残胃癌的治疗难题和辅助化疗的作用:对 KEGG 多中心观察研究中 313 例患者的分析。

IF 6 1区 医学 Q1 GASTROENTEROLOGY & HEPATOLOGY
Gastric Cancer Pub Date : 2024-11-01 Epub Date: 2024-08-08 DOI:10.1007/s10120-024-01544-z
Ryosuke Okamura, Ryuhei Aoyama, Shigeru Tsunoda, Yoshito Yamashita, Hiroaki Hata, Yosuke Kinjo, Akira Miki, Seiichiro Kanaya, Michihiro Yamamoto, Koichi Matsuo, Dai Manaka, Eiji Tanaka, Hironori Kawada, Masato Kondo, Atsushi Itami, Takatsugu Kan, Yoshio Kadokawa, Tetsuo Ito, Shunpei Jikihara, Keiko Kasahara, Takashi Sakamoto, Shintaro Okumura, Hisatsugu Maekawa, Tatsuto Nishigori, Shigeo Hisamori, Kazutaka Obama
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引用次数: 0

摘要

背景:由于残胃癌(RGC)非常罕见,其临床发现和术后随访数据非常有限。此外,RGC 的术前分期、根治手术和复发管理也是重大的临床挑战:我们分析了在日本 17 家医疗机构接受根治性手术的 313 例连续性 RGC 患者的临床病理结果、辅助化疗和术后复发模式。该研究探讨了 RGC 的最佳治疗方法以及辅助化疗(AC)对无复发生存率(RFS)的影响:结果:病理分期为 I、II 和 III 期的患者分别占 55.9%(175 例)、24.9%(78 例)和 19.2%(60 例)。临床和病理T分期的总体吻合率为58.3%,临床T4诊断病理T4的敏感性为41.4%。在中位 4.6 年的随访期间,24.3% 的患者出现了疾病复发。大多数复发(超过80%)发生在RGC手术后2.5年内,96.1%发生在5年内。腹膜复发在晚期RGC患者中最为常见,在II期和III期分别占14.1%和28.3%。多变量回归分析显示,AC与更长的RFS显著相关,危险比为0.45(95%置信区间:0.26-0.76):我们的研究强调了早期发现、术前准确分期和术后监测在管理晚期RGC病例中的重要性。尽管存在一些局限性,但我们的研究结果表明,胃癌根治术可为患者带来与原发性胃癌相当的生存益处。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Management challenges and the role of adjuvant chemotherapy in remnant gastric cancer: an analysis of 313 patients from the KEGG multicenter observational study.

Management challenges and the role of adjuvant chemotherapy in remnant gastric cancer: an analysis of 313 patients from the KEGG multicenter observational study.

Background: Clinical findings and postoperative follow-up data on remnant gastric cancer (RGC) are limited due to its rarity. Additionally, the preoperative staging, radical surgery, and managing recurrence in RGC present significant clinical challenges.

Methods: We analyzed the clinicopathological findings, adjuvant chemotherapy, and patterns of postoperative recurrence of 313 consecutive patients who underwent curative surgery for RGC at 17 Japanese institutions. This study investigated the optimal management of RGC and the impact of adjuvant chemotherapy (AC) on recurrence-free survival (RFS).

Results: Pathological stages I, II, and III were observed in 55.9% (N = 175), 24.9% (N = 78), and 19.2% (N = 60) of the patients, respectively. The overall concordance rate between clinical and pathological T staging was 58.3%, with a clinical T4 sensitivity of 41.4% for diagnosing pathological T4. During the median follow-up period of 4.6 years, disease recurrence occurred in 24.3% of patients. Most recurrences (over 80%) occurred within 2.5 years, and 96.1% within 5 years after RGC surgery. Peritoneal recurrence was the most common in patients with advanced RGC, accounting for 14.1% in stage II and 28.3% in stage III. Multivariable regression analysis showed that AC was significantly associated with a longer RFS, with a hazard ratio of 0.45 (95% confidence interval: 0.26-0.76).

Conclusions: Our study underscores the importance of early detection, accurate preoperative staging, and postoperative surveillance in managing advanced RGC cases. Despite some limitations, our findings indicate that AC may provide survival benefits comparable to those seen in primary gastric cancer.

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来源期刊
Gastric Cancer
Gastric Cancer 医学-胃肠肝病学
CiteScore
14.70
自引率
2.70%
发文量
80
审稿时长
6-12 weeks
期刊介绍: Gastric Cancer is an esteemed global forum that focuses on various aspects of gastric cancer research, treatment, and biology worldwide. The journal promotes a diverse range of content, including original articles, case reports, short communications, and technical notes. It also welcomes Letters to the Editor discussing published articles or sharing viewpoints on gastric cancer topics. Review articles are predominantly sought after by the Editor, ensuring comprehensive coverage of the field. With a dedicated and knowledgeable editorial team, the journal is committed to providing exceptional support and ensuring high levels of author satisfaction. In fact, over 90% of published authors have expressed their intent to publish again in our esteemed journal.
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