胃腺癌的手术治疗趋势。
Trends in the surgical treatment of gastric adenocarcinoma.
机构信息
Division of Surgical Oncology, Department of Surgery, University Hospitals Seidman Cancer Center, Case Western Reserve University, Cleveland, OH, USA.
出版信息
Ann Surg Oncol. 2014 Feb;21(2):569-74. doi: 10.1245/s10434-013-3314-x. Epub 2013 Oct 29.
BACKGROUND
In past decade, the treatment of gastric adenocarcinoma has evolved as a result of the publication of two seminal randomized controlled trials. We aimed to examine treatment trends for resectable gastric cancer (stage I-III) using the National Cancer Data Base (NCDB). Our hypothesis was that the use of chemotherapy and chemoradiotherapy in addition to surgery for the treatment of gastric adenocarcinoma has increased from 2000 to 2009.
METHODS
Patients diagnosed with stage I-III gastric adenocarcinoma between 2000 and 2009 were selected from the NCDB Hospital Comparison Benchmark Reports. Attention was paid to the initial treatment regimen and data on hospital setting were collected and analyzed. The Cochran-Armitage test for trend was used to assess changes in treatment over time.
RESULTS
A total of 50,778 patients with stage I-III gastric adenocarcinoma were included in the analysis. Between 2000 and 2009, the use of surgery alone decreased significantly across all three stages at both teaching hospitals and community hospitals (p < 0.0001 for all cases). In the same period, the use of chemotherapy in addition to surgery increased significantly across all three stages and at both hospital settings (p < 0.0001 for all cases). Surgery plus chemoradiotherapy increased for stage I-III disease at community hospitals (p < 0.05 for all) but only increased significantly for stage II disease at teaching hospitals (p < 0.01). Incidentally, nonsurgical treatment increased across all three stages at both hospital settings (p < 0.001 for all cases).
CONCLUSIONS
Data from the NCDB from 2000 to 2009 demonstrate that there has been an increasing use of chemotherapy in addition to surgery for resectable gastric cancer.
背景
在过去的十年中，由于两项开创性的随机对照试验的发表，胃腺癌的治疗方法发生了演变。我们旨在使用国家癌症数据库（NCDB）检查可切除胃癌（I-III 期）的治疗趋势。我们的假设是，除手术外，化疗和放化疗在治疗胃腺癌中的应用从 2000 年到 2009 年有所增加。
方法
从 NCDB 医院比较基准报告中选择 2000 年至 2009 年间诊断为 I-III 期胃腺癌的患者。关注初始治疗方案，并收集和分析医院设置的数据。使用 Cochran-Armitage 趋势检验来评估随时间的治疗变化。
结果
共纳入 50778 例 I-III 期胃腺癌患者。在 2000 年至 2009 年间，在所有三个阶段，教学医院和社区医院的单纯手术使用率均显著下降（所有病例 p < 0.0001）。在此期间，所有三个阶段和两种医院设置的手术加化疗使用率均显著增加（所有病例 p < 0.0001）。社区医院 I-III 期疾病的手术加放化疗增加（所有病例 p < 0.05），但仅在教学医院的 II 期疾病中显著增加（p < 0.01）。顺便说一下，两种医院设置的所有三个阶段的非手术治疗均增加（所有病例 p < 0.001）。
结论
2000 年至 2009 年 NCDB 的数据表明，可切除胃癌除手术外，化疗的应用有所增加。
Zotero 插件