Long-term assessment of efficacy with a novel Thoracic Survivorship Program for patients with lung cancer.
Long-term assessment of efficacy with a novel Thoracic Survivorship Program for patients with lung cancer.
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DOI：
10.1016/j.jtcvs.2021.11.026
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发表时间：
2022-05
影响因子：
6
通讯作者：
Rusch, Valerie W.
中科院分区：
文献类型：
--
作者：
Keshava, Hari B.;Tan, Kay See;Dycoco, Joe;Huang, James;Berkowitz, Alison;Sumner, Dyana;Devigne, Amy;Adusumilli, Prasad;Bains, Manjit;Bott, Matthew;Isbell, James;Downey, Robert;Molena, Daniela;Park, Bernard;Rocco, Gaetano;Sihag, Smita;Jones, David R.;Rusch, Valerie W.
我们开发了一种新颖的、由执业护士管理的胸部幸存者计划，以帮助长期随访。切除后至少 1 年无病的非小细胞肺癌患者可以由外科医生转诊至胸部生存计划。我们的目标是总结随访依从性并评估胸部存活计划注册和非胸部存活计划之间的长期结果。 2006 年至 2016 年间接受 I 至 IIIA 期 R0 切除的患者根据参加胸部生存计划与仅外科医生随访（非胸部生存计划）进行分层。随访包括为期 6 个月的胸部计算机断层扫描，持续两年，然后每年一次。缺乏随访依从性的定义是连续 2 次或以上连续延迟每年计算机断层扫描/就诊 ± 90 天。使用多变量 Cox 比例风险回归和反映入组时间的时变协变量，对胸部生存计划与第二原发性非小细胞肺癌、胸腔外癌症和生存之间的关系进行量化。 3940 名患者中共有 1162 名患者 (29.5%) 参加了胸部幸存者计划。入学的中位时间为 2.3 年； 3940 人中的 3279 人 (83%) 有完整的计算机断层扫描数据，3279 人中的 60 人 (1.8%) 有 2 次或更多延迟扫描； 9082 例非胸部生存计划就诊中，有 323 例 (3.6%) 不合规，而胸部生存计划就诊的 4823 例中，有 132 例 (2.7%) 不合规 (P = .009)； 1146 名胸部生存计划患者中，有 136 人发展为第二原发性非小细胞肺癌，1123 人中 69 人发展为胸外癌症，而 2794 名非胸部生存计划患者中，322 人发展为第二原发性非小细胞肺癌，2817 名患者中，225 人发展为胸外癌症。在多变量分析中，参加胸部生存计划与改善无病生存率相关（风险比，0.57；95% 置信区间，0.48-0.67；P < .001）。我们新颖的护士执业者运行的胸部生存计划与患者的高依从性和结果相关，与基于医生的随访所看到的结果没有什么不同。这些结果对医疗保健资源分配和成本具有重要意义。以 TSP 登记状态作为时变协变量的第二肺原发性肿瘤的生存曲线。
We developed a novel, nurse practitioner–run Thoracic Survivorship Program to aid in long-term follow-up. Patients with non–small cell lung cancer who were disease-free at least 1 year after resection could be referred to the Thoracic Survivorship Program by their surgeon. Our objectives were to summarize follow-up compliance and assess long-term outcomes between Thoracic Survivorship Program enrollment and non–Thoracic Survivorship Program. Patients who underwent R0 resection for stages I to IIIA between 2006 and 2016 were stratified by enrollment in Thoracic Survivorship Program versus surgeon only follow-up (non–Thoracic Survivorship Program). Follow-up included 6-month chest computed tomography scans for 2 years and then annually. Lack of follow-up compliance was defined by 2 or more consecutive delayed annual computed tomography scans/visits ± 90 days. Relationships between Thoracic Survivorship Program and second primary non–small cell lung cancers, extrathoracic cancers, and survival were quantified using multivariable Cox proportional hazards regression with time-varying covariate reflecting timing of enrollment. A total of 1162 of 3940 patients (29.5%) were enrolled in the Thoracic Survivorship Program. The median time to enrollment was 2.3 years; 3279 of 3940 (83%) had complete computed tomography scan data, and 60 of 3279 (1.8%) had 2 or more delayed scans; 323 of 9082 (3.6%) non–Thoracic Survivorship Program visits were noncompliant versus 132 of 4823 (2.7%) of Thoracic Survivorship Program visits (P = .009); 136 of 1146 Thoracic Survivorship Program patients developed second primary non–small cell lung cancer, and 69 of 1123 developed extrathoracic cancer, whereas 322 of 2794 of non–Thoracic Survivorship Program patients developed second primary non–small cell lung cancer and 225 of 2817 patients developed extrathoracic cancer. In multivariable analyses, Thoracic Survivorship Program enrollment was associated with improved disease-free survival (hazard ratio, 0.57; 95% confidence interval, 0.48-0.67; P < .001). Our novel nurse practitioner–run Thoracic Survivorship Program is associated with high patient compliance and outcomes not different from those seen with physician-based follow-up. These results have important implications for health care resource allocation and costs. Survival curves for second lung primary tumors with TSP enrollment status as a time-varying covariate.
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影响因子：
3.6
作者：
Hill-Kayser, Christine E.;Vachani, Carolyn;Metz, James M.
通讯作者：
Metz, James M.
影响因子：
--
作者：
Nekhlyudov, Larissa;Aziz, Noreen M.;Virgo, Katherine S.
通讯作者：
Virgo, Katherine S.
影响因子：
2.8
作者：
Moore, Sally;Wells, Mary;Corner, Jessica
通讯作者：
Corner, Jessica
DOI：
10.6004/jnccn.2020.0037
发表时间：
2020-08
期刊：
Journal of the National Comprehensive Cancer Network : JNCCN
影响因子：
--
作者：
Denlinger CS;Sanft T;Moslehi JJ;Overholser L;Armenian S;Baker KS;Broderick G;Demark-Wahnefried W;Friedman DL;Goldman M;Henry NL;Hill-Kayser C;Hudson M;Khakpour N;Koura D;McDonough AL;Melisko M;Mooney K;Moore HCF;Moryl N;O'Connor T;Paskett ED;Patel C;Peterson L;Pirl W;Rodriguez MA;Ruddy KJ;Shockney L;Smith S;Syrjala KL;Tevaarwerk A;Zee P;McMillian NR;Freedman-Cass DA
通讯作者：
Freedman-Cass DA
DOI：
10.1007/s11764-011-0191-9
发表时间：
2012-03
期刊：
Journal of cancer survivorship : research and practice
影响因子：
--
作者：
Krebs P;Coups EJ;Feinstein MB;Burkhalter JE;Steingart RM;Logue A;Park BJ;Ostroff JS
通讯作者：
Ostroff JS