Epidemiological guideline influence on the therapeutic trend and patient outcome of uterine cervical cancer in Japan: Japan society of gynecologic oncology guideline evaluation committee project

Autor: Shogo Shigeta, Fumiaki Takahashi, Mikio Mikami, Daisuke Aoki, Wataru Yamagami, Masako Shida, Satoru Nagase, Nobuo Yaegashi, Takeo Shibata, Masae Ikeda, Hidetaka Katabuchi
Rok vydání: 2020
Předmět:
Adult
0301 basic medicine
medicine.medical_specialty
medicine.medical_treatment
Uterine Cervical Neoplasms
Gynecologic oncology
Hysterectomy
Medical Oncology
03 medical and health sciences
0302 clinical medicine
Japan
Obstetrics and gynaecology
Epidemiology
medicine
Humans
Registries
Practice Patterns
Physicians'
Stage (cooking)
Societies
Medical
Survival analysis
Aged
Neoplasm Staging
Aged
80 and over
Evidence-Based Medicine
business.industry
General surgery
Obstetrics and Gynecology
Guideline
Middle Aged
Survival Analysis
Neoadjuvant Therapy
Cancer registry
Survival Rate
Radiation therapy
Treatment Outcome
030104 developmental biology
Oncology
Chemotherapy
Adjuvant
Gynecology
030220 oncology & carcinogenesis
Practice Guidelines as Topic
Female
Radiotherapy
Adjuvant
Guideline Adherence
business
Zdroj: Gynecologic Oncology. 159:248-255
ISSN: 0090-8258
DOI: 10.1016/j.ygyno.2020.07.023
Popis: Objective The Japan Society of Gynecologic Oncology published its first clinical guidelines for uterine cervical cancer in 2007 which has been revised twice in 2011 and 2017. The aim of this study was to investigate the influence of the first guideline publication on the therapeutic trend and patient outcome by analyzing uterine cervical cancer cases registered to the cancer registry organized by the Japan Society of Obstetrics and Gynecology. Methods Data of uterine cervical cancer cases registered to the cancer registry from 2000 to 2012 were provided. Epidemiological and clinical trend were analyzed by the Chi-squared test with subsequent standardized residual analysis. Overall survival among the patients registered between 2004 and 2009 was analyzed using the Fine and Gray competing risk model. Results 68,707 cases were registered during the study period. A trend analysis revealed that the guideline publication may have led to a decrease in neoadjuvant chemotherapy in parallel with an increase in radiation therapy mainly in stage II and III patients undergoing primary treatment. A survival analysis indicated that the introduction of the guideline may have improved overall survival among stage III uterine cervical cancer patients, even though a significant difference was not observed in all of the cases. Conclusions This study demonstrated the potential influence of the guideline publication on the clinical trend and patient outcome. As this is the first assessment of the guideline for uterine cervical cancer in Japan, continuous evaluation is necessary to further comprehend the significance of this guideline.
Databáze: OpenAIRE
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