针对伴有肺转移的胃癌患者进行的肿瘤定向手术的影响：一项预后分析。
Impact of cancer-directed surgery for gastric cancer patients with lung metastasis: a prognosis analysis.
作者信息
Tan Zhongyu, Du Xiyao, Zeng Mo, Huang Yingli, Cai Yunlong, Huang Shanshan
机构信息
Department of Oncology, The First Affiliated Hospital of Nanchang University, Nanchang, China.
The First Clinical Medical College, Nanchang University, Nanchang, China.
出版信息
J Gastrointest Oncol. 2025 Jun 30;16(3):890-898. doi: 10.21037/jgo-2024-976. Epub 2025 Jun 27.
BACKGROUND
Gastric cancer (GC) is acknowledged as a fatal malignant disease. The impact of cancer-directed surgery (CDS) on the prognosis of patients with lung metastatic gastric cancer (LMGC) was investigated in this study.
METHODS
The clinical data of LMGC patients after CDS were obtained from the Surveillance, Epidemiology, and End Results (SEER) database [2000-2020]. This study used the R software to perform propensity score matching (PSM). Then, the influence of different variables on overall survival (OS) was measured by Cox regression analysis and Kaplan-Meier curve analysis.
RESULTS
A total of 1,045 LMGC patients were included in the present study. Among these patients, 970 (92.82%) patients were assigned to the non-CDS group and 75 (7.18%) were assigned to the CDS group. After PSM, 165 (72.37%) patients in the non-CDS group and 63 (27.63%) patients in the CDS group were identified. The Kaplan-Meier analysis results revealed that the median OS was significantly longer in the CDS group (12 6 months, P=0.03). Furthermore, the multivariate Cox regression analysis after PSM indicated that chemotherapy [hazard ratio (HR) = 0.35, 95% confidence interval (CI): 0.30-0.40, P<0.001] and CDS (HR =0.50, 95% CI: 0.38-0.67, P<0.001) were associated to favorable OS for LMGC patients.
CONCLUSIONS
CDS may improve the prognosis of patients with LMGC.
背景
胃癌（GC）是一种公认的致命恶性疾病。本研究探讨了癌症导向手术（CDS）对肺转移胃癌（LMGC）患者预后的影响。
方法
从监测、流行病学和最终结果（SEER）数据库[2000 - 2020]中获取CDS后LMGC患者的临床数据。本研究使用R软件进行倾向评分匹配（PSM）。然后，通过Cox回归分析和Kaplan - Meier曲线分析测量不同变量对总生存期（OS）的影响。
结果
本研究共纳入1045例LMGC患者。其中，970例（92.82%）患者被分配到非CDS组，75例（7.18%）患者被分配到CDS组。PSM后，非CDS组有165例（72.37%）患者，CDS组有63例（27.63%）患者。Kaplan - Meier分析结果显示，CDS组的中位OS显著更长（12.6个月，P = 0.03）。此外，PSM后的多因素Cox回归分析表明，化疗[风险比（HR）= 0.35，95%置信区间（CI）：0.30 - 0.40，P < 0.001]和CDS（HR = 0.50，95% CI：0.38 - 0.67，P < 0.001）与LMGC患者的良好OS相关。
结论
CDS可能改善LMGC患者的预后。
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