Does delaying surgery following induction chemotherapy compromise survival in patients with mesothelioma?  

作　　者：Lye-Yeng Wong Ioana Baiu Matthew Leipzig Ashley Titan Douglas Z.Liou Natalie Lui Mark Berry Joseph B.Shrager Leah Backhus 

机构地区：[1]Department of Cardiothoracic Surgery,Division of Thoracic Surgery,Stanford Hospital and Clinics,Stanford,CA 94304,USA [2]Department of Surgery,Division of General Surgery,Stanford Hospital and Clinics,Stanford,CA 94304,USA [3]VA Palo Alto Health Care System,Department of Surgery,Palo Alto,CA 94304,USA

出　　处：《Journal of Cancer Metastasis and Treatment》2023年第1期459-470,共12页癌症转移与治疗（英文版）

摘　　要：Objective:The ideal time interval between induction chemotherapy and surgery and the impact on cancer mortality in patients with mesothelioma remains unclear.Methods:We queried the National Cancer Database(2004-2017)for patients with favorable prognostic factors considered for surgery.Immediate surgery was performed within 3 months following the start of induction chemotherapy,while delayed surgery was defined as surgery performed later than 3 months.We compared both groups to those who did not have an operation despite being surgical candidates,as well as to those who were treated with surgery only.Overall mortality was assessed using Cox proportional hazard models adjusting for covariates.Results:A total of 4,294 patients were included,with the majority of patients undergoing induction chemotherapy followed by no surgery(3,370,78%).The proportion of patients undergoing both immediate and delayed surgery increased over the last decade,but delayed surgery continued to be more common.There were no significant differences in baseline characteristics between the immediate and delayed surgery groups.Higher comorbidity scores were significantly associated with an increased risk of death on multivariable analysis,but the timing of surgery was not.This held true with a sensitivity analysis using 6 months as the definition of delayed surgery.Conclusions:This study shows that delaying surgery following induction chemotherapy does not compromise overall survival in patients with mesothelioma.

关 键 词：Malignant pleural mesothelioma mesothelioma surgery mesothelioma treatment 

分 类 号：R734.3[医药卫生—肿瘤]