2019年冠状病毒病大流行期间延迟肿瘤手术对胃癌患者生存结局的影响：循证策略
The Effect of Delayed Oncology Surgery on Survival Outcomes for Patients With Gastric Cancer During the COVID-19 Pandemic: Evidence-Based Strategies.
作者信息
Ma Jichun, Zhu Chenglou, Li Weidong, Qiu Zhisheng, Yang Jian, Ge Long, Da Mingxu
机构信息
The First Clinical Medical College of Lanzhou University, Lanzhou University, Lanzhou, China.
Clinical Medicine College, Ningxia Medical University, Yinchuan, China.
出版信息
Front Oncol. 2022 May 19;12:780949. doi: 10.3389/fonc.2022.780949. eCollection 2022.
OBJECTIVE
To evaluate the impact of delay in gastrectomy on gastric cancer patients' survival outcomes during the COVID-19 pandemic.
METHODS
Databases including PubMed, MEDLINE (using the Ovid platform), Embase, the Cochrane Library, COVID-19 Open Research Dataset Challenge, COVID-19 Research Database (WHO), ClinicalTrials.gov, and WHO International Clinical Trials Registry Platform were searched for studies of any design and in any setting that included patients with gastric cancer from their inception to July 31, 2021. Hazard ratio (HR) and 95% confidence intervals (CI) of research endpoints in each study were calculated. Statistical analyses were performed with Stata 12.0.
RESULTS
A total of 8 studies involving 4,052 gastric cancer patients were eligible and included in the present meta-analysis. The result of the meta-analysis was shown that delaying surgery for less than 8 weeks may not decrease OS (HR = 0.91, 95% CI: 0.801.04, p = 0.167) and DFS (HR = 0.96, 95% CI: 0.621.50, p = 0.872) in gastric cancer. Our meta-analysis also illustrated that delay in surgery for more than 4 weeks (HR = 0.85, 95% CI: 0.561.27, p = 0.421), 6 weeks (HR = 0.88, 95% CI: 0.611.27, p = 0.490), and 8 weeks (HR = 0.93, 95% CI: 0.80~1.07, p = 0.314) was also not associated with a decreased OS.
CONCLUSION
A delay in surgery of less than 8 weeks is not associated with worse overall survival for patients with gastric cancer.
目的
评估在2019年冠状病毒病（COVID-19）大流行期间，胃癌患者胃切除术延迟对其生存结局的影响。
方法
检索包括PubMed、MEDLINE（使用Ovid平台）、Embase、Cochrane图书馆、COVID-19开放研究数据集挑战赛、COVID-19研究数据库（世界卫生组织）、ClinicalTrials.gov和世界卫生组织国际临床试验注册平台在内的数据库，查找从研究开始至2021年7月31日期间，任何设计和任何环境下纳入胃癌患者的研究。计算每项研究中研究终点的风险比（HR）和95%置信区间（CI）。使用Stata 12.0进行统计分析。
结果
共有8项涉及4052例胃癌患者的研究符合纳入标准并被纳入本荟萃分析。荟萃分析结果显示，胃癌手术延迟少于8周可能不会降低总生存期（OS，HR = 0.91，95% CI：0.801.04，p = 0.167）和无病生存期（DFS，HR = 0.96，95% CI：0.621.50，p = 0.872）。我们的荟萃分析还表明，手术延迟超过4周（HR = 0.85，95% CI：0.561.27，p = 0.421）、6周（HR = 0.88，95% CI：0.611.27，p = 0.490）和8周（HR = 0.93，95% CI：0.80~1.07，p = 0.314）也与总生存期降低无关。
结论
手术延迟少于8周与胃癌患者较差的总生存期无关。
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