Zhang Chunmei, Tang Ruiyi, Zhu Hanlong, Ge Xianxiu, Wang Yue, Wang Xue, Miao Lin
Medical Centre for Digestive Diseases, the Second Affiliated Hospital of Nanjing Medical University, 121 Jiangjiayuan Road, Nanjing, 210011, Jiangsu, China.
Department of Gastroenterology and Hepatology, Jinling Hospital, Medical School of Nanjing University, Nanjing, 210002, Jiangsu, China.
Sci Rep. 2022 Apr 15;12(1):6288. doi: 10.1038/s41598-022-10156-5.
Treatments for early-onset gastric cancer (EOGC) patients are rarely included in clinical trials, resulting in an unclear impact on survival. This study aimed to investigate the treatment patterns of EOGC patients and their impact on survival. Based on the Surveillance, Epidemiology, and End Results database, we conducted a retrospective analysis of 1639 EOGC patients (< 50 years) diagnosed between 2010 and 2018. Patients with larger tumours, distant metastasis, and AJCC TNM stage in IV were prone to receive nonsurgical treatment. Patients treated with surgery alone had a better prognosis than those receiving SROC or SCRT or nonsurgical treatment. However, analyses stratified by histological type, tumour size and TNM stage showed that patients did not benefit more from SROC and SCRT than from surgery alone. Similar results were observed in the stratified Cox regression risk analysis. Patients who received nonsurgical treatment had the highest risk of overall death [hazard ratio (HR) = 2.443, 95% confidence interval (CI) 1.865-3.200, P < 0.001]. This study indicated that additional radiotherapy, chemotherapy or chemoradiotherapy did not provide a coordinated survival benefit to EOGC patients.
早期胃癌（EOGC）患者的治疗很少被纳入临床试验，因此对生存率的影响尚不清楚。本研究旨在调查EOGC患者的治疗模式及其对生存率的影响。基于监测、流行病学和最终结果数据库，我们对2010年至2018年间诊断出的1639例EOGC患者（<50岁）进行了回顾性分析。肿瘤较大、有远处转移且美国癌症联合委员会（AJCC）TNM分期为IV期的患者倾向于接受非手术治疗。单纯接受手术治疗的患者预后优于接受新辅助放化疗（SROC）或同步放化疗（SCRT）或非手术治疗的患者。然而，按组织学类型、肿瘤大小和TNM分期分层分析显示，与单纯手术相比，患者从SROC和SCRT中获益并不更多。在分层Cox回归风险分析中也观察到了类似结果。接受非手术治疗的患者总体死亡风险最高[风险比（HR）=2.443，95%置信区间（CI）1.865 - 3.200，P<0.001]。本研究表明，额外的放疗、化疗或放化疗并未给EOGC患者带来协同的生存获益。
