T2-3期食管胃交界腺癌和胃上部三分之一腺癌患者近端胃切除术与全胃切除术的长期生存结局：一项倾向评分匹配分析
Long-term survival outcomes of proximal gastrectomy versus total gastrectomy in patients with T2-3 esophagogastric junction adenocarcinoma and upper third gastric adenocarcinoma: a propensity score-matching analysis.
作者信息
Liao Yi, Chen Hao, Xiang Jun, Huang Jintuan, Chen Chunyu, Yang Zuli
机构信息
Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China.
Guangdong Provincial Key Laboratory of Colorectal and Pelvic Floor Disease, The Sixth Affiliated Hospital, Sun Yat-sen University, Guangzhou, Guangdong, P. R. China.
出版信息
Gastroenterol Rep (Oxf). 2025 Aug 4;13:goaf071. doi: 10.1093/gastro/goaf071. eCollection 2025.
BACKGROUND
We aimed to investigate long-term survival outcome in patients with locally advanced esophagogastric junction adenocarcinoma and upper third gastric adenocarcinoma (EGJ-UG adenocarcinoma) who underwent proximal gastrectomy (PG) or total gastrectomy (TG).
METHODS
We searched and analyzed the data from the Surveillance, Epidemiology, and End Results (SEER) database. Patients with T2-3 EGJ-UG adenocarcinoma receiving TG or PG were included. We performed a propensity score 1:2 matching, and matched datasets were generated and compared.We obtained the patients' long-term survival benefits according to stratification of surgical approaches.
RESULTS
Of 1,291 patients identified from the SEER database, 901 (69.8%) patients received PG and 390 (30.2%) patients received TG. After matching, 584 patients in the PG group were matched by propensity score to 344 patients in the TG group. There were no differences in overall survival and cancer-specific survival in matched data between different surgical approaches. For patients with tumor size ≤4 cm, similar long-term survival was observed in patients receiving PG and TG. For patients with tumor size >4 cm, TG was associated with improved overall survival and cancer-specific survival compared with PG.
CONCLUSION
This study has shown similar survival outcomes between PG and TG for patients with T2-3 EGJ-UG adenocarcinoma and with tumor size <4 cm.
背景
我们旨在调查接受近端胃切除术（PG）或全胃切除术（TG）的局部晚期食管胃交界腺癌和胃上三分之一腺癌（EGJ-UG腺癌）患者的长期生存结果。
方法
我们检索并分析了监测、流行病学和最终结果（SEER）数据库中的数据。纳入接受TG或PG的T2-3期EGJ-UG腺癌患者。我们进行了倾向评分1:2匹配，生成并比较了匹配数据集。我们根据手术方式分层获得了患者的长期生存获益。
结果
在从SEER数据库中识别出的1291例患者中，901例（69.8%）接受了PG，390例（30.2%）接受了TG。匹配后，PG组的584例患者通过倾向评分与TG组的344例患者匹配。不同手术方式的匹配数据在总生存和癌症特异性生存方面没有差异。对于肿瘤大小≤4 cm的患者，接受PG和TG的患者观察到相似的长期生存。对于肿瘤大小>4 cm的患者，与PG相比，TG与改善的总生存和癌症特异性生存相关。
结论
本研究表明，对于T2-3期EGJ-UG腺癌且肿瘤大小<4 cm的患者，PG和TG的生存结果相似。
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