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IB期胃癌是否需要辅助治疗:一项回顾性队列研究

Is Adjuvant Therapy Necessary for Stage IB Gastric Cancer: A Retrospective Cohort Study.

作者信息

Gu Mingyu, Zhao Binghe, Sui Changda, Wen Minghai, Wang Xinxin

机构信息

Department of General Surgery, The First Medical Center of Chinese, PLA General Hospital, Beijing, China.

出版信息

Ann Surg Oncol. 2025 Feb;32(2):1210-1217. doi: 10.1245/s10434-024-16444-w. Epub 2024 Nov 7.

Abstract

BACKGROUND

The benefit of adjuvant therapy for patients with IB gastric cancer (GC) is a topic of debate. This study aimed to evaluate the benefit of adjuvant therapy for patients with IB GC.

METHODS

Overall, the study selected 510 IB GC patients after gastrectomy at the First Medical Center of the Chinese PLA General Hospital, Beijing, China between 2005 and 2018. Overall survival (OS) and disease-free survival (DFS) were analyzed using the Kaplan-Meier method and the log-rank test. Cox regression analyses were used to confirm the independent prognostic factors.

RESULTS

Patients who received postoperative adjuvant therapy had a longer 5-year OS (92.9 %) than those who received surgery alone (86.7 %; P < 0.05), but the 5-year DFS did not differ significantly between the two groups (92.6 vs. 95.0 %; P > 0.05). Moreover, DFS did not differ between monotherapy, and combination therapy. Uni- and multivariate analyses showed that older age was a significant risk factor for tumor recurrence. Subgroup analyses also failed to identify suitable candidates for chemotherapy.

CONCLUSIONS

Because adjuvant therapy did not demonstrate any benefits in terms of tumor recurrence or DFS, these treatment strategies may be unnecessary for IB GC patients after gastrectomy. Further studies are required to identify subgroups of IB GC patients who may benefit from adjuvant treatments.

摘要

背景

IB 期胃癌(GC)患者辅助治疗的获益是一个存在争议的话题。本研究旨在评估 IB 期 GC 患者辅助治疗的获益情况。

方法

总体而言,本研究选取了 2005 年至 2018 年期间在中国北京解放军总医院第一医学中心接受胃切除术后的 510 例 IB 期 GC 患者。采用 Kaplan-Meier 法和对数秩检验分析总生存期(OS)和无病生存期(DFS)。使用 Cox 回归分析来确定独立的预后因素。

结果

接受术后辅助治疗的患者 5 年总生存率(92.9%)高于单纯接受手术的患者(86.7%;P<0.05),但两组间 5 年无病生存率无显著差异(92.6%对 95.0%;P>0.05)。此外,单药治疗和联合治疗的无病生存率无差异。单因素和多因素分析表明,年龄较大是肿瘤复发的显著危险因素。亚组分析也未能确定适合化疗的患者。

结论

由于辅助治疗在肿瘤复发或无病生存期方面未显示出任何益处,对于胃切除术后的 IB 期 GC 患者,这些治疗策略可能不必要。需要进一步研究以确定可能从辅助治疗中获益的 IB 期 GC 患者亚组。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/041e/11698797/d15cc924486b/10434_2024_16444_Fig1_HTML.jpg

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