肿瘤手术和术后结果的性别差异:法国全国范围内的综合研究。

IF 8.6 1区 医学 Q1 SURGERY British Journal of Surgery Pub Date : 2024-08-02 DOI:10.1093/bjs/znae179
Floriane Jochum, Anne-Sophie Hamy, Paul Gougis, Élise Dumas, Beatriz Grandal, Mathilde Sauzey, Enora Laas, Jean-Guillaume Feron, Virginie Fourchotte, Thomas Gaillard, Noemie Girard, Lea Pauly, Elodie Gauroy, Lauren Darrigues, Judicael Hotton, Lise Lecointre, Fabien Reyal, Fabrice Lecuru, Cherif Akladios
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引用次数: 0

摘要

背景:本研究的主要目的是详尽调查癌症手术中与性别有关的差异:本研究的主要目的是对癌症手术中的性别差异进行详尽调查:这项观察性研究使用的数据来自法国国家医疗保险系统数据库,覆盖了98.8%的人口。研究纳入了2018年1月至2019年12月期间诊断为非性别特异性实体侵袭性癌症的患者。主要结果是接受癌症手术的可能性、所实施的肿瘤手术类型,以及相关的术后30天、60天和90天再手术率和死亡率(按性别分列):在纳入的 367 887 名患者中,女性接受癌症手术的可能性比男性高 44%(OR 1.44,95% c.i. 1.31 至 1.59;P <0.001)。然而,随着年龄的增长(OR 0.98,0.98 至 0.98;P <0.001)和并发症数量的增加(OR 0.95,0.95 至 0.96;P <0.001),手术的可能性会降低,尤其是女性。总体而言,男性的90天再次手术率(21.2%对18.8%;P<0.001)和死亡率(1.2%对0.9%;P<0.001)高于女性,大多数癌症类型也是如此,但膀胱癌除外,女性的90天死亡率更高(1.8%对1.4%;P<0.001)。在对年龄、并发症数量和手术方式进行调整后,男性的90天死亡率仍然较高(OR 1.16,1.07至1.26;P <0.001),男性在90天内再次手术的可能性比女性高21%(OR 1.21,1.18至1.23;P <0.001):女性比男性更有可能接受癌症手术,但随着年龄的增长和并发症的增加,手术的可能性会降低,尤其是女性。这些研究结果突出表明,有必要提高人们的认识并制定相关策略,以确保在接受肿瘤外科治疗和改善治疗效果方面实现性别平等。
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Sex-related differences in oncological surgery and postoperative outcomes: comprehensive, nationwide study in France.

Background: The main objective of this study was to undertake an exhaustive investigation of sex-related differences in cancer surgery.

Methods: This observational study used data from the French national health insurance system database covering 98.8% of the population. Patients diagnosed with non-sex-specific solid invasive cancers between January 2018 and December 2019 were included. The main outcomes were likelihood of undergoing cancer surgery, type of oncological surgery performed, and associated 30-, 60-, and 90-day postoperative reoperation and mortality rates, by sex.

Results: For the 367 887 patients included, women were 44% more likely than men to undergo cancer surgery (OR 1.44, 95% c.i. 1.31 to 1.59; P < 0.001). However, the likelihood of surgery decreased with advancing age (OR 0.98, 0.98 to 0.98; P < 0.001), and with increasing number of co-morbid conditions (OR 0.95, 0.95 to 0.96; P < 0.001), especially in women. Men had higher 90-day reoperation (21.2 versus 18.8%; P < 0.001) and mortality (1.2 versus 0.9%; P < 0.001) rates than women, overall, and for most cancer types, with the exception of bladder cancer, for which the 90-day mortality rate was higher among women (1.8 versus 1.4%; P < 0.001). After adjustment for age, number of co-morbid conditions, and surgical procedure, 90-day mortality remained higher in men (OR 1.16, 1.07 to 1.26; P < 0.001), and men were 21% more likely than women to undergo reoperation within 90 days (OR 1.21, 1.18 to 1.23; P < 0.001).

Conclusion: Women were much more likely than men to undergo cancer surgery than men, but the likelihood of surgery decreased with advancing age and with increasing number of co-morbid conditions, especially in women. These findings highlight a need for both increased awareness and strategies to ensure gender equality in access to oncological surgical treatment and improved outcomes.

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来源期刊
CiteScore
12.70
自引率
7.30%
发文量
1102
审稿时长
1.5 months
期刊介绍: The British Journal of Surgery (BJS), incorporating the European Journal of Surgery, stands as Europe's leading peer-reviewed surgical journal. It serves as an invaluable platform for presenting high-quality clinical and laboratory-based research across a wide range of surgical topics. In addition to providing a comprehensive coverage of traditional surgical practices, BJS also showcases emerging areas in the field, such as minimally invasive therapy and interventional radiology. While the journal appeals to general surgeons, it also holds relevance for specialty surgeons and professionals working in closely related fields. By presenting cutting-edge research and advancements, BJS aims to revolutionize the way surgical knowledge is shared and contribute to the ongoing progress of the surgical community.
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