Nishida Tsutomu, Sugimoto Aya, Tomita Ryo, Higaki Yu, Osugi Naoto, Takahashi Kei, Mukai Kaori, Matsubara Tokuhiro, Nakamatsu Dai, Hayashi Shiro, Yamamoto Masashi, Nakajima Sachiko, Fukui Koji, Inada Masami
Department of Gastroenterology, Toyonaka Municipal Hospital, Osaka 560-8565, Japan.
World J Gastrointest Oncol. 2019 Jan 15;11(1):28-38. doi: 10.4251/wjgo.v11.i1.28.
It is unclear whether treatment delay affects the clinical outcomes of chemotherapy in advanced gastric cancer (A-GC).
To assess whether treatment delay affects the clinical outcomes of chemotherapy in A-GC.
This single-center retrospective study examined consecutive patients with A-GC between April 2012 and July 2018. In total, 110 patients with stage IV A-GC who underwent chemotherapy were enrolled. We defined the wait time (WT) as the interval between diagnosis and chemotherapy initiation. We evaluated the influence of WT on overall survival (OS).
The mean OS was 303 d. The median WT was 17 d. We divided the patients into early and elective WT groups, with a 2-wk cutoff point. There were 46 and 64 patients in the early and elective WT groups, respectively. Compared with the elective WT group, the early WT group had significantly lower albumin (Alb) levels and higher neutrophil/lymphocyte ratios and C-reactive protein (CRP) levels but not a lower performance status. The elective WT group underwent more combination chemotherapy than did the early WT group. OS was different between the two groups (230 d 340 d, respectively). Multivariate analysis revealed that higher CRP levels, lower Alb levels and monotherapy were significantly related to a poor prognosis. To minimize potential selection bias, patients in the elective WT group were 1:1 propensity score matched with patients in the early WT group; no significant difference in OS was found (303 d 311 d, respectively, log-rank = 0.9832).
A longer WT in patients with A-GC does not appear to be associated with a worse prognosis.
治疗延迟是否会影响晚期胃癌（A-GC）化疗的临床结局尚不清楚。
评估治疗延迟是否会影响A-GC化疗的临床结局。
这项单中心回顾性研究对2012年4月至2018年7月期间连续收治的A-GC患者进行了检查。总共纳入了110例接受化疗的IV期A-GC患者。我们将等待时间（WT）定义为诊断与化疗开始之间的间隔。我们评估了WT对总生存期（OS）的影响。
平均OS为303天。WT的中位数为17天。我们将患者分为早期和择期WT组，以2周为分界点。早期和择期WT组分别有46例和64例患者。与择期WT组相比，早期WT组的白蛋白（Alb）水平明显较低，中性粒细胞/淋巴细胞比率和C反应蛋白（CRP）水平较高，但体能状态并不低。择期WT组比早期WT组接受了更多的联合化疗。两组的OS不同（分别为230天和340天）。多变量分析显示，较高的CRP水平、较低的Alb水平和单一疗法与预后不良显著相关。为了尽量减少潜在的选择偏倚，对择期WT组的患者与早期WT组的患者进行1:1倾向评分匹配；未发现OS有显著差异（分别为303天和311天，对数秩检验P = 0.9832）。
A-GC患者较长的WT似乎与较差的预后无关。
