治疗性食道切除术后的无复发条件生存:对11项试验的个体患者数据分析
Jun Okui1,2, Satoru Matsuda1, Kengo Nagashima3
1Department of Surgery, Keio University School of Medicine, Tokyo, Japan.
在食道癌患者中,无复发生存期 (RFS) 随着时间的推移而有所改善. 条件RFS表明,一旦患者达到早期无复发的里程碑,可以调整随访强度.
科学领域:
- 在瘤学瘤学.
- 临床试验 临床试验
- 癌症的生存率 癌症的生存率
背景情况:
- 大多数食道癌复发发生在手术后2年内.
- 传统的无复发生存率 (RFS) 可能低估了长期预后.
- 需要个性化的后续策略.
研究的目的:
- 在食道癌症中评估条件RFS.
- 为了分析手术后复发时间.
- 为了告知个性化的患者随访.
主要方法:
- 对RCT的个人患者数据 (IPD) 分析.
- 包括可切除的食道或胃食道结癌患者.
- 估计的条件RFS (RFS和RFSx).
主要成果:
- 随着时间的推移,所有阶段的条件RFS显著改善.
- 在状细胞癌中,5年RFS从RFS0的47.9%增加到RFS4.4的81.2%.
- 复发模式因pN状态而异,在pN阳性病例中出现较早的复发.
结论:
- 有条件的RFS随着时间的推移提供了更乐观的预后.
- 晚期患者从改善的条件RFS中受益.
- 在实现早期无复发状态后,可能会重新考虑随访强度.
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