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在局部晚期胃癌患者的新辅助疗法后,最佳应答人群:一个多中心研究

Qing Zhong¹, Yuqin Sun^1,2, Mingqiao Lian²

¹Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou 350000, China.

Chinese journal of cancer research = Chung-kuo yen cheng yen chiu

|May 12, 2025

概括

在胃癌 (GC) 新辅助疗法后获得最佳反应的患者的生存率显著提高. 这种最佳响应人群 (ORP) 可能不会从辅助化疗中进一步受益.

科学领域:

在瘤学瘤学.
胃肠病学胃肠病学
临床研究临床研究

背景情况:

胃癌 (GC) 的新辅助疗法 (NAT) 后的病理完整反应 (pCR) 是罕见的,但表明预后有利.
定义最佳响应人群 (ORP) 对于确定从NAT.中受益最多的患者至关重要.

研究的目的:

在经过新辅助疗法 (NAT) 的胃癌 (GC) 患者中重新评估最佳应答人群 (ORP).
评估ORP中的各种T和N阶段的预后结果,包括生存和复发模式.

主要方法:

在10家中国三级医院 (2008-2021) 接受NAT和激进胃切除术的1,076名GC患者的回顾性分析.
倾向分数匹配 (PSM) 用于将ORP (定义为pCR或ypT1N0) 与非ORP组进行比较.
分析了无疾病生存率 (DFS) 和总生存率 (OS),以及复发模式.

主要成果:

在PSM后,ORP组 (12.6%) 与非ORP组 (P<0.001) 相比,在3年内显著优异的OS (89.0%对55.0%) 和DFS (85.8%对49.7%) 与非ORP组相比 (P<0.001).
辅助化疗没有显著影响ORP组患者的预后 (3年OS: 89.0% vs. 89.7%,P=0.988;3年DFS: 84.9% vs. 89.7%,P=0.700).

结论:

这项研究重新定义了新辅助疗法 (NAT) 后局部晚期胃癌 (GC) 的最佳应答人群 (ORP).
实现ORP的患者显著改善了生存结果.
在ORP组的患者中,辅助化疗可能不需要,这表明治疗的潜在降级.

关键词:

新辅助疗法是一种新辅助疗法.人口的最佳反应是人口的最佳反应.病理学的完整反应.幸存率幸存率生存率

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