Zhao Qian-Wen, Quan Zheng, Liu Shan-Shan, Wang Yu-Dan, Guo Hao-Nan
Department of Clinical Laboratory, The Affiliated Hospital of Guilin Medical University, Guilin, China.
Department of Oncology Surgery, Xi'an No. 3 Hospital, The Affiliated Hospital of Northwest University, Xi'an, China.
Transl Gastroenterol Hepatol. 2024 Sep 25;9:61. doi: 10.21037/tgh-24-11. eCollection 2024.
While single organ metastases generally present a more optimistic prognosis compared to multiple metastases, the influence of the specific organ site for single organ metastases on prognosis remains undetermined. This retrospective study aimed to investigate the prognostic differences in late-stage gastric cancer with single organ metastasis.
Data for patients diagnosed with gastric cancer were retrieved from the Surveillance, Epidemiology, and End Results (SEER) database for survival analysis, covering years spanning from 2010 to 2016. Furthermore, Kaplan-Meier survival curves and Cox regression were utilized to analyze overall survival (OS) and disease-specific survival (DSS). Additionally, given the impact of confounders and bias on the results, prognosis was further analyzed using propensity score matching (PSM) and floating absolute risk methods.
A cohort comprising 4,297 patients diagnosed with gastric cancer and exhibiting single organ metastasis was hereby enrolled. Liver metastasis was the most common (71% of the total), while brain metastasis accounted for the least (1.7% of the total). Compared to other metastases, patients with bone metastasis presented the worst OS [hazard ratio (HR), 1.319; 95% confidence interval (CI): 1.207-1.442; P<0.001], and this remained consistent even upon the application of floating absolute risk (HR, 1.10; 95% CI: 1.01-1.20) and PSM methods (HR, 1.187; 95% CI: 1.053-1.339; P=0.005). In addition, subgroup analysis and interaction tests of OS revealed an interaction between age (P=0.02), histological type (P=0.002), and bone metastasis.
In patients with single organ metastasis of gastric cancer, the prognosis varies by the metastatic site, with bone metastasis presenting the poorest outcome. Overall, this study forges a foundation for further research on the mechanisms and patterns of different metastatic sites in gastric cancer and informs treatment strategies.
虽然与多发转移相比，单器官转移通常预后更为乐观，但单器官转移的特定器官部位对预后的影响仍不明确。本回顾性研究旨在探讨晚期胃癌单器官转移的预后差异。
从监测、流行病学和最终结果（SEER）数据库中检索出胃癌患者的数据进行生存分析，涵盖2010年至2016年。此外，采用Kaplan-Meier生存曲线和Cox回归分析总生存期（OS）和疾病特异性生存期（DSS）。此外考虑到混杂因素和偏倚对结果产生的影响，使用倾向评分匹配（PSM）和浮动绝对风险方法进一步分析预后。
本研究纳入了4297例诊断为胃癌且有单器官转移的患者队列。肝转移最为常见（占总数的71%），而脑转移最少（占总数的1.7%）。与其他转移相比，骨转移患者的OS最差[风险比（HR），1.319；95%置信区间（CI）：1.207-1.442；P<0.001]，即使应用浮动绝对风险（HR，1.10；95%CI：1.01-1.20）和PSM方法（HR，1.187；95%CI：1.053-1.339；P=0.005），情况依然如此。此外，OS的亚组分析和交互检验显示年龄（P=0.02）、组织学类型（P=0.002）和骨转移之间存在交互作用。
在胃癌单器官转移患者中，预后因转移部位而异，骨转移的预后最差。总体而言，本研究为进一步研究胃癌不同转移部位的机制和模式奠定了基础，并为治疗策略提供了参考依据。
