年龄为64.7岁，20%为未经产。卵巢癌的诊断评估在50%的病例中由家庭医生或内科医生发起，在16%的病例中由产科医生或妇科医生发起。102例（95%）患者接受了手术治疗，80例（75%）患者接受了初次化疗。I期或II期肿瘤的5年生存率为88%，III期或IV期肿瘤的5年生存率为17%。在接受两种治疗的患者中，二级护理的平均费用高于初级护理（36，110美元对32，367美元; P < 0.05）。50%的死于卵巢癌的患者在死亡前平均接受了39.0天的临终关怀。结论：大多数导致卵巢癌诊断的评估都是由初级医生发起的。在这个以社区为基础的人群中，早期和低级别的翻身者很常见（30%），并且与较低的护理成本和较高的5年生存率相关。需要二次治疗的患者的总治疗费用约为仅需要一次治疗的患者的两倍，其中与住院治疗相关的费用约占50%。
Background: Previous studies of the management and costs of ovarian cancer have been based on data from oncology practices. Such studies may exclude patients who are not candidates for treatment and may not account for costs incurred during diagnosis or primary treatment.Objective: The purpose of this study was to describe the epidemiology, management, and costs of care of ovarian cancer in a geographically defined population to better rt fleet the total spectrum of the disease and its: care.Methods: We conducted a retrospective review of the medical records of all residents of Olmsted County, Minnesota, who received a first diagnosis of epithelial ovarian carcinoma (including postmortem diagnoses) between 1985 and 1997,Results: Of the 107 women with a new diagnosis of ovarian carcinoma, 42 (39%) had stage I or II tumors at the time of diagnosis. The mean age of the patients at the time of diagnosis was 64.7 years, and 20% were nulliparous. The diagnostic assessment for ovarian carcinoma was initiated by a family physician or internist in 50% of cases and by an obstetrician or gynecologist in 16% of cases. One hundred two patients (95%) underwent surgical treatment, and 80 (75%) received primary chemotherapy. The 5-year survival rate was 88% in those with stage I or II tumors and 17% in those with stage III or IV tumors. The mean charges for secondary care were higher than those for primary care ($36,110 vs $32,367; P < 0.05) in those receiving both types of therapy. Fifty percent of those dying of ovarian cancer received hospice care for a mean of 39.0 days before death.Conclusions: Most assessments leading to a diagnosis of ovarian carcinoma were initiated by primary carl physicians. In this community-based population, early-stage and low-grade turners were common (30%) and were associated with lower costs of care and higher 5-year survival rates. Total treatment costs for those requiring secondary therapy were approximately twice the costs for those requiring primary treatment only, with similar to 50% of costs associated with inpatient care.