一种新的评分系统，用于评估 D2 胃切除术后 T2N0M0 期胃癌患者的辅助化疗。
A new scoring system to evaluate adjuvant chemotherapy for patients with T2N0M0 gastric cancer after D2 gastrectomy.
机构信息
Department of Pancreatic and Gastric Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
出版信息
World J Gastroenterol. 2022 Oct 14;28(38):5626-5635. doi: 10.3748/wjg.v28.i38.5626.
BACKGROUND
At present, there is insufficient medical evidence to determine whether adjuvant chemotherapy is necessary for T2N0M0 gastric cancer.
AIM
To obtain a risk score to assess the need for adjuvant chemotherapy in patients with T2N0M0 gastric cancer.
METHODS
We identified 325 patients with pathological T2N0M0 stage primary gastric cancer at the National Cancer Center between 2011 and 2018. Univariate and multivariate Cox regression analyses were performed to predict factors affecting prognosis. Vascular invasion, tumor site, and body mass index were assessed, and a scoring system was established. We compared the survival outcomes and benefits of adjuvant chemotherapy between the different subgroups.
RESULTS
Five-year survival rates of the score 0, 1, 2, and 3 groups were 92%, 95%, 80%, and 50%, respectively ( < 0.001). In the score 2-3 group, five-year survival rates for patients in the adjuvant chemotherapy group and postoperative observation group were 95% and 61%, respectively ( = 0.021).
CONCLUSION
For patients with T2N0M0 stage gastric cancer and two or more risk factors, adjuvant chemotherapy after D2 gastrectomy may have a survival benefit.
背景
目前，尚无足够的医学证据来确定 T2N0M0 期胃癌是否需要辅助化疗。
目的
建立一个风险评分系统来评估 T2N0M0 期胃癌患者接受辅助化疗的必要性。
方法
我们纳入了 2011 年至 2018 年期间在国家癌症中心接受治疗的 325 例病理 T2N0M0 期原发性胃癌患者。采用单因素和多因素 Cox 回归分析预测影响预后的因素。评估血管侵犯、肿瘤部位和体重指数，并建立评分系统。我们比较了不同亚组之间的生存结局和辅助化疗的获益。
结果
评分 0、1、2 和 3 组的 5 年生存率分别为 92%、95%、80%和 50%（<0.001）。在评分 2-3 组中，辅助化疗组和术后观察组的 5 年生存率分别为 95%和 61%（=0.021）。
结论
对于 T2N0M0 期胃癌且存在两个或以上危险因素的患者，D2 胃切除术后辅助化疗可能具有生存获益。
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