胃肝样腺癌患者根治术后辅助化疗的长期预后获益：一项全国多中心研究。

Long-term prognostic benefit of adjuvant chemotherapy for patients with hepatoid adenocarcinoma of the stomach after radical resection: A national multicenter study.

机构信息

Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China.

Department of Gastrointestinal Oncology Surgery, Xiamen Cancer Center, The First Affiliated Hospital of Xiamen University, Xiamen, China.

出版信息

Eur J Surg Oncol. 2023 Nov;49(11):106975. doi: 10.1016/j.ejso.2023.07.001. Epub 2023 Jul 15.

DOI:10.1016/j.ejso.2023.07.001

PMID:37474342

Abstract

BACKGROUND

There is no consensus on whether adjuvant chemotherapy (AC) is effective for hepatoid adenocarcinoma of the stomach (HAS). The aim of this study was to investigate the relationship between AC and the long-term prognosis of patients with HAS.

METHODS

The clinicopathological data of 239 patients with primary HAS who underwent radical surgery from April 1, 2004 to December 31, 2019 in 14 centers in China were retrospectively analyzed. Patients were divided into the AC group (127 patients) and the nonadjuvant chemotherapy (NAC) group (112 patients).

RESULTS

Kaplan‒Meier (KM) analysis showed that there were no significant differences in the 1-year3-year overall survival rate (OS) and 1-year, 3-year recurrence-free survival rate (RFS) between the AC group and the NAC group (1-year OS: 85.6% vs. 79.8%, 3-year OS: 59.8% vs. 62.4%, 1-year RFS: 69.8% vs. 74.4%, 3-year RFS: 57.2% vs. 55.9%, all P > 0.05). The subpopulation treatment effect pattern plots (STEPP) did not show treatment heterogeneity of AC in patients with HAS. The proportions of local recurrence and metastasis sites in the two groups were similar. Although the smoothed hazard curves of the NAC and AC groups crossed, the peak hazard time was later in the AC group (5.9 and 4.7 months), and the peak hazard rate was lower (0.032 and 0.038, P = 0.987).

CONCLUSION

The current AC regimen may not significantly improve the survival of patients with HAS after radical surgery.

摘要

背景

辅助化疗（adjuvant chemotherapy，AC）是否对胃肝样腺癌（hepatoid adenocarcinoma of the stomach，HAS）有效尚无共识。本研究旨在探讨 AC 与 HAS 患者长期预后的关系。

方法

回顾性分析 2004 年 4 月 1 日至 2019 年 12 月 31 日在中国 14 个中心接受根治性手术的 239 例原发性 HAS 患者的临床病理资料。患者分为 AC 组（127 例）和非辅助化疗（nonadjuvant chemotherapy，NAC）组（112 例）。

结果

Kaplan-Meier（KM）分析显示，AC 组和 NAC 组患者的 1 年、3 年总生存率（overall survival rate，OS）和 1 年、3 年无复发生存率（recurrence-free survival rate，RFS）差异均无统计学意义（1 年 OS：85.6% vs. 79.8%，3 年 OS：59.8% vs. 62.4%，1 年 RFS：69.8% vs. 74.4%，3 年 RFS：57.2% vs. 55.9%，均 P>0.05）。亚组治疗效果模式图（subpopulation treatment effect pattern plots，STEPP）未显示 HAS 患者 AC 的治疗异质性。两组患者局部复发和转移部位的比例相似。尽管 NAC 组和 AC 组的平滑危险曲线交叉，但 AC 组的高峰危险时间较晚（5.9 和 4.7 个月），高峰危险率较低（0.032 和 0.038，P=0.987）。