Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Retzius Street 13A, 4th, Floor, 171 77, Stockholm, Sweden.
School of Cancer and Pharmacological Sciences, King's College London, London, UK.
Gastric Cancer. 2024 Nov;27(6):1180-1188. doi: 10.1007/s10120-024-01545-y. Epub 2024 Sep 4.
It is unknown if gastric adenocarcinoma survivors have longer, shorter, or similar survival compared to the background population. This knowledge could contribute to evidence-based monitoring strategies, healthcare recommendations, and information for patients and families.
This population-based cohort study included all patients who underwent gastrectomy for gastric adenocarcinoma between 2006-2015 in Sweden and survived ≥ 5 years after surgery. They were followed up until death, postoperative year 10, or end of study period (31 December, 2020). Division of the observed by the expected survival yielded relative survival rates with 95% confidence intervals (CIs) using the life table method. The expected survival was derived from the entire Swedish population of the corresponding age, sex, and calendar year. Data came from medical records and nationwide registers.
The survival among all 767 gastric adenocarcinoma survivors was shorter than the expected. The reduction in relative survival increased for each follow-up year, from 97.3% (95% CI 95.4-99.1%) year 6 to 86.6% (95% CI 82.3-90.9%) year 10. The decline in relative survival was more pronounced among patients who had gastrectomy in earlier calendar years (82.9% [95% CI 77.4-88.4%] year 10 for years 2011-2015), shorter education (85.2% [95% CI 77.4-93.0%] year 10 for education ≤ 9 years), more comorbidities (78.0% [95% CI 63.9-92.0%] year 10 for Charlson comorbidity score ≥ 2), and no neoadjuvant therapy (83.2% [95% CI 77.4-89.0%] year 10).
Gastric adenocarcinoma survivors seem to have poorer survival than the corresponding background population, particularly in certain subgroups.
目前尚不清楚胃腺癌幸存者的生存时间是否长于、短于或与普通人群相似。这一知识可能有助于制定基于证据的监测策略、医疗保健建议，并为患者及其家属提供信息。
本项基于人群的队列研究纳入了 2006 年至 2015 年间在瑞典接受胃腺癌胃切除术且术后生存时间≥5 年的所有患者。他们的随访时间截至死亡、术后第 10 年或研究期末（2020 年 12 月 31 日）。采用寿命表法，通过观察生存率与预期生存率之比得出相对生存率，并计算其 95%置信区间（CI）。预期生存率由相应年龄、性别和年份的瑞典全体人群得出。数据来自医疗记录和全国性登记处。
所有 767 例胃腺癌幸存者的生存时间均短于预期。随着随访时间的延长，相对生存率逐渐下降，从第 6 年的 97.3%（95%CI 95.4-99.1%）降至第 10 年的 86.6%（95%CI 82.3-90.9%）。在更早年份接受手术（2011-2015 年为第 10 年的 82.9%[95%CI 77.4-88.4%]）、受教育程度较低（≤9 年为第 10 年的 85.2%[95%CI 77.4-93.0%]）、合并症更多（Charlson 合并症评分≥2 为第 10 年的 78.0%[95%CI 63.9-92.0%]）和未接受新辅助治疗（83.2%[95%CI 77.4-89.0%]）的患者，相对生存率下降更为显著。
胃腺癌幸存者的生存似乎不如普通人群，尤其是在某些亚组人群中。
