Staging quality is related to the survival of women with endometrial cancer: a Scottish population based study. Deficient surgical staging and omission of adjuvant radiotherapy is associated with poorer survival of women diagnosed with endometrial cancer
Staging quality is related to the survival of women with endometrial cancer: a Scottish population based study. Deficient surgical staging and omission of adjuvant radiotherapy is associated with poorer survival of women diagnosed with endometrial cancer
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分期质量与子宫内膜癌女性的生存相关：一项基于苏格兰人口的研究。
DOI：
10.1038/sj/bjc.6600358
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发表时间：
2002
期刊：
影响因子：
--
通讯作者：
Nadeem Siddiqui
中科院分区：
文献类型：
--
作者：
S. C. Crawford;L. D. Caestecker;C. R. Gillis;D. Hole;J. A. Davis;Gillian Penney;Nadeem Siddiqui
研究了子宫内膜癌女性的治疗变化与生存之间的关系。回顾性队列分析基于 1996 年 1 月 1 日至 1997 年 12 月 31 日期间在 ICD10 中编码为 C54 和 C55 的住院和日间病例出院数据（苏格兰发病率记录-1）和癌症登记（苏格兰发病率记录-6）登记的完整苏格兰人口。 1996年至1997年间，苏格兰诊断出子宫内膜癌的781名患者中，有703名患者接受了手术治疗。手术分期的总体质量较差。分期的质量与外科医生通过英国皇家妇产科学院会员考试的年份以及“专科医生”身份有关，但与外科医生的病例数无关。发现两个临床上重要的预后因素与生存相关：是否记录国际妇产科联合会分期，RHR= 2.0（95% CI= 1.3 至 3.1），以及辅助放疗的使用，RHR= 2.2（95% CI= 1.5 至 3.5）。在国际妇产科联合会 1C 期至 3 期晚期疾病患者中，与生存的相关性最强。分期的缺陷和辅助放疗使用的变化可能是子宫内膜癌患者可避免的死亡的一个可能原因。因此，应该更加重视提高子宫内膜癌手术分期的整体质量。
The association between treatment variation and survival of women with endometrial cancer was investigated. A retrospective cohort based upon the complete Scottish population registered on in-patient and day-case hospital discharge data (Scottish Morbidity Record-1) and cancer registration (Scottish Morbidity Record-6) coded C54 and C55 in ICD10, between 1st January 1996 to 31st December 1997 were analysed. Seven hundred and three patients who underwent surgical treatment out of 781 patients that were diagnosed with endometrial cancer in Scotland during 1996 and 1997. The overall quality of surgical staging was poor. The quality of staging was related to both the year that the surgeon passed the Member of the Royal College of Obstetricians and Gynaecologists examination and also to ‘specialist’status but was not related to surgeon caseload. Two clinically important prognostic factors were found to be associated with survival; whether the International Federation of Obstetrics and Gynaecology stage was documented, RHR= 2.0 (95% CI= 1.3 to 3.1) and also to the use of adjuvant radiotherapy, RHR= 2.2 (95% CI= 1.5 to 3.5). The associations with survival were strongest in patients with advanced disease, International Federation of Obstetrics and Gynaecology stages 1C through to stage 3. Deficiencies in staging and variations in the use of adjuvant radiotherapy represent a possible source of avoidable mortality in patients with endometrial cancer. Consequently, there should be a greater emphasis on improving the overall quality of surgical staging in endometrial cancer.