在胃癌根治术后的幸存者中，骨转移是一种晚发且不利的疾病：临床观察队列的结果

Cancer pathogenesis and therapy Pub Date : 2024-01-01 DOI:10.1016/j.cpt.2023.11.003

Cheng Zhang , Xiaopeng Zhang , Chong Feng , Yahui Yang , Minmin Xie , Ying Feng , Zhijun Wu , Hui Xu , Changhao Wu , Tai Ma

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引用次数: 0

摘要

背景胃癌（GC）根治性胃切除术后复发骨转移（BM）的时间和发生率以及这些患者的生存率尚不完全清楚。本研究的目的是分析观察性胃癌队列的数据，找出接受根治性胃切除术后出现复发性骨转移的患者，以描述和阐明术后骨转移演变的模式和概况。记录特定器官转移事件的时间点，并计算转移事件的人年发生率。采用方差分析法测量了胃切除术后BM事件的潜伏期，并与其他两种最常见的转移事件（肝转移（LM）和远处淋巴结转移（LNM））的潜伏期进行了比较。结果 2011年1月至2021年12月期间，共有1324例GC病例接受了根治性胃切除术。其中，67 例 BM、218 例 LM 和 248 例 LNM 发生在最后一次随访之前。BM事件的发生率为1.7/100人年，比LM和远处LNM事件的发生率（分别为5.5/100人年和6.3/100人年）低约3倍。BM事件的潜伏期（中位时间，16.5个月）明显长于LM和LNM事件（分别为11.1个月和12.0个月）。与 LM 和 LNM（中位生存期分别为 7.7 个月和 7.1 个月）相比，复发 BM 的预后更差（中位生存期为 4.5 个月）。结论与其他常见转移事件相比，胃切除术后GC的BM是一种晚发事件，预示着生存率较低。试验登记号：ChiCTR1800019978；http://www.chictr.org.cn/。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

Bone metastasis is a late-onset and unfavorable event in survivors of gastric cancer after radical gastrectomy: Results from a clinical observational cohort

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Bone metastasis is a late-onset and unfavorable event in survivors of gastric cancer after radical gastrectomy: Results from a clinical observational cohort

Background

The timing and incidence of recurrent bone metastasis (BM) after radical gastrectomy in patients with gastric cancer (GC) as well as the survival of these patients were not fully understood. The aim of this study was to analyze the data of an observational GC cohort and identify patients who underwent curative gastrectomy and had recurrent BM to describe and clarify the pattern and profile of BM evolution after surgery.

Methods

Data were retrieved from a hospital-based GC cohort, and patients who underwent upfront radical gastrectomy were selected. The time points of specific organ metastatic events were recorded, and the person-year incidence rate of metastatic events was calculated. The latency period of BM events after gastrectomy was measured and compared with that of the other two most common metastatic events, liver metastasis (LM) and distant lymph node metastasis (LNM), using analysis of variance. Propensity score matching and subgroup analysis were used for sensitivity analysis.

Results

A total of 1324 GC cases underwent radical gastrectomy between January 2011 and December 2021. Of these, 67 BM, 218 LM, and 248 LNM occurred before the last follow-up. The incidence of BM events was 1.7/100 person-years, which was approximately 3-fold lower than that of LM and distant LNM events (5.5 and 6.3 per 100 person-years, respectively). BM events had a significantly longer latency (median time, 16.5 months) than LM and LNM events (11.1 and 12.0 months, respectively). Recurrent BM led to a worse prognosis (median survival, 4.5 months) than those of LM and LNM events (median survival, 7.7 and 7.1 months, respectively). However, no difference in overall survival after gastrectomy was observed among the groups.