围手术期化疗可提高局部晚期弥漫性胃癌患者的生存率。
Perioperative chemotherapy improves survival of patients with locally advanced diffuse gastric cancer.
作者信息
Li Ze-Feng, Li Zheng, Zhang Xiao-Jie, Sun Chong-Yuan, Fei He, Du Chun-Xia, Guo Chun-Guang, Zhao Dong-Bing
机构信息
Department of Pancreatic and Gastric Surgical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100021, China.
Department of Medical Oncology, 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 Gastrointest Surg. 2024 Sep 27;16(9):2878-2892. doi: 10.4240/wjgs.v16.i9.2878.
BACKGROUND
Whether patients with diffuse gastric cancer, which is insensitive to chemotherapy, can benefit from neoadjuvant or adjuvant chemotherapy has long been controversial.
AIM
To investigate whether perioperative chemotherapy can improve survival of patients with locally advanced diffuse gastric cancer.
METHODS
A total of 2684 patients with locally advanced diffuse gastric cancer from 18 population-based cancer registries in the United States were analyzed.
RESULTS
Compared with surgery alone, perioperative chemotherapy improved the prognosis of patients with locally advanced gastric cancer. Before stabilized inverse probability of treatment weighting (IPTW), the median overall survival (OS) times were 40.0 months and 13.0 months ( < 0.001), respectively. After IPTW, the median OS times were 33.0 months and 17.0 months ( < 0.001), respectively. Neoadjuvant chemotherapy did not improve the prognosis of patients with locally advanced gastric cancer compared with adjuvant chemotherapy after IPTW. After IPTW, the median OS times were 38.0 months in the neoadjuvant chemotherapy group and 42.0 months in the adjuvant chemotherapy group ( = 0.472).
CONCLUSION
Patients with diffuse gastric cancer can benefit from perioperative chemotherapy. There was no significant difference in survival between patients who received neoadjuvant chemotherapy and those who received adjuvant chemotherapy.
背景
对化疗不敏感的弥漫性胃癌患者能否从新辅助化疗或辅助化疗中获益，长期以来一直存在争议。
目的
探讨围手术期化疗能否提高局部进展期弥漫性胃癌患者的生存率。
方法
分析了来自美国18个基于人群的癌症登记处的2684例局部进展期弥漫性胃癌患者。
结果
与单纯手术相比，围手术期化疗改善了局部进展期胃癌患者的预后。在稳定的逆概率处理加权（IPTW）之前，中位总生存期（OS）分别为40.0个月和13.0个月（<0.001）。IPTW后，中位OS分别为33.0个月和17.0个月（<0.001）。与IPTW后的辅助化疗相比，新辅助化疗并未改善局部进展期胃癌患者的预后。IPTW后，新辅助化疗组的中位OS为38.0个月，辅助化疗组为42.0个月（=0.472）。
结论
弥漫性胃癌患者可从围手术期化疗中获益。接受新辅助化疗和辅助化疗的患者在生存率上无显著差异。
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