Department of Preventive Medicine, Yonsei University College of Medicine, 50-1 Yonsei-ro, Seoul, Seodaemun-gu, 03722, Republic of Korea.
Department of Internal Medicine, Yonsei University College of Medicine, Seoul, Republic of Korea.
Gastric Cancer. 2024 Nov;27(6):1159-1168. doi: 10.1007/s10120-024-01541-2. Epub 2024 Aug 12.
The impact of economic engagement on the health of cancer survivors is notable. Our study aims to explore the association between early loss of economic activity (EA) and the risk of all-cause mortality among gastric cancer survivors.
This retrospective cohort study utilized data from Korea's National Health Insurance Service, focusing on 30-59-year-old gastric cancer patients who received either surgery or endoscopic procedures from January 2009 to December 2013. The primary outcome measure was all-cause mortality. Early loss of EA was identified when a patient's insurance status shifted to dependent within one year following treatment. Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality were estimated using multivariable Cox proportional hazards models, conducting separate analyses for surgical and endoscopic groups.
Among 24,159 patients (median follow-up, 9.9 years), 2976 (12.3%) experienced all-cause mortality. Specifically, 2835 of these deaths occurred in patients who underwent surgery, while 141 were in the endoscopic procedure group. Early loss of EA was recorded in 14.4% of the surgery group and 7.7% of the endoscopic procedure group. Adjusted HRs (95% CI) for all-cause mortality associated with early loss of EA were 1.39 (1.27-1.54) for the surgery group and 2.27 (1.46-3.52) for the endoscopic procedure group.
This study highlights a significant association between the early loss of EA and an increased risk of all-cause mortality in those who have undergone curative treatments for gastric cancer. It underscores the crucial role of sustaining EA in enhancing the health outcomes of these survivors.
经济参与对癌症幸存者的健康影响显著。我们的研究旨在探讨早期经济活动丧失（EA）与接受手术或内镜治疗的胃癌幸存者全因死亡率之间的关联。
这是一项回顾性队列研究，利用了韩国国家健康保险服务的数据，研究对象为 2009 年 1 月至 2013 年 12 月期间接受手术或内镜治疗的 30-59 岁胃癌患者。主要结局指标为全因死亡率。当患者在治疗后一年内保险状态转为依赖时，即确定为早期 EA 丧失。使用多变量 Cox 比例风险模型分别对手术和内镜组进行分析，估计全因死亡率的调整后的危险比（HR）和 95%置信区间（CI）。
在 24159 名患者（中位随访时间为 9.9 年）中，有 2976 人（12.3%）发生了全因死亡。具体来说，2835 例死亡发生在接受手术的患者中，而 141 例发生在接受内镜治疗的患者中。手术组中有 14.4%的患者和内镜组中有 7.7%的患者记录到了早期 EA 丧失。与早期 EA 丧失相关的全因死亡率的调整后 HR（95%CI）分别为手术组 1.39（1.27-1.54）和内镜组 2.27（1.46-3.52）。
本研究强调了早期 EA 丧失与接受胃癌根治性治疗患者全因死亡率增加之间存在显著关联。它强调了维持 EA 对提高这些幸存者健康结局的重要作用。
