Perioperative chemotherapy improves survival of patients with locally advanced diffuse gastric cancer.

IF 1.8 4区 医学 Q3 GASTROENTEROLOGY & HEPATOLOGY
Ze-Feng Li, Zheng Li, Xiao-Jie Zhang, Chong-Yuan Sun, He Fei, Chun-Xia Du, Chun-Guang Guo, Dong-Bing Zhao
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Abstract

Background: Whether patients with diffuse gastric cancer, which is insensitive to chemotherapy, can benefit from neoadjuvant or adjuvant chemotherapy has long been controversial.

Aim: To investigate whether perioperative chemotherapy can improve survival of patients with locally advanced diffuse gastric cancer.

Methods: A total of 2684 patients with locally advanced diffuse gastric cancer from 18 population-based cancer registries in the United States were analyzed.

Results: Compared with surgery alone, perioperative chemotherapy improved the prognosis of patients with locally advanced gastric cancer. Before stabilized inverse probability of treatment weighting (IPTW), the median overall survival (OS) times were 40.0 months and 13.0 months (P < 0.001), respectively. After IPTW, the median OS times were 33.0 months and 17.0 months (P < 0.001), respectively. Neoadjuvant chemotherapy did not improve the prognosis of patients with locally advanced gastric cancer compared with adjuvant chemotherapy after IPTW. After IPTW, the median OS times were 38.0 months in the neoadjuvant chemotherapy group and 42.0 months in the adjuvant chemotherapy group (P = 0.472).

Conclusion: Patients with diffuse gastric cancer can benefit from perioperative chemotherapy. There was no significant difference in survival between patients who received neoadjuvant chemotherapy and those who received adjuvant chemotherapy.

围手术期化疗可提高局部晚期弥漫性胃癌患者的生存率。
背景:对化疗不敏感的弥漫性胃癌患者能否从新辅助化疗或辅助化疗中获益一直存在争议:目的:研究围手术期化疗能否提高局部晚期弥漫性胃癌患者的生存率:结果:与单纯手术相比,围手术期化疗可提高患者的生存率:与单纯手术相比,围手术期化疗可改善局部晚期胃癌患者的预后。在稳定的逆概率治疗加权(IPTW)之前,中位总生存(OS)时间分别为 40.0 个月和 13.0 个月(P < 0.001)。IPTW后,中位OS时间分别为33.0个月和17.0个月(P < 0.001)。与IPTW后的辅助化疗相比,新辅助化疗并不能改善局部晚期胃癌患者的预后。IPTW后,新辅助化疗组的中位OS时间为38.0个月,辅助化疗组为42.0个月(P=0.472):结论:弥漫性胃癌患者可以从围手术期化疗中获益。结论:弥漫性胃癌患者可从围术期化疗中获益,接受新辅助化疗的患者与接受辅助化疗的患者在生存期上无明显差异。
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