在晚期胃癌中治疗性胃切除术后的教科书瘤结果和预后:一项多中心研究
Ze-Ning Huang1, Chang-Yue Zheng2, Ju Wu3
1Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China; Key Laboratory of Gastrointestinal Cancer (Fujian Medical University), Ministry of Education, Fuzhou, China; Fujian Key Laboratory of Tumor Microbiology, Department of Medical Microbiology, Fujian Medical University, Fuzhou, China.
概括
在晚期胃癌 (AGC) 手术中实现教科书瘤结局 (TOO) 显著提高了生存率. 诸如开放性手术和缺乏保险等因素也会阻碍TOO,影响患者的预后.
科学领域:
- 在瘤学瘤学.
- 改善外科手术的质量
- 癌症预后 癌症预后
背景情况:
- 在晚期胃癌 (AGC) 中,教科书瘤结局 (TOO) 的预后意义需要进一步调查.
- TOO作为多模式治疗在癌症护理中的质量指标.
研究的目的:
- 评估实现TOO对晚期胃癌 (AGC) 患者预后的影响.
- 确定与AGC中TOO未实现相关的因素.
主要方法:
- 对3626名接受治疗性胃切除术的AGC患者 (2010-2017年) 的回顾性分析.
- TOO定义为实现教科书结果加上新辅助剂/辅助剂化疗.
- 考克斯和后勤回归模型用于预后和风险因素分析.
主要成果:
- 57.6%的患者实现了TOO,显示出明显改善的5年整体存活率 (OS) 和无病存活率 (DFS) (p <0.05).
- TOO是一个独立的预后因素,用于改善5年后的OS (HR 0.67) 和DFS (HR 0.73).
- 非TOO成就的危险因素包括开放性胃切除术,缺乏保险,年龄较大,ASA得分较高和瘤尺寸较大.
结论:
- 教科书瘤结局 (TOO) 是一个可靠的预测器,可预测晚期胃癌的良好预后.
- 改善TOO成绩的策略应侧重于优化外科手术技术和提高医疗保险的可获得性.
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