Department of Gastroenterology and Gastrointestinal Oncology, National Cancer Center Hospital East, 6-5-1, Kashiwanoha, Kashiwa, Chiba 277-8577, Japan.
J Cancer Res Clin Oncol. 2013 Aug;139(8):1383-9. doi: 10.1007/s00432-013-1452-y. Epub 2013 May 25.
The impact of post-progression survival (PPS) on the overall survival (OS) of patients with advanced gastric cancer (AGC) has not yet been reported in detail. We analyzed prospectively collected data from AGC patients who received first-line chemotherapy including fluoropyrimidine plus platinum.
We partitioned OS into progression-free survival (PFS) and PPS in each patient and analyzed correlations between OS and either PFS or PPS using the Spearman rank correlation coefficient (ρ).
A total of 291 AGC patients met the inclusion criteria with median PFS, PPS, and OS of 5.3, 8.1, and 14.8 months, respectively. PFS and OS for each patient showed a correlation of ρ = 0.75 [95% confidence interval (CI) 0.69-0.81]. PPS and OS showed a correlation of ρ = 0.87 (95% CI 0.84-0.91). According to multivariate analysis, performance status at progression, PFS of first-line chemotherapy, and use of second-line chemotherapy were independently associated with PPS.
These results indicate that both PFS and PPS are correlated with OS in first-line chemotherapy for AGC, suggesting the importance of reporting detailed patient characteristics and treatment course after disease progression in clinical trials of first-line chemotherapy for AGC.
目前尚未详细报道晚期胃癌（AGC）患者进展后生存（PPS）对总生存（OS）的影响。我们分析了接受氟嘧啶加铂类一线化疗的 AGC 患者前瞻性收集的数据。
我们将每个患者的 OS 分为无进展生存（PFS）和 PPS，并使用 Spearman 秩相关系数（ρ）分析 OS 与 PFS 或 PPS 之间的相关性。
共 291 例 AGC 患者符合纳入标准，中位 PFS、PPS 和 OS 分别为 5.3、8.1 和 14.8 个月。每位患者的 PFS 和 OS 呈ρ=0.75（95%CI 0.69-0.81）相关。PPS 和 OS 呈ρ=0.87（95%CI 0.84-0.91）相关。多因素分析显示，进展时的体能状态、一线化疗的 PFS 和二线化疗的使用与 PPS 独立相关。
这些结果表明，PFS 和 PPS 与 AGC 一线化疗的 OS 相关，提示在 AGC 一线化疗临床试验中报告详细的患者特征和疾病进展后治疗过程的重要性。
