Deficiencies in postoperative surveillance for veterans with gastrointestinal cancer.
Deficiencies in postoperative surveillance for veterans with gastrointestinal cancer.
复制标题
对患有胃肠道癌症的退伍军人的术后监测存在缺陷。
DOI：
10.1002/jso.25333
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发表时间：
2019
影响因子：
2.5
通讯作者：
Abbott,DanielE
中科院分区：
文献类型：
--
作者：
Taylor,LaurenJ;Xu,Kerui;Maloney,JamesD;Voils,CorrineI;Weber,SharonM;Funk,LukeM;Abbott,DanielE
背景和目的国家胃肠癌指南提供了监测算法，以促进复发性疾病的检测，但依从率尚不清楚。我们试图描述在三级护理退伍军人事务hospital.MethodsA单中心回顾性队列研究中，从2010年至2016年接受结直肠、胃食管或肝胰胆管恶性肿瘤手术切除的患者的胃肠道癌症退伍军人术后监测模式。我们计算了癌症导向的门诊和腹部成像的年发病率，并使用国家综合癌症网络指南作为基准，以评估充分的surveillance.ResultsNine ‐ 7例患者符合纳入标准。中位监测时间为1203天。总体而言，44%的患者监测不足。具体而言，11%的患者未接受术后影像学检查，7%的患者未接受针对癌症的门诊访视。另外30%的人接受的监测成像少于推荐的，12%的人参加的门诊少于推荐的。根据疾病部位，影像学检查不足是最常见的肝胰胆管癌患者（63%），而临床随访不足是最高的结直肠癌（24%）。这一缺陷是通过有针对性的努力，包括远程医疗以及对病人和提供者的教育加以改善的机会。
Background and ObjectivesNational guidelines for gastrointestinal (GI) cancers offer surveillance algorithms to facilitate detection of recurrent disease, yet adherence rates are unknown. We sought to characterize postoperative surveillance patterns for veterans with GI cancer at a tertiary care Veterans Affairs Hospital.MethodsA single‐center retrospective cohort study identified patients who underwent surgical resection for colorectal, gastroesophageal or hepatopancreaticobiliary malignancy from 2010‐2016. We calculated the annual rate of cancer‐directed clinic visits and abdominal imaging and used National Comprehensive Cancer Network guidelines as a benchmark by which to assess adequate surveillance.ResultsNinety‐seven patients met inclusion criteria. Median surveillance time was 1203 days. Overall, 44% of patients had insufficient surveillance. Specifically, 11% received no postoperative imaging and 7% had no cancer‐directed clinic visits. An additional 30% received less than recommended surveillance imaging and 12% attended fewer than recommended clinic visits. By disease site, insufficient imaging was most common for patients with hepatopancreaticobiliary cancer (63%), while inadequate clinic follow‐up was highest for colorectal cancer (24%).ConclusionA significant proportion of veterans with GI cancer received either inadequate postoperative surveillance based on national guidelines. This deficiency represents an opportunity for improvement through targeted efforts, including telemedicine and education of patients and providers.