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老年早期胃癌患者根治性胃切除术后常规随访的影响

Impact of Routine Follow-Ups After Curative Gastrectomy in Elderly Patients with Early Gastric Cancer.

作者信息

Yoo Juno, Ko Chang Seok, Jeong Seong-A, Oh Seul-Gi, Seong Ba Ool, Yook Jeong Hwan, Yoo Moon-Won, Kim Beom Su, Lee In-Seob, Gong Chung Sik, Min Sa-Hong, Lee Jung-Bok

机构信息

Division of Gastrointestinal Surgery, Department of Surgery, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Republic of Korea.

Department of Surgery, Gangneung Asan Hospital, University of Ulsan College of Medicine, Gangneung, Republic of Korea.

出版信息

Ann Surg Oncol. 2025 Apr;32(4):2629-2636. doi: 10.1245/s10434-024-16713-8. Epub 2024 Dec 29.

Abstract

INTRODUCTION

Elderly patients with early gastric cancer exhibit a relatively shorter life expectancy and lower recurrence risk, prompting consideration of whether the regular follow-up strategy should apply to this demographic. This study was designed to determine the effect of routine postoperative follow-up on the elderly patients, specifically those pathologically diagnosed with stage I gastric cancer.

METHODS AND MATERIALS

This retrospective analysis was conducted at a single tertiary center and enrolled patients aged ≥ 75 years who underwent curative gastrectomy for stage I gastric cancer between January of 2007 and December of 2016. The patients were divided into routine and nonroutine follow-up groups, depending on whether the recommended follow-up examinations (endoscopy, CT, and blood tests) were complete. Propensity score matching was performed to compare the overall survival (OS) and disease-specific survival (DSS) between the two study groups.

RESULTS

Among 385 patients enrolled, 301 (78.2%) were routine and 84 (21.8%) were nonroutine follow-up patients. After propensity score matching, each study group consisted of 83 patients. There was no significant difference in OS (85.5% vs. 83.1%, p = 0.47) and DSS (98.6% vs. 98.3%, p = 0.57) between the two study groups. There were six (1.5%) recurrences in the entire cohort: four in the routine and two in the nonroutine follow-up group.

CONCLUSIONS

Regular follow-up of elderly patients with stage I gastric cancer did not significantly impact the OS and DSS rates.

摘要

引言

老年早期胃癌患者的预期寿命相对较短,复发风险较低,这促使人们思考常规随访策略是否适用于这一人群。本研究旨在确定术后常规随访对老年患者,特别是那些病理诊断为I期胃癌患者的影响。

方法与材料

本回顾性分析在一家三级中心进行,纳入2007年1月至2016年12月期间接受I期胃癌根治性胃切除术、年龄≥75岁的患者。根据推荐的随访检查(内镜检查、CT和血液检查)是否完成,将患者分为常规随访组和非常规随访组。采用倾向评分匹配法比较两组研究对象的总生存期(OS)和疾病特异性生存期(DSS)。

结果

在纳入的385例患者中,301例(78.2%)为常规随访患者,84例(21.8%)为非常规随访患者。倾向评分匹配后,每个研究组由83例患者组成。两组研究对象的OS(85.5%对83.1%,p = 0.47)和DSS(98.6%对98.3%,p = 0.57)无显著差异。整个队列中有6例(1.5%)复发:常规随访组4例,非常规随访组2例。

结论

对I期老年胃癌患者进行常规随访对OS和DSS率无显著影响。

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