在接受新辅助化学免疫疗法后进行手术的局部晚期胃癌患者中,哪个代孕终点最能预测存活率? 一个多中心的回顾性研究
Xiong Sun1, Xuanfei Li2, Shijun Zhao3
1Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
概括
新辅助化疗免疫疗法 (NCIT) 改善了局部晚期胃癌 (LAGC) 的反应率. 病理性淋巴结 (ypN0) 状态,而不是pCR或MPR,是NCIT和手术后更好的无事件和整体生存的关键预测因素.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 新辅助化疗免疫疗法 (NCIT) 提高了局部晚期胃癌 (LAGC) 的病理完整反应 (pCR) 和主要病理反应 (MPR) 率.
- 在LAGC的NCIT之后,使用替代终点预测生存结果仍然是一个挑战.
研究的目的:
- 评估在LAGC患者中NCIT后病理反应的预后意义.
- 确定使用NCIT治疗的LAGC中生存的可靠代用终点.
主要方法:
- 对84名接受NCIT和彻底切除的LAGC患者的回顾性分析.
- 卡普兰-梅尔和日志等级测试用于生存分析 (EFS,OS).
- 单变量和多变量考克斯回归用于预后因素识别.
主要成果:
- 在60.7%的患者中实现了ypN0状态.
- ypN0与显著改善的EFS和OS相关 (p < 0.05).
- 病态淋巴结状况,而不是pCR或MPR,在多变量分析中独立预测EFS和OS.
结论:
- ypN0状态作为一个关键的替代品,有利的临床结果在LAGC患者治疗NCIT和手术.
- ypN0状态与瘤入侵和转移的减少有关.
- 需要进一步验证以确认ypN0作为可靠的替代终点.
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