| アブストラクト | OBJECTIVE: The incidence and mortality rates of endometrial cancer are increasing globally, including in Japan. Quality of cancer care is promoted through guideline adherence. This study aimed to establish quality indicators (QIs) for endometrial cancer and explore the factors contributing to treatment nonadherence. METHODS: QIs and pattern-of-care indicators (PCIs) were developed using the Research and Development/University of California Los Angeles modified Delphi method. QIs reflect desirable healthcare patterns, whereas PCIs address treatment areas with lacking evidence. Data from the Hospital-Based Cancer Registry and Diagnosis Procedure Combination Survey were used. Patients diagnosed or treated between January 1 and December 31, 2020 were included. The reasons for nonadherence were collected. Logistic regression was used to analyze the factors influencing adherence, including age, body mass index, comorbidities, facilities, and recurrence risk. RESULTS: Of the 35 proposed QI candidates, 8 QIs and 9 PCIs were selected, predominantly focusing on surgical aspects. Adherence rates varied, with peritoneal lavage cytology being the highest (93.1%), and postoperative hormone replacement therapy (HRT) for patients aged <45 years being the lowest (30.9%), when focusing on process indicators. Reasons for nonadherence included patient preference and medical comorbidities as significant factors. Multivariate analysis highlighted age, clinical stage, and Barthel index as significant contributors to nonadherence. CONCLUSION: We developed QIs to comprehensively assess endometrial cancer treatment. Adherence rates are favorable; however, HRT has a low adherence rate. Factors leading to nonadherence include advanced age and incomplete activities of daily living, particularly in advanced stages. |
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| ジャーナル名 | Journal of gynecologic oncology |
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| Pubmed追加日 | 2025/4/4 |
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| 投稿者 | Kakuwa, Tamaki; Ichinose, Yuichi; Rikitake, Ryoko; Ishii, Taisuke; Nagase, Satoru; Kobayashi, Yoichi; Kaneuchi, Masanori; Tokunaga, Hideki; Seino, Manabu; Kajiyama, Hiroaki; Takekuma, Munetaka; Tabata, Tsutomu; Terai, Yoshito; Terao, Yasuhisa; Morisada, Tohru; Watari, Hidemichi; Yamamoto, Yoko; Kawata, Akira; Higashi, Takahiro |
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| 組織名 | Division of Health Services Research, Institute for Cancer Control, National;Cancer Center, Tokyo, Japan.;Department of Public Health and Health Policy, Graduate School of Medicine,;University of Tokyo, Tokyo, Japan. tamaki.kakuwa@gmail.com.;University of Tokyo, Tokyo, Japan.;Department of Obstetrics and Gynecology, Yamagata University School of Medicine,;Yamagata, Japan.;Department of Obstetrics and Gynecology, Kyorin University Faculty of Medicine,;Tokyo, Japan.;Department of Gynecology, Otaru General Hospital, Otaru, Japan.;Division of Obstetrics and Gynecology, Faculty of Medicine, Tohoku Medical and;Pharmaceutical University, Sendai, Japan.;Department of Obstetrics and Gynecology, Nagoya University Graduate School of;Medicine, Nagoya, Japan.;Division of Gynecology, Shizuoka Cancer Center, Shizuoka, Japan.;Department of Obstetrics and Gynecology, Tokyo Women's Medical University, Tokyo,;Japan.;Department of Obstetrics and Gynecology, Kobe University Graduate School of;Medicine, Kobe, Japan.;Department of Obstetrics and Gynecology, Faculty of Medicine, Juntendo;University, Tokyo, Japan.;Department of Obstetrics and Gynecology, Hokkaido University Graduate School of;Medicine, Sapporo, Japan.;Department of Obstetrics and Gynecology, Graduate School of Medicine, The |
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| Pubmed リンク | https://www.ncbi.nlm.nih.gov/pubmed/40183694/ |
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