在食道状细胞癌中,术后化疗与单独手术对比:单中心倾向匹配生存分析
Youqiang Qiu1, Peiyuan Wang2, Hao He1
1Department of Thoracic Oncology Surgery, Clinical Oncology School of Fujian Medical University, Fujian Cancer Hospital, Fuzhou, China.
概括
辅助化疗 (ACT) 改善了食道状细胞癌 (ESCC) 患者的存活率. 更好的结果的关键预测因素包括BMI,淋巴结产量和淋巴血管入侵的缺乏.
科学领域:
- 在瘤学瘤学.
- 手术瘤学手术瘤学
- 医学瘤学 医学瘤学
背景情况:
- 临床指南缺乏关于切除食道状细胞癌 (ESCC) 的辅助化疗 (ACT) 的共识.
- 评估ACT的生存益处和预测因素对于优化治疗策略至关重要.
研究的目的:
- 评估ACT在ESCC患者手术后的生存益处.
- 在接受ACT的ESCC患者中确定改善结果的预测因素.
主要方法:
- 对1039名ESCC患者的回顾性分析,比较了ACT和仅手术的组.
- 倾向分数匹配 (PSM) 创建了311个平衡对,以便进行可靠的比较.
- 卡普兰-梅尔分析和考克斯回归确定了生存终点和预后因素.
主要成果:
- ACT显著改善了5年整体存活率 (OS) (HR 0.67) 和无病存活率 (DFS) (HR 0.69).
- 在患有晚期瘤负担 (pT3-4,pN1-3) 和特定的pT3N0病例的患者中观察到生存益处.
- 改善OS/DFS的独立预测因素包括更高的BMI,ACT,淋巴结产量,较低的结节负担,早期阶段,以及LVI/PNI的缺乏.
结论:
- ACT为ESCC患者提供了显著的生存优势,ESCC患者具有先进的病理性瘤负担.
- 确定特定的患者子组和预后因素可以指导个性化辅助治疗决策.
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