State Key Laboratory of Oncology in South China, 651 Dongfeng Road East, Guangzhou 510060, China.
Med Oncol. 2013 Jun;30(2):514. doi: 10.1007/s12032-013-0514-y. Epub 2013 Feb 24.
This study analyzed the time-varying pattern of the recurrence risk for gastric cancer after surgery. A total of 1,222 gastric patients undergoing D2 resection surgery were studied retrospectively. The annual recurrence hazard curve for all of the populations showed one early peak and a late rise within 10 years after the surgery. The first major recurrence peak covers the first 3 years after the surgery, rising to a maximum at 1.5 years after surgery, followed by a decline until 7.5 years after the surgery, at which point the curve began to rise again. A subgroup analysis of this pattern also revealed that the curves of the patients with bigger tumors, poorly differentiated/undifferentiated adenocarcinomas, lymphatic/venous invasion, T3 and T4, node positive or with fewer lymph nodes retrieved were steeper. Chemotherapy can reduce the hazard rate for recurrence of gastric cancer. Our study confirms the time-varying pattern of the recurrence risk for gastric cancer, and it further supports the hypothesis of tumor dormancy after surgery. To effectively reduce the recurrence risk, new adjuvant therapies beyond chemotherapy may be needed.
本研究分析了胃癌手术后复发风险的时变模式。回顾性研究了 1222 例接受 D2 切除术的胃癌患者。所有人群的年复发危险曲线显示出一个早期高峰和手术后 10 年内的晚期上升。第一个主要复发高峰涵盖手术后的头 3 年，在手术后 1.5 年达到最大值，然后下降至手术后 7.5 年，此时曲线开始再次上升。对这种模式的亚组分析还表明，肿瘤较大、低分化/未分化腺癌、淋巴管/静脉侵犯、T3 和 T4、淋巴结阳性或淋巴结检出较少的患者的曲线更陡峭。化疗可以降低胃癌复发的危险率。本研究证实了胃癌复发风险的时变模式，并进一步支持了手术后肿瘤休眠的假说。为了有效降低复发风险，可能需要除化疗以外的新辅助治疗方法。
