胃切除术伴D2淋巴结清扫患者新辅助化疗后条件生存率的回顾性研究。

IF 2.1 4区医学 Q2 MEDICINE, GENERAL & INTERNAL

International Journal of General Medicine Pub Date : 2025-03-25 eCollection Date: 2025-01-01 DOI:10.2147/IJGM.S514702

Xiuding Yang, Feiyu Meng, Fenglin Cai, Jingyu Deng

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引用次数: 0

摘要

背景：条件存活率是一种随时间变化的动态估计方法。我们的研究旨在评估胃癌根治术患者在新辅助化疗后的条件性疾病特异性生存率和条件性无复发生存率。方法：本研究纳入260例术前化疗后行胃切除术并D2淋巴结清扫的患者。2年有条件疾病特异性生存率（CDS2）表示患者在初始治疗后存活x年，再存活2年，计算公式为：CDS2 =疾病特异性生存率（DSS） (x + 2)/疾病特异性生存率(x)。同理，2年无条件复发生存率（CRFS2）公式为：CRFS2 =无复发生存期（Recurrence-Free Survival， RFS） (x + 2)/无复发生存期（Recurrence-Free Survival, x）。采用Cox比例风险回归分析确定与DSS和RFS相关的因素。结果：1年、3年和5年精算DSS率分别为82%、57.6%和50.7%。根据条件疾病特异性生存率（conditional disease-specific survival rate， CDS）估算，已经存活1年、3年和5年的患者CDS2分别为70.2%、88%和93.3%。1年、3年和5年的RFS精算率分别为73.1%、52.5%和46.4%。根据无条件复发生存率（CRFS）估算，存活1年、3年和5年无复发患者的CRFS2分别为71.8%、88.4%和100%。淋巴管浸润、ypN分期、肿瘤分化、TRG分级和手术类型是DSS和RFS的危险因素。结论：胃切除术伴D2淋巴结清扫患者在新辅助化疗后，CDS和CRFS随时间逐渐升高。具有不良肿瘤特征的患者在CDS和CRFS中均表现出最显著的改善。

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Conditional Survival Rate of Patients Undergoing Gastrectomy with D2 Lymph Node Dissection After Neoadjuvant Chemotherapy: A Retrospective Study.

Background: The conditional survival rate is a dynamic estimation method that changes over time. Our research aimed to assesses the conditional disease-specific survival rate and conditional recurrence-free survival rate among patients who undergoing radical gastrectomy for gastric cancer after neoadjuvant chemotherapy.

Methods: This study included 260 patients who undergoing gastrectomy with D2 lymph node dissection after preoperative chemotherapy. The 2-year conditional disease-specific survival rate (CDS2) indicates that patients who have survived for x years after initial treatment will survive for another 2 years, calculated as follows: CDS2 = Disease-Specific Survival (DSS) (x + 2)/ Disease-Specific Survival (x). Similarly, the 2-year conditional recurrence free survival rate (CRFS2) formula is as follows: CRFS2 = Recurrence-Free Survival (RFS) (x + 2)/ Recurrence-Free Survival (x). Cox proportional risk regression analysis was used to identify factors related to DSS and RFS.

Results: The 1-, 3-, and 5-year actuarial DSS rates were 82%, 57.6%, and 50.7%, respectively. According to conditional disease-specific survival rate (CDS) estimation, the CDS2 of patients who have already survived for 1 year, 3 years, and 5 years is 70.2%, 88%, and 93.3%, respectively. The RFS actuarial rates for 1 year, 3 years, and 5 years were 73.1%, 52.5%, and 46.4%, respectively. According to conditional recurrence free survival rate (CRFS) estimation, the CRFS2 of patients who survived for 1 year, 3 years, and 5 years without recurrence was 71.8%, 88.4%, and 100%, respectively. Lymph vessel infiltration, ypN stage, tumor differentiation, TRG grading, and surgical type are risk factors for DSS and RFS.

Conclusion: The CDS and CRFS of patients undergoing gastrectomy with D2 lymph node dissection after neoadjuvant chemotherapy demonstrate gradual increase over time. Patients with adverse tumor characteristics exhibited the most substantial improvement in both CDS and CRFS.

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来源期刊

International Journal of General Medicine Medicine-General Medicine

自引率

0.00%

发文量

1113

审稿时长

16 weeks

期刊介绍： The International Journal of General Medicine is an international, peer-reviewed, open access journal that focuses on general and internal medicine, pathogenesis, epidemiology, diagnosis, monitoring and treatment protocols. The journal is characterized by the rapid reporting of reviews, original research and clinical studies across all disease areas. A key focus of the journal is the elucidation of disease processes and management protocols resulting in improved outcomes for the patient. Patient perspectives such as satisfaction, quality of life, health literacy and communication and their role in developing new healthcare programs and optimizing clinical outcomes are major areas of interest for the journal. As of 1st April 2019, the International Journal of General Medicine will no longer consider meta-analyses for publication.