Prognosis of Young Survivors of Gastric Cancer in China and the U.S.: Determining Long‐Term Outcomes Based on Conditional Survival.
In: Oncologist, Jg. 24 (2019-06-01), Heft 6, S. e260- (15S.)
Online
academicJournal
Zugriff:
Background: Young survivors of gastric cancer (GC) have better prognoses than elderly patients, yet their disease‐specific survival (DSS) has received little attention. Patients and Methods: Data on young patients (aged ≤40 years) with GC undergoing resections at three Chinese institutions (n = 542) and from the SEER database (n = 533) were retrospectively analyzed. Three‐year conditional disease‐specific survival (CS3) was assessed. The effects of well‐known prognostic factors over time were analyzed by time‐dependent Cox regression. Results: Overall, young Chinese patients with GC had a better 5‐year DSS than U.S. patients (62.8% vs. 54.1%; p <.05). The disease‐specific mortality likelihood of the entire cohort was not constant over time, with most deaths occurring during the first 3 years after surgery but peaking at 1 and 2 years in China and the U.S., respectively. Based on 5‐year survivorship, the CS3 rates of both groups were similar (90.9% [U.S.] vs. 91.5% [China]; p >.05). Cox regression showed that for Chinese patients, site, size, T stage, and N stage were independent prognostic factors at baseline (p <.05). For U.S. patients, grade, T stage. and N stage significantly affected DSS at baseline (p <.05). In both groups, only T stage continuously affected DSS within 3 years after gastrectomy. However, for both groups, the initial well‐known prognostic factors lost prognostic significance after 5 years of survival (all p >.05). Although the 5‐year DSS rates of young Chinese patients with T3 and T4a disease were significantly better than those of young U.S. patients, in each T stage, the CS3 of both regions trended toward consistency over time. Conclusion: For young patients with GC, the factors that predict survival at baseline vary over time. Although the initial 5‐year DSS is heterogeneous, insight into conditional survival will help clinicians evaluate the long‐term prognoses of survivors while ignoring population differences. Implications for Practice: With the increasing number of young survivors of gastric cancer (GC), it is essential for clinicians to understand the dynamic prognosis of these patients. Based on large data sets from China and the U.S., this study found that the prognostic factors that predict survival for young patients with GC at baseline vary over time. Although the initial 5‐year disease‐specific survival is heterogeneous, insight into conditional survival will help clinicians evaluate the long‐term prognoses of survivors while ignoring population differences. This knowledge may be more effective in helping young patients with GC to manage future uncertainties, especially when they need to make important life plans. This report describes results of a study that compared the clinicopathological features of young patients with gastric cancer in China and the U.S. and evaluated the dynamic survival of patients in the two regions, focusing on whether these factors predicted the survival of younger patients after resection over time. [ABSTRACT FROM AUTHOR]
摘要 背景。胃癌 (GC) 的年轻幸存者比老年患者具有更好的预后,但他们的疾病特异性生存率 (DSS) 却很少受到关注。 患者和方法。回顾性分析了三个中国机构 (n = 542) 和 SEER 数据库 (n = 533) 中进行 GC 切除的年轻患者(年龄 ≤ 40岁)的数据。评估了三年条件疾病特异性生存率 (CS3)。通过时间依赖性 Cox 回归分析了已知预后因素随时间的变化。 结果。总体而言,中国的年轻 GC 患者的 5 年 DSS 优于美国患者 (62.8% vs. 54.1%; p < 0.05)。整个队列的疾病特异性死亡率可能性并非一直恒定,大多数死亡发生在手术后的前 3 年,在中国和美国的峰值分别为 1 年和 2 年。根据 5 年生存率,两组的 CS3 率相似 [90.9%(美国) vs. 91.5% (中国);p> 0.05]。Cox 回归分析显示,对于中国患者,发病位置、大小、T 分期和 N 分期是基线时的独立预后因素 (p < 0.05)。对于美国患者,分级、T 分期和 N 分期在基线时显著影响 DSS (p < 0.05)。在两组中,只有 T 分期在胃切除术后 3 年内持续影响 DSS。然而,对于这两组,最初已知的预后因素在 5 年生存期后失去预后意义(所有 p > 0.05)。虽然中国年轻 T3 和 T4a 疾病患者的 5 年 DSS 率显著优于美国年轻患者,但在每个 T 分期,两个地区的 CS3 随时间推移趋于一致。 结论。对于患有 GC 的年轻患者,预测基线存活率的因素随时间而变化。虽然最初的 5 年 DSS 不均匀,但对条件生存率的洞察将有助于临床医生在忽略人群差异时评估幸存者的长期预后。 对实践的启示:随着胃癌 (GC) 年轻幸存者数量的增加,临床医生必须了解这些患者的动态预后。基于来自中国和美国的大量数据集,本研究发现,预测基线时年轻 GC 患者存活率的预后因素随时间而变化。虽然最初的 5 年疾病特异性生存率不均匀,但对条件生存率的洞察将有助于临床医生在忽略人群差异时评估幸存者的长期预后。这些认知可以更有效地帮助年轻的 GC 患者管理未来的不确定性,特别是当他们需要制定重要的人生计划时。 [ABSTRACT FROM AUTHOR]
Copyright of Oncologist is the property of Oxford University Press / USA and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Titel: |
Prognosis of Young Survivors of Gastric Cancer in China and the U.S.: Determining Long‐Term Outcomes Based on Conditional Survival.
|
---|---|
Autor/in / Beteiligte Person: | Chen, Qi‐Yue ; Zhong, Qing ; Wang, Wei ; Chen, Shi ; Li, Ping ; Xie, Jian‐Wei ; Wang, Jia‐Bing ; Lin, Jian‐Xian ; Lu, Jun ; Cao, Long‐Long ; Lin, Mi ; Tu, Ru‐Hong ; Huang, Ze‐Ning ; Lin, Ju‐Li ; Zheng, Hua‐Long ; Liu, Zhi‐Yu ; Zheng, Chao‐Hui ; Peng, Jun‐Sheng ; Zhou, Zhi‐Wei ; Huang, Chang‐Ming |
Link: | |
Zeitschrift: | Oncologist, Jg. 24 (2019-06-01), Heft 6, S. e260- (15S.) |
Veröffentlichung: | 2019 |
Medientyp: | academicJournal |
ISSN: | 1083-7159 (print) |
DOI: | 10.1634/theoncologist.2018-0220 |
Schlagwort: |
|
Sonstiges: |
|