eb病毒相关胃癌根治性胃切除术后的长期生存分析：一项多中心研究

IF 3.5 2区医学 Q2 ONCOLOGY

Ejso Pub Date : 2025-03-02 DOI:10.1016/j.ejso.2025.109737

Rong-Zhen Xie , Ze-Ning Huang , Xing-Qi Zhang , Yu-Qin Sun , Jiao-Bao Huang , Qi-Yue Chen , Jian-Wei Xie , Chao-Hui Zheng , Chang-Ming Huang , Jian-Xian Lin , Ping Li

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引用次数: 0

摘要

Epstein-Barr病毒相关性胃癌（EBVaGC）的预后需要高质量的研究来验证。本研究旨在利用多中心数据评估EBVaGC患者根治性胃切除术后的长期生存，以探讨EBV感染状态作为预后预测因子的潜在价值。方法分析2013年1月至2020年7月行根治性胃切除术的EBVaGC和eb病毒阴性胃癌（EBVnGC）患者的临床资料。采用Kaplan-Meier法和Cox回归分析评价总生存期（OS）和无病生存期（DFS）。建立随机生存森林（RSF）模型预测预后。结果经倾向评分匹配后，EBVaGC组205例，EBVnGC组410例。EBVaGC组3年OS和DFS明显高于EBVnGC组。多因素分析显示，eb病毒编码小RNA阳性是OS和DFS的独立保护因素。在II期和III期EBVaGC患者中，接受≥4个化疗周期的患者3年OS明显优于接受≥4个化疗周期的患者。基于EBER状态的RSF模型在预测3年OS和DFS方面优于Cox模型和TNM分期系统。结论基于EBER状态建立的预后预测模型具有良好的临床应用价值，可为临床随访管理提供新的参考。建议II期和III期EBVaGC患者术后接受至少4个周期的化疗以提高生存率。

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Long-term survival analysis after radical gastrectomy for Epstein-Barr virus-associated gastric cancer: A multicenter study

Background

The prognosis of Epstein-Barr virus-associated gastric cancer (EBVaGC)needs to be validated by high-quality studies. This study aimed to assess the long-term survival of EBVaGC patients after radical gastrectomy using multicenter data to explore the potential value of EBV infection status as a prognostic predictor.

Methods

We analyzed the clinical data of patients with EBVaGC and Epstein-Barr virus-negative gastric cancer (EBVnGC) who underwent radical gastrectomy from January 2013 to July 2020. The Kaplan-Meier method and Cox regression analysis were used to evaluate overall survival (OS) and disease-free survival (DFS). A Random Survival Forest (RSF) model was constructed to predict the prognosis.

Results

After propensity score matching, 205 and 410 patients were included in the EBVaGC and EBVnGC groups, respectively. The 3-year OS and DFS rates in the EBVaGC group were significantly higher than those in the EBVnGC group. Multivariate analysis indicated that EBER(Epstein-Barr virus-encoded small RNA) positivity was an independent protective factor for OS and DFS. Among stage II and III EBVaGC patients, those receiving ≥4 cycles of chemotherapy had a 3-year OS significantly better than those receiving <4 cycles. The RSF model based on EBER status outperformed the Cox model and TNM staging system in predicting the 3-year OS and DFS.

Conclusion

The prognostic prediction model established based on the EBER status has good clinical application value and can provide a new reference for clinical follow-up management. It is recommended that patients with stage II and III EBVaGC receive at least four cycles of chemotherapy postoperatively to improve survival.

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来源期刊

Ejso 医学-外科

CiteScore

6.40

自引率

2.60%

发文量

1148

审稿时长

41 days

期刊介绍： JSO - European Journal of Surgical Oncology ("the Journal of Cancer Surgery") is the Official Journal of the European Society of Surgical Oncology and BASO ~ the Association for Cancer Surgery. The EJSO aims to advance surgical oncology research and practice through the publication of original research articles, review articles, editorials, debates and correspondence.