腹水是恶性肿瘤患者生命最后一年的预测因素--不同癌症类型之间的比较。

IF 2.2 3区 医学 Q2 HEALTH CARE SCIENCES & SERVICES Journal of palliative medicine Pub Date : 2024-10-23 DOI:10.1089/jpm.2024.0140
Johan Fridegren, Linda Björkhem-Bergman, Torbjörn Schultz, Peter Strang
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引用次数: 0

摘要

背景:恶性肿瘤腹水通常与预后不良有关,但不同癌症类型的腹水预测值可能有所不同。研究目的目的:绘制恶性肿瘤患者腹水发生的频率和时间模式与死亡时间的关系图,并评估腹水的发生在不同癌症类型中作为预测因素的情况,并将其限制在生命的最后一年。设计:根据瑞典斯德哥尔摩地区七年来所有就诊登记数据进行了一项回顾性研究。所有在生前最后一年接受过至少一次腹腔穿刺术的死亡受试者均被纳入研究范围。结果:在 23056 名死于癌症的患者中,有 1863 人在生命的最后一年接受过腹腔穿刺术(8.0%)。需要进行腹腔穿刺的腹水最常见于阑尾癌(38%)、卵巢癌(35%)、胆管癌(26%)、肝细胞癌(19%)和胰腺癌(17%)。在所有癌症类型中,首次腹腔穿刺的中位时间介于死亡前 248 天和 20 天之间。卵巢癌首次腹腔穿刺术的中位时间与上消化道癌相比有显著差异,前者为 81 天,后者为 30 天(P < 0.0001)。前列腺癌腹水发生率仅为1.9%,但如果出现腹水,则在生命的最后三个月内进行腹腔穿刺的频率会明显增加。结论晚期癌症患者出现腹水通常预示着死亡将在未来几个月内来临,尤其是上消化道癌症患者。对于卵巢癌和阑尾癌,腹水作为一种预测工具的作用较小。
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Ascites as a Predictive Factor in Malignancies in the Last Year of Life-Comparison Between Different Cancer Types.

Background: Ascites in malignancies is usually associated with poor prognosis, but the predictive value may vary between different cancer types. Objectives: The aim was to map the frequency and temporal pattern of paracentesis in patients with malignancies in relation to time to death and to evaluate the occurrence of ascites as a predictive factor in different cancer types, with a limitation to the last year of life. Design: A retrospective study based on registry data covering all care visits in the Stockholm Region, Sweden, for seven years was performed. All deceased subjects that had at least one registered paracentesis in the last year of life were included. Results: Of 23,056 subjects dying from cancer, 1863 had undergone paracentesis in the last year of life (8.0%). Ascites requiring paracentesis was most frequently seen in appendiceal cancer (38%), ovarian cancer (35%), cholangiocarcinoma (26%), hepatocellular carcinoma (19%), and pancreatic cancer (17%). The median time for the first paracentesis in all cancer types varied between 248 and 20 days before death. For ovarian cancer, the median time for first paracentesis differed significantly compared with upper gastro-intestinal (GI) cancers, 81 days compared with 30 days (p < 0.0001). Ascites in prostate cancer was rare,1.9%, but when present, a pronounced increase in the frequency of paracentesis was observed in the last three months of life. Conclusion: The occurrence of paracentesis in patients with advanced cancer is generally a sign that death is approaching within the coming months, especially in upper GI cancer. For ovarian and appendiceal cancers, ascites is less useful as a predictive tool.

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来源期刊
Journal of palliative medicine
Journal of palliative medicine 医学-卫生保健
CiteScore
3.90
自引率
10.70%
发文量
345
审稿时长
2 months
期刊介绍: Journal of Palliative Medicine is the premier peer-reviewed journal covering medical, psychosocial, policy, and legal issues in end-of-life care and relief of suffering for patients with intractable pain. The Journal presents essential information for professionals in hospice/palliative medicine, focusing on improving quality of life for patients and their families, and the latest developments in drug and non-drug treatments. The companion biweekly eNewsletter, Briefings in Palliative Medicine, delivers the latest breaking news and information to keep clinicians and health care providers continuously updated.
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