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How appropriate is treating patients diagnosed with advanced esophageal cancer with anticancer drugs? A multicenter retrospective cohort Spanish study
Santero, Marilina (Institut de Recerca Sant Pau)
Requeijo, Carolina (Institut de Recerca Sant Pau)
Quintana Ruiz, Maria Jesús (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)
Rodríguez, Dulce (Hospital Universitari Sant Joan de Reus (Tarragona))
Bottaro, David (Hospital Universitari Sant Joan de Reus (Tarragona))
Macias Declara, Ismael (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Pericay, Carles (Parc Taulí Hospital Universitari. Institut d'Investigació i Innovació Parc Taulí (I3PT))
Farina, Natalie (Hospital de Donostia (Sant Sebastià, País Basc))
Blanco, Jesus Manuel (Hospital de Donostia (Sant Sebastià, País Basc))
Urreta-Barallobre, Iratxe (Hospital Universitario de Donostia (Sant Sebastià, País Basc))
Punti, Laura (Hospital Universitario de Donostia (Sant Sebastià, País Basc))
Bonfill, X. (Xavier) (Universitat Autònoma de Barcelona. Departament de Pediatria, Obstetrícia i Ginecologia i Medicina Preventiva i Salut Pública)

Data: 2024
Resum: Aim: To assess the appropriateness of systemic oncological treatments (SOT) provided to patients diagnosed with advanced esophageal cancer (EC) across a group of participating hospitals. Methods: Multicenter, retrospective cohort study in five Spanish hospitals including newly confirmed advanced EC cases between July 1, 2014, and June 30, 2016, with a 5-year follow-up. Results: We identified 157 patients fulfilling the inclusion criteria (median age: 65 years, 85. 9% males). Most patients, 125 (79. 6%) were treated at least with one active treatment, and 33% received two or more lines of SOT. The 1-, 2- and 5-year overall survival rates were 30. 3% [95%CI: 23. 8, 38. 7], 14. 0% [95%CI: 9. 3, 21. 0], and 7. 1% [95% CI: 3. 8, 13. 1] respectively, and the median survival time 8 months (95% CI: 6, 19) for stages IIIb IIIc and 7 months (95% CI: 5, 9) for stage IV. Clinical stage, receiving more than one line of SOT, and treatment with radiotherapy accelerated the time to death (0. 4, 0. 9-, and 0. 8-times shorter survival respectively, p < 0. 05). Better performance status (ECOG < 2) extended survival time by 2. 2 times (p = 0. 04). Age < 65 years (OR 9. 4, 95% CI 3. 2, 31. 4, p < 0. 001), and being treated in one particular hospital (OR 0. 2, 95% CI 0. 0, 0. 8, p < 0. 01) were associated with the administration of two or more lines of SOT. Altogether, 18. 9% and 9. 0% of patients received chemotherapy in the last four and two weeks of life, respectively. Moreover, 2. 5% of patients were prescribed a new line of chemotherapy during the last month of life. The proportion of all patients who did not have access to palliative care reached 29. 3%, and among those who had access to it, 34. 2% initiated it in the last month of life. Conclusion: A high proportion of advanced EC patients receive many treatments not based on sound evidence and they do not benefit enough from palliative care services. The most accepted appropriateness indicators point out that some of the analyzed patients could have been overtreated. This study provides important insights into the quality of care provided to advanced EC, and furthermore, for giving valuable insight and opportunities for improvement.
Ajuts: Instituto de Salud Carlos III PI18/00034
Instituto de Salud Carlos III PI19/00335
Nota: Altres ajuts: acords transformatius de la UAB
Drets: Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. Creative Commons
Llengua: Anglès
Document: Article ; recerca ; Versió publicada
Matèria: Keywords Advanced esophageal cancer ; Systemic oncological treatment ; Appropriateness ; Palliative care
Publicat a: Clinical & translational oncology, 2024 , ISSN 1699-3055

DOI: 10.1007/s12094-024-03436-1
PMID: 38662169


11 p, 1.0 MB

El registre apareix a les col·leccions:
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut d’Investigació i Innovació Parc Taulí (I3PT)
Documents de recerca > Documents dels grups de recerca de la UAB > Centres i grups de recerca (producció científica) > Ciències de la salut i biociències > Institut de Recerca Sant Pau
Revisar > Revisió Biblioteca de Medicina
Articles > Articles de recerca
Articles > Articles publicats

 Registre creat el 2024-05-14, darrera modificació el 2024-06-11



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