Tiengo Tatiane, Fernandes Gisele Aparecida, Curado Maria Paula
Post Graduation Program A.C. Camargo Cancer Center, São Paulo, Brazil.
Nucleus of Epidemiology and Statistics in Cancer, A. C. Camargo Cancer Center, São Paulo, Brazil.
Front Oncol. 2022 Sep 8;12:918833. doi: 10.3389/fonc.2022.918833. eCollection 2022.
To analyze factors affecting 1-year overall survival and burden of gastric adenocarcinoma in a single-institution cohort.
A prospective cohort study of gastric adenocarcinoma patients from a cancer center in São Paulo, Brazil, was conducted between February 2016 and July 2019. Overall survival was analyzed at 12 months post-diagnosis using the Kaplan-Meier method. A log-rank test was applied to compare curves. Sociodemographic and clinicopathological features were assessed to detect prognostic factors using univariate and multivariable Cox regression analyses to calculate hazard ratio (HR) and its confidence intervals (CIs). Disability-adjusted life years (DALY) constituted the sum of years of life lost (YLL) plus years lived with disability (YLD). YLL represented the sum of years lost before the age of 76.6 years. YLD was calculated as the number of cases multiplied by the duration and burden of the disease. YLL per death was calculated as the mean YLL for each individual.
Overall survival at 1-year follow-up was 80.8%. The multivariable model adjusted for age and sex identified cerebrovascular disease (HR 8.5, 95% CI 3.3-21.8), stage III/IV (HR 5.7, 95% CI 2.3-13.7), diabetes (HR 3.2, 95% CI 1.5-6.6), and<9 years of education (HR 2.9, 95% CI 1.5-5.8) as prognostic factors. Out of the 214 treated cases, there was 700.72 DALY during the first year, of which 90.55% corresponded to YLL and 9.45% to YLD. The average YLL per death was 15.48 and was higher among women (19.24 YLL per death).
At a single cancer center, 1-year overall survival probability was approximately 80% in patients with gastric adenocarcinoma. Patients with a higher risk of death had cerebrovascular disease, advanced clinical staging, diabetes, and/or lower educational level. Approximately 700 years of DALY was documented, with women having the highest YLL per death. Because this study was conducted at a single cancer center, the results might not be representative of a general population. To the best of our knowledge, this study was the first to assess gastric adenocarcinoma DALY, YLL, and YLL per death in the first year of follow-up in a hospital cohort in Brazil.
分析单机构队列中影响胃腺癌患者1年总生存率及负担的因素。
对2016年2月至2019年7月间来自巴西圣保罗一家癌症中心的胃腺癌患者进行前瞻性队列研究。采用Kaplan-Meier法在诊断后12个月分析总生存率。应用对数秩检验比较曲线。通过单因素和多因素Cox回归分析评估社会人口统计学和临床病理特征以检测预后因素，计算风险比（HR）及其置信区间（CI）。伤残调整生命年（DALY）由生命损失年数（YLL）加上带病生存年数（YLD）构成。YLL代表76.6岁之前损失的年数总和。YLD通过病例数乘以疾病持续时间和负担来计算。每例死亡的YLL按个体的平均YLL计算。
1年随访时的总生存率为80.8%。经年龄和性别调整的多变量模型确定脑血管疾病（HR 8.5，95%CI 3.3 - 21.8）、III/IV期（HR 5.7，95%CI 2.3 - 13.7）、糖尿病（HR 3.2，95%CI 1.5 - 6.6）以及教育年限<9年（HR 2.9，95%CI 1.5 - 5.8）为预后因素。在214例接受治疗的病例中，第一年有700.72个DALY，其中90.55%对应YLL，9.45%对应YLD。每例死亡的平均YLL为15.48，女性的该值更高（每例死亡19.24个YLL）。
在一家单一癌症中心，胃腺癌患者1年总生存概率约为80%。死亡风险较高的患者患有脑血管疾病、临床分期较晚、糖尿病和/或教育水平较低。记录了约700个DALY，女性每例死亡的YLL最高。由于本研究是在一家单一癌症中心进行的，结果可能不代表一般人群。据我们所知，本研究是巴西一家医院队列中首次在随访第一年评估胃腺癌的DALY、YLL及每例死亡的YLL。
