Zhang Jieyun, Gan Lu, Xu Mi-Die, Huang Mingzhu, Zhang Xiaowei, Gong Yiwei, Wang Xi, Yu Guanzhen, Guo Weijian
Department of Medical Oncology, Fudan University Shanghai Cancer Center, Shanghai 200032, P.R. China.
Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China.
J Cancer. 2018 Mar 8;9(7):1188-1199. doi: 10.7150/jca.22085. eCollection 2018.
We explored the influence of age on clinicopathologic features and survival of patients with M0 gastric cancer (GC). 16856 GC patients from Surveillance, Epidemiology and End Results (SEER) database and 1037 GC patients from Chinese multiple centers were enrolled in the U.S. and Chinese cohort, respectively. 50-year-old was treated as cutoff age. Propensity score method was used to carry out a 1:1 paired match. In the U.S. cohort, we found that younger patients presented poor tumor behavior. However, in spite of worse outcome in stage IIV cohort, young group showed better 3-year survival in M0 patients, especially for those who underwent a total gastrectomy. In a matched analysis, a better prognosis was still observed in younger group. The prognostic value of age was also validated in M0 GC patients with gastrectomy in Chinese cohort. In spite of the worse outcome in survival curve of stage IIV GC cohort, young patients with gastrectomy presented favorable survival in M0 subgroup. It is also applicable in China. Early diagnosis and treatment should be taken seriously in young GC patients since they often possess poorer characteristics but benefited more from gastrectomy.
我们探讨了年龄对M0期胃癌（GC）患者临床病理特征和生存情况的影响。分别从美国监测、流行病学与最终结果（SEER）数据库纳入16856例GC患者，以及来自中国多个中心的1037例GC患者作为美国队列和中国队列。以50岁作为年龄分界点。采用倾向评分法进行1:1配对匹配。在美国队列中，我们发现年轻患者的肿瘤行为较差。然而，尽管IIV期队列的结局较差，但年轻组M0期患者的3年生存率更高，尤其是那些接受全胃切除术的患者。在配对分析中，年轻组仍显示出较好的预后。年龄的预后价值在中国队列中接受胃切除术的M0期GC患者中也得到了验证。尽管IIV期GC队列生存曲线的结局较差，但接受胃切除术的年轻患者在M0亚组中表现出良好的生存情况。这在中国也适用。年轻的GC患者应重视早期诊断和治疗，因为他们往往具有较差的特征，但从胃切除术中获益更多。
