Department of General Surgery, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, #453, Tiyuchang Road, Xihu District, Hangzhou, 310000, Zhejiang Province, China.
Department of Respiratory and Critical Care Medicine, Hangzhou TCM Hospital Affiliated to Zhejiang Chinese Medical University, #453, Tiyuchang Road, Xihu District, Hangzhou, 310000, Zhejiang Province, China.
World J Surg Oncol. 2022 Apr 17;20(1):123. doi: 10.1186/s12957-022-02591-5.
This study aimed to investigate the potential effect of adjuvant chemotherapy in patients diagnosed with stage IB gastric adenocarcinoma (GAC).
A total of 1727 patients were included in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 and divided into the chemotherapy and no-chemotherapy groups. Then, the methods of Kaplan-Meier analysis, propensity score matching (PSM), and competing risk analysis were implemented.
After PSM, no significant difference was found in the chemotherapy and no-chemotherapy groups in overall survival (OS) (p=0.4) and cancer-specific survival (CSS) (p=0.12) in survival curves. The competing risk analysis presented that the 5-year cumulative incidence of cancer-specific death (CSD) was significantly lower in patients receiving chemotherapy (11.5% vs. 20.8%, p=0.007), while no significant discrepancy was observed in other causes of death (OCD) in both groups (10.6% vs. 10.9%, p=0.474). Multivariable competing risks regression models presented a significant correlation between chemotherapy and CSD (HR, 0.51; 95%CI, 0.31-0.82; p=0.007).
The stage IB GAC patients can benefit from adjuvant chemotherapy based on this competing risk analysis.
本研究旨在探讨辅助化疗对诊断为 IB 期胃腺癌（GAC）患者的潜在影响。
从 2004 年至 2015 年，共纳入 1727 例患者进入监测、流行病学和最终结果（SEER）数据库，并分为化疗组和无化疗组。然后，采用 Kaplan-Meier 分析、倾向评分匹配（PSM）和竞争风险分析方法。
PSM 后，生存曲线中化疗组和无化疗组的总生存（OS）（p=0.4）和癌症特异性生存（CSS）（p=0.12）无显著差异。竞争风险分析显示，接受化疗的患者 5 年癌症特异性死亡（CSD）累积发生率显著降低（11.5%比 20.8%，p=0.007），而两组其他死亡原因（OCD）无显著差异（10.6%比 10.9%，p=0.474）。多变量竞争风险回归模型显示，化疗与 CSD 之间存在显著相关性（HR，0.51；95%CI，0.31-0.82；p=0.007）。
根据这项竞争风险分析，IB 期 GAC 患者可从辅助化疗中获益。
