Department of Oncology I, Cancer Center, Renmin Hospital of Wuhan University, Wuhan, China.
Technol Cancer Res Treat. 2020 Jan-Dec;19:1533033820960746. doi: 10.1177/1533033820960746.
To explore the clinical and pathological features of gastric signet ring cell carcinoma, and evaluate the survival impact of preoperative radiotherapy on these patients.
The Surveillance, Epidemiology, and End Results database was used to extract eligible patients from 2004 to 2015. The patients were divided into those with and without preoperative radiotherapy. The categorical variables were described by chi-square tests. The patients' survival was compared between the 2 groups by Kaplan-Meier method with log-rank tests. Cox proportional hazard model was adopted to identify prognostic factors of cancer-specific survival.
Totally 4771 patients were recruited, of whom 218(4.6%) patients received preoperative radiotherapy, while 4553(95.4%) patients didn't receive this treatment. Survival analysis of the entire cohort demonstrated that preoperative radiotherapy improved both cancer-specific survival and overall survival (p < 0.001) of the patients. Cox proportional hazard models identified age >60, tumor size >50 mm, TNM stage II-IV as independent risk factors for poor prognosis (HR > 1, p < 0.05). Notably, preoperative radiotherapy was identified as an independent protective factor for favorable prognosis (HR < 1, p < 0.05). Subgroup survival analysis showed that preoperative radiotherapy exerted significant survival benefits for the stages III and IV patients.
In this population-based study, preoperative radiotherapy is associated with significant survival benefits for the patients with advanced gastric signet ring cell carcinoma. Hence preoperative radiotherapy is feasible for these patients.
探讨胃印戒细胞癌的临床病理特征，并评估术前放疗对这些患者生存的影响。
利用监测、流行病学和最终结果数据库，从 2004 年至 2015 年提取符合条件的患者。将患者分为术前接受放疗和未接受放疗两组。采用卡方检验描述分类变量。采用 Kaplan-Meier 法和对数秩检验比较两组患者的生存情况。采用 Cox 比例风险模型识别癌症特异性生存的预后因素。
共纳入 4771 例患者，其中 218 例（4.6%）患者接受术前放疗，4553 例（95.4%）患者未接受该治疗。全队列生存分析表明，术前放疗改善了患者的癌症特异性生存和总生存（p<0.001）。Cox 比例风险模型确定年龄>60 岁、肿瘤直径>50mm、TNM 分期 II-IV 期为预后不良的独立危险因素（HR>1，p<0.05）。值得注意的是，术前放疗被确定为预后良好的独立保护因素（HR<1，p<0.05）。亚组生存分析显示，术前放疗对 III 期和 IV 期患者具有显著的生存获益。
在这项基于人群的研究中，术前放疗与晚期胃印戒细胞癌患者的生存显著获益相关。因此，术前放疗对这些患者是可行的。
