Adjuvant chemotherapy may have no significant survival benefit in older patients with stage II/III gastric cancer: a multicenter retrospective study.

IF 2.7 3区 医学 Q3 ONCOLOGY
Zheng-Zheng Shen, En-Ze Li, Ruo-Lan Zhang, Meng-Xuan Cao, Yan-Qiang Zhang, Qing Yang, Can Hu, Si-Wei Pan, Zhi-Yuan Xu, Zai-Sheng Ye, Jing-Yang He
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引用次数: 0

Abstract

Aim: Postoperative adjuvant chemotherapy is known to enhance cure rates and is thus recommended for stages pII to pIII. However, specific guidelines for such treatment in elderly gastric cancer (GC) patients are currently lacking. This study examines the impact of adjuvant chemotherapy on the postoperative survival of these patients.

Methods: We reviewed a total of 7749 patients with GC who underwent radical gastrectomy at Zhejiang Cancer Hospital and Fujian Cancer Hospital from January 2007 to December 2019. We conducted univariate and multivariate Cox regression analyses to investigate the impact of clinicopathological factors on overall survival (OS) and cancer-specific survival (CSS) in these patients. Additionally, we created a meta-analysis forest plot and employed propensity score matching (PSM) to mitigate confounding bias.

Results: Age and adjuvant chemotherapy were independent risk factors for OS and CSS. Stratified analysis based on chemotherapy use revealed a statistically significant difference in OS and CSS between younger patients who did and did not receive adjuvant chemotherapy. In contrast, no significant differences in OS and CSS were observed between older patients with or without adjuvant chemotherapy. These findings remained consistent after propensity score matching (PSM).

Conclusions: Age and adjuvant chemotherapy are independent risk factors for OS and CSS in patients with stage II/III GC; for patients with stage II/III gastric cancer aged ≥ 75 years, shared decision-making should be made taking into account functional status and comorbidities, rather than conventional adjuvant chemotherapy.

辅助化疗可能对老年II/III期胃癌患者没有显著的生存益处:一项多中心回顾性研究。
目的:已知术后辅助化疗可提高治愈率,因此推荐用于pII至pIII期。然而,目前缺乏针对老年胃癌(GC)患者的具体治疗指南。本研究探讨了辅助化疗对这些患者术后生存的影响。方法:回顾性分析2007年1月至2019年12月在浙江省肿瘤医院和福建省肿瘤医院行根治性胃切除术的胃癌患者7749例。我们通过单因素和多因素Cox回归分析来研究临床病理因素对这些患者总生存期(OS)和癌症特异性生存期(CSS)的影响。此外,我们创建了一个荟萃分析森林图,并采用倾向得分匹配(PSM)来减轻混淆偏差。结果:年龄和辅助化疗是OS和CSS的独立危险因素。基于化疗使用的分层分析显示,接受和未接受辅助化疗的年轻患者的OS和CSS具有统计学意义。相比之下,接受或不接受辅助化疗的老年患者的OS和CSS无显著差异。这些发现在倾向评分匹配(PSM)后保持一致。结论:年龄和辅助化疗是II/III期GC患者发生OS和CSS的独立危险因素;对于年龄≥75岁的II/III期胃癌患者,共同决策应考虑功能状态和合并症,而不是常规的辅助化疗。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
4.00
自引率
2.80%
发文量
577
审稿时长
2 months
期刊介绍: The "Journal of Cancer Research and Clinical Oncology" publishes significant and up-to-date articles within the fields of experimental and clinical oncology. The journal, which is chiefly devoted to Original papers, also includes Reviews as well as Editorials and Guest editorials on current, controversial topics. The section Letters to the editors provides a forum for a rapid exchange of comments and information concerning previously published papers and topics of current interest. Meeting reports provide current information on the latest results presented at important congresses. The following fields are covered: carcinogenesis - etiology, mechanisms; molecular biology; recent developments in tumor therapy; general diagnosis; laboratory diagnosis; diagnostic and experimental pathology; oncologic surgery; and epidemiology.
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