Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.
Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden.
Gastric Cancer. 2022 Nov;25(6):989-1001. doi: 10.1007/s10120-022-01326-5. Epub 2022 Aug 7.
Gastric cancer is the fourth leading cause of cancer-related deaths globally. There is a paucity of national studies examining gastric cancer mortality in relation to treatment status. This study evaluated the survival trends in gastric adenocarcinoma and all gastric cancers stratified by treatment in Finland during 1987-2016.
This population-based, nationwide, retrospective cohort study included all gastric cancer patients registered in the Finnish Cancer Registry and Patient Registry. The survival rates were calculated for 1, 3, and 5 years, stratified by treatment. Prognostic factors were determined using Cox regression.
A total of 18,713 non-cardia gastric adenocarcinoma, and 3617 cardia adenocarcinoma patients were included. Surgical treatment decreased for non-cardia adenocarcinoma and remained constant for cardia adenocarcinoma. In non-cardia adenocarcinoma, the 5-year survival declined from 17% to 16% from 1987-1991 to 2012-2016. In surgically treated patients, survival increased from 29% to 38%, while an increase from 4% to 7% in those undergoing chemotherapy and decrease from 6% to 3% in those not receiving any treatment were observed. In cardia adenocarcinoma, the 5-year survival increased from 10% to 18% in all patients, 16% to 40% in surgical patients, 0% to 5% in patients receiving chemotherapy, and from 5% to 9% in patients receiving no treatment. Earlier calendar periods, older age, male sex, and higher comorbidity were risk factors for poor prognosis.
Gastric non-cardia adenocarcinoma survival declined, limited to advanced stage patients not receiving any treatment. Gastric cardia cancer survival seems to have improved over time in Finland. This study evaluated survival trends of gastric cancer in Finland during 1987-2016 and established that the 5-year survival is declining in non-cardia adenocarcinoma but improving in all gastric cancers.
胃癌是全球导致癌症死亡的第四大主要原因。目前，针对治疗状况与胃癌死亡率的关系，仅有少数国家研究对此进行了探讨。本研究评估了 1987-2016 年期间芬兰胃腺癌和所有胃癌患者的生存趋势，按治疗方法进行了分层。
本研究为基于人群的全国性回顾性队列研究，纳入了所有在芬兰癌症登记处和患者登记处登记的胃癌患者。按治疗方法对 1、3 和 5 年的生存率进行分层计算。使用 Cox 回归确定预后因素。
共纳入 18713 例非贲门胃腺癌和 3617 例贲门腺癌患者。非贲门腺癌的手术治疗减少，贲门腺癌则保持不变。非贲门腺癌患者的 5 年生存率从 1987-1991 年至 2012-2016 年从 17%降至 16%。在接受手术治疗的患者中，生存率从 29%上升至 38%，而接受化疗的患者从 4%上升至 7%，未接受任何治疗的患者则从 6%下降至 3%。在贲门腺癌患者中，所有患者的 5 年生存率从 10%上升至 18%，手术患者从 16%上升至 40%，接受化疗的患者从 0%上升至 5%，未接受任何治疗的患者从 5%上升至 9%。较早的时间阶段、年龄较大、男性和较高的合并症是预后不良的危险因素。
胃非贲门腺癌的生存率下降，仅限于未接受任何治疗的晚期患者。在芬兰，贲门癌的生存率似乎随着时间的推移而提高。本研究评估了 1987-2016 年期间芬兰胃癌的生存趋势，结果表明非贲门腺癌的 5 年生存率下降，但所有胃癌的生存率提高。
