Utilization and Outcomes of Sentinel Lymph Node Biopsy for Vulvar Cancer.
Utilization and Outcomes of Sentinel Lymph Node Biopsy for Vulvar Cancer.
复制标题
DOI：
10.1097/aog.0000000000001648
复制
发表时间：
2016-10
影响因子：
7.2
通讯作者：
Wright JD
中科院分区：
文献类型：
--
作者：
Cham S;Chen L;Burke WM;Hou JY;Tergas AI;Hu JC;Ananth CV;Neugut AI;Hershman DL;Wright JD
探讨前哨淋巴结活检在外阴癌患者中的应用及其预测因素。Perspective数据库是一个收集了500多家医院数据的所有付款人数据库，用于对2006年至2015年接受外阴切除术和淋巴结评估的外阴癌女性进行回顾性队列研究。多变量模型用于确定与前哨淋巴结活检相关的因素。比较了接受前哨淋巴结活检和淋巴结切除术的妇女的住院时间和费用。在2，273名女性中，618名（27.2%）采用前哨淋巴结活检，而1655名（72.8%）接受腹股沟股淋巴结切除术。前哨淋巴结活检的性能从2006年的17.0%（95% CI，12.0-22.0%）增加到2015年的39.1%（95% CI，27.1-51.0%）。在一个多变量模型中，最近接受治疗的妇女更有可能接受前哨淋巴结活检，而合并症较多的妇女和在农村医院接受治疗的妇女不太可能接受该手术。与接受腹股沟股淋巴结切除术的女性（中位数3天，IQR 2-4）相比，接受前哨淋巴结活检的女性（中位数2天，IQR 1-3）的中位住院时间较短。前哨淋巴结活检的费用为7599美元（IQR，5739美元-9922美元），而淋巴结切除术的费用为8095美元（IQR，5917美元-11，281美元）。自2006年以来，外阴癌前哨淋巴结活检的使用增加了一倍多。与腹股沟股淋巴结切除术相比，前哨淋巴结活检与更短的住院时间和更低的费用相关。
To examine the use and predictors of sentinel node biopsy in women with vulvar cancer. The Perspective database, an all-payer database that collects data from over 500 hospitals, was used to perform a retrospective cohort study of women with vulvar cancer who underwent vulvectomy and lymph node assessment from 2006 to 2015. Multivariable models were used to determine factors associated with sentinel node biopsy. Length of stay and cost were compared between women who underwent sentinel node biopsy and lymphadenectomy. Among 2,273 women, sentinel node biopsy was utilized in 618 (27.2%), while 1655 (72.8%) underwent inguinofemoral lymphadenectomy. Performance of sentinel node biopsy increased from 17.0% (95% CI, 12.0-22.0%) in 2006 to 39.1% (95% CI, 27.1-51.0%) in 2015. In a multivariable model, women treated more recently were more likely to undergo sentinel node biopsy while women with more comorbidities and those treated at rural hospitals were less likely to undergo the procedure. The median length of stay was shorter for those undergoing sentinel node biopsy (median 2 days; IQR 1-3) compared to women who underwent inguinofemoral lymphadenectomy (median 3 days, IQR 2-4). The cost of sentinel node biopsy was $7599 (IQR, $5739-$9922) versus $8095 (IQR, $5917-$11,281) for lymphadenectomy. The use of sentinel node biopsy for vulvar cancer has more than doubled since 2006. Sentinel lymph node biopsy is associated with a shorter hospital stay and decreased cost compared to inguinofemoral lymphadenectomy.