劳伦分类法在局部晚期胃癌或胃食管交界癌新辅助/围手术期化疗患者中的意义——来自德国一个大型单中心队列的分析

Significance of Lauren Classification in Patients Undergoing Neoadjuvant/Perioperative Chemotherapy for Locally Advanced Gastric or Gastroesophageal Junction Cancers-Analysis from a Large Single Center Cohort in Germany.

作者信息

Schirren Rebekka, Novotny Alexander, Oesterlin Christian, Slotta-Huspenina Julia, Friess Helmut, Reim Daniel

机构信息

Department of Surgery, TUM School of Medicine, Technical University Munich, 81675 Munich, Germany.

Institute of Pathology, TUM School of Medicine, Technical University Munich, 81675 Munich, Germany.

出版信息

Cancers (Basel). 2021 Jan 14;13(2):290. doi: 10.3390/cancers13020290.

BACKGROUND

the purpose of this analysis was to analyze the outcomes of multimodal treatment that are related to Lauren histotypes in gastro-esophageal cancer (GEC).

METHODS

patients with GEC between 1986 and 2013 were analyzed. Uni- and multivariate regression analysis were performed to identify predictors for overall survival. Lauren histotype stratified overall survival (OS)-rates were analyzed by the Kaplan-Meier method. Further, propensity score matching (PSM) was performed to balance for confounders.

RESULTS

1290 patients were analyzed. After PSM, the median survival was 32 months for patients undergoing primary surgery (PS) and 43 months for patients undergoing neoadjuvant chemotherapy (nCTx) ahead of surgery. For intestinal types, median survival time was 34 months (PS) vs. 52 months (nCTx+surgery) = 0.07, 36 months (PS) vs. (31) months (nCTx+surgery) in diffuse types ( = 0.44) and 31 months (PS) vs. 62 months (nCTx+surgery) for mixed types ( = 0.28). Five-/Ten-year survival rates for intestinal, diffuse, and mixed types were 44/29%, 36/17%, and 43/33%, respectively. After PSM, Kaplan-Meier showed a survival benefit for patients undergoing nCTx+surgery in intestinal and mixed types.

CONCLUSION

the Lauren histotype might be predictive for survival outcome in GEC-patients after neoadjuvant/perioperative chemotherapy.

背景

本分析的目的是分析与胃食管癌（GEC）中劳伦组织学类型相关的多模式治疗结果。

方法

对1986年至2013年间的GEC患者进行分析。进行单因素和多因素回归分析以确定总生存的预测因素。采用Kaplan-Meier法分析按劳伦组织学类型分层的总生存率（OS）。此外，进行倾向评分匹配（PSM）以平衡混杂因素。

结果

共分析了1290例患者。PSM后，接受初次手术（PS）的患者中位生存期为32个月，术前接受新辅助化疗（nCTx）的患者中位生存期为43个月。肠型患者的中位生存时间为34个月（PS）对52个月（nCTx+手术），弥漫型为36个月（PS）对31个月（nCTx+手术）（P=0.44），混合型为31个月（PS）对62个月（nCTx+手术）（P=0.28）。肠型、弥漫型和混合型的5年/10年生存率分别为44%/29%、36%/17%和43%/33%。PSM后，Kaplan-Meier分析显示肠型和混合型患者接受nCTx+手术后有生存获益。