转移性胃癌治疗策略与生存的国际比较。
International comparison of treatment strategy and survival in metastatic gastric cancer.
机构信息
Department of Surgery Leiden University Medical Centre Leiden the Netherlands.
Department of Medical Oncology Leiden University Medical Centre Leiden the Netherlands.
出版信息
BJS Open. 2018 Oct 9;3(1):56-61. doi: 10.1002/bjs5.103. eCollection 2019 Feb.
BACKGROUND
In the randomized Asian REGATTA trial, no survival benefit was shown for additional gastrectomy over chemotherapy alone in patients with advanced gastric cancer with a single incurable factor, thereby discouraging surgery for these patients. The purpose of this study was to evaluate treatment strategies for patients with metastatic gastric cancer in daily practice in five European countries, along with relative survival in each country.
METHODS
Nationwide population-based data from Belgium, Denmark, the Netherlands, Norway and Sweden were combined. Patients with primary metastatic gastric cancer diagnosed between 2006 and 2014 were included. The proportion of gastric resections performed and the administration of chemotherapy (irrespective of surgery) within each country were determined. Relative survival according to country was calculated.
RESULTS
Overall, 15 057 patients with gastric cancer were included. The proportion of gastric resections varied from 8·1 per cent in the Netherlands and Denmark to 18·3 per cent in Belgium. Administration of chemotherapy was 39·2 per cent in the Netherlands, compared with 63·2 per cent in Belgium. The 6-month relative survival rate was between 39·0 (95 per cent c.i. 37·8 to 40·2) per cent in the Netherlands and 54·1 (52·1 to 56·9) per cent in Belgium.
CONCLUSION
There is variation in the use of gastrectomy and chemotherapy in patients with metastatic gastric cancer, and subsequent differences in survival.
背景
在随机亚洲 REGATTA 试验中，对于单一不可治愈因素的晚期胃癌患者，与单独化疗相比，胃切除术并未显示出生存获益，从而使这些患者的手术受到阻碍。本研究的目的是评估在五个欧洲国家的日常实践中对转移性胃癌患者的治疗策略，以及每个国家的相对生存率。
方法
合并了来自比利时、丹麦、荷兰、挪威和瑞典的全国性基于人群的资料。纳入了 2006 年至 2014 年间诊断为原发性转移性胃癌的患者。确定了每个国家进行胃切除术的比例和化疗（无论是否手术）的实施情况。按国家计算相对生存率。
结果
共有 15057 例胃癌患者纳入研究。胃切除术的比例从荷兰和丹麦的 8.1%到比利时的 18.3%不等。荷兰化疗的实施比例为 39.2%，而比利时为 63.2%。6 个月的相对生存率在荷兰为 39.0%（95%可信区间 37.8%至 40.2%），在比利时为 54.1%（52.1%至 56.9%）。
结论
转移性胃癌患者胃切除术和化疗的应用存在差异，随后的生存率也存在差异。
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