Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan.
Division of Gastric Surgery, Shizuoka Cancer Center, Shizuoka, Japan; Division of Surgery, Keio University School of Medicine, Tokyo, Japan.
Eur J Surg Oncol. 2019 Oct;45(10):1964-1968. doi: 10.1016/j.ejso.2019.06.006. Epub 2019 Jun 8.
Patients with stage I gastric cancer tend to wait for surgery. Although the cancer may progress during such a delay, effects of wait time for surgery on survival remain inconsistent. Here, we evaluated the safety of surgical wait time on survival of patients with clinical stage I gastric cancer.
The outcomes of 556 patients who underwent gastrectomy for clinical stage I gastric cancer between January 2007 and December 2011 were retrospectively evaluated. Patients were stratified into three groups based on wait time: short- (<61 days, n = 185), intermediate- (61-90 days, n = 218), and long-wait (91-180 days, n = 153) groups. Clinicopathological findings and survival were compared among the groups.
The median wait time was 72 days. Age and comorbidities differed among the groups, but clinical and pathological cancer stages did not. Overall survival was comparable; the 5-year overall survival was 90.2%, 93.6%, and 88.8% in the short-, intermediate-, and long-wait groups, respectively. Multivariate analysis revealed that wait time was not an independent prognostic factor for overall survival. Adjusted hazard ratios (HRs) were 0.69 (p = 0.262) and 1.03 (p = 0.926) in the intermediate- and long-wait groups, respectively, with short wait time as the reference. Relapse-free survival was comparable among the groups (intermediate-wait HR = 0.80, p = 0.476; long-wait HR = 1.10, p = 0.740).
A half-year wait time for surgery was not independently associated with survival of patients with clinical stage I gastric cancer and may therefore be acceptable.
I 期胃癌患者倾向于等待手术。尽管在此期间癌症可能会进展,但手术等待时间对生存的影响仍不一致。在这里,我们评估了手术等待时间对临床 I 期胃癌患者生存的安全性。
回顾性分析了 2007 年 1 月至 2011 年 12 月期间接受胃切除术治疗的 556 例临床 I 期胃癌患者的结局。根据等待时间将患者分为三组:短(<61 天,n=185)、中(61-90 天,n=218)和长等待(91-180 天,n=153)组。比较了各组的临床病理特征和生存情况。
中位等待时间为 72 天。年龄和合并症在各组之间存在差异,但临床和病理癌症分期没有差异。总体生存率相当;5 年总生存率分别为短、中、长等待组的 90.2%、93.6%和 88.8%。多变量分析显示,等待时间不是总生存的独立预后因素。调整后的风险比(HR)分别为 0.69(p=0.262)和 1.03(p=0.926),以短等待时间为参照。各组之间无复发生存率相当(中等待 HR=0.80,p=0.476;长等待 HR=1.10,p=0.740)。
半年的手术等待时间与临床 I 期胃癌患者的生存无关,因此可能是可以接受的。