基于SEER数据库的T2N0M0期胃癌术后辅助化疗与单纯手术生存率的比较  

Comparison of survival rates between postoperative adjuvant chemotherapy and surgery alone in T2N0M0 gastric cancer based on the SEER database

作　　者：罗洪 程朋 谢启超 蓝美玲 LUO Hong;CHENG Peng;XIE Qichao;LAN Meiling(Department of Oncology,Western Theater General Hospital,Chengdu,Sichuan 610083,China;Department of Oncology,the Third Affiliated Hospital of Chongqing Medical University(Gener Hospital),Chongqing 401120,China)

机构地区：[1]西部战区总医院肿瘤科,成都610083 [2]重庆医科大学附属第三医院(捷尔医院)肿瘤科,401120

出　　处：《重庆医学》2023年第15期2282-2287,2294,共7页Chongqing medicine

基　　金：国家自然科学基金青年科学基金项目(82102920);重庆市自然科学基金项目(cstc2019jcyj-msxmX0190)。

摘　　要：目的比较T2N0M0期胃癌术后辅助化疗和单纯手术的总生存(OS)率。方法使用监测、流行病学和最终结果(SEER)数据库收集2010-2015年接受根治性手术的570例T2N0M0期胃癌患者资料,根据治疗方式不同分为辅助化疗组(179例)和单纯手术组(391例),进行单变量和多变量分析、倾向评分匹配,并用log-rank检验评估OS率。结果与单纯手术组比较,术后辅助化疗组年龄更小,组织学分级Ⅲ~Ⅳ级、其他组织学类型比例更高,死亡率更低,差异有统计学意义(P<0.05)。术后辅助化疗组和单纯手术组的3、5年OS率分别为82.2%、73.8%和73.1%、64.0%。单因素COX回归分析显示年龄、种族和辅助化疗是OS率的影响因素(P<0.05),多因素COX回归分析显示年龄、种族是OS率的独立影响因素(P<0.05)。倾向性匹配评分后,在总体人群中,术后辅助化疗组OS率有优于单纯手术组的趋势,两组3、5年OS率分别为83.9%、74.4%和75.9%、70.4%,但差异无统计学意义(P>0.05),术后辅助化疗并未明显降低死亡风险。在组织学分级Ⅰ~Ⅱ级患者中,术后辅助化疗组与单纯手术组OS率无差异(P>0.05)。在组织学分级Ⅲ~Ⅳ级患者中,术后辅助化疗组OS率有优于单纯手术组的趋势,但差异无统计学意义(P>0.05)。结论对于Ⅲ~Ⅳ级的高危T2N0M0期胃癌,术后辅助化疗比单纯手术可能会给患者带来生存获益。Objective To compare the overall survival(OS)rate between postoperative adjuvant chemotherapy and surgery alone for T2N0M0 gastric cancer.Methods The Surveillance,Epidemiology,and End Results(SEER)database was used to collect data on 570 patients with T2N0M0 gastric cancer who underwent radical surgery from 2010 to 2015.According to different treatment methods,the patients were divided into two groups:the adjuvant chemotherapy group(179 cases)and the surgery group(391 cases).Univariate and multivariate analyses,propensity score matching,and the log-rank test were used to evaluate the OS rate.Results Compared to the simple surgery group,the postoperative adjuvant chemotherapy group was younger and had a higher proportion of histological gradesⅢ-Ⅳand other histological types.Additionally,the postoperative adjuvant chemotherapy group had a lower mortality rate,and difference was statistically significant(P<0.05).The 3-year and 5-year OS rates of the postoperative adjuvant chemotherapy group and the surgery group were 82.2%and 73.8%,and 73.1%and 64.0%,respectively.Univariate COX regression analysis showed that age,race,and postoperative adjuvant chemotherapy were significant factors influencing OS rate(P<0.05).Furthermore,multivariate COX regression analysis demonstrated that age and race were independent factors influencing OS rate(P<0.05).After propensity matching scores,the overall population showed that the OS of the postoperative adjuvant chemotherapy group tended to be better than that of the surgery group.The 3-year and 5-year OS rates in the two groups were 83.9%and 74.4%,and 75.9%and 70.4%,respectively.However,the difference between the two groups was not statistically significant(P>0.05).Postoperative adjuvant chemotherapy did not significantly reduce the risk of death.In patients with histological gradeⅠ-Ⅱ,there was no difference in OS rate between the postoperative adjuvant chemotherapy group and the surgery group(P>0.05).In patients with histological gradesⅢ-Ⅳ,the OS rate of the postoperative

关 键 词：胃癌 T2N0M0 辅助化疗 总生存 监测、流行病学和最终结果数据库 

分 类 号：R735.2[医药卫生—肿瘤]