以大型单中心医院登记为基础的6737例接受手术切除的胃癌患者的生存报告  

Survival analysis of 6737 surgically resected gastric cancer cases in China from a large single institution hospitalbased cancer registry database

作　　者：沈洁 王江立 王泽洲 莫淼[1] 周昌明 袁晶[1] 徐大志 郑莹 SHEN Jie;WANG Jiangli;WANG Zezhou;MO Miao;ZHOU Changming;YUAN Jing;XU Dazhi;ZHENG Ying(Department of Cancer Prevention,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Department of Gastric Surgery,Division 1,Fudan University Shanghai Cancer Center,Department of Oncology,Shanghai Medical College,Fudan University,Shanghai 200032,China;Shanghai Engineering Research Center of Artificial Intelligence Technology for Tumor Diseases,Shanghai 200032,China)

机构地区：[1]复旦大学附属肿瘤医院肿瘤预防部,复旦大学上海医学院肿瘤学系,上海200032 [2]复旦大学附属肿瘤医院胃外1科,复旦大学上海医学院肿瘤学系,上海200032 [3]上海肿瘤疾病人工智能工程技术研究中心,上海200032

出　　处：《中国癌症杂志》2024年第3期268-277,共10页China Oncology

基　　金：上海市加强公共卫生体系建设三年行动计划(2023—2025年)(GWVI-11.2-YQ37);上海市申康医院发展中心市级医院诊疗技术推广及优化管理项目(SHDC22022308)。

摘　　要：背景与目的:收集以医院登记为基础的6737例接受手术切除的胃癌患者的随访资料,分析其1、3和5年观察总生存(overall survival,OS)率和无病生存(disease-free survival,DFS)率,为中国的胃癌防控和政策制定提供真实世界研究证据。方法:纳入2015年1月1日—2020年12月31日在复旦大学附属肿瘤医院接受手术治疗的胃癌患者共6737例,通过查阅患者病史了解患者的临床信息,并通过复诊病史、电话随访和死因数据链接等方式收集患者的生存随访资料,随访统计时间截至2023年11月30日。采用Kaplan-Meier法估计患者1、3和5年OS率和DFS率,并在不同年龄组、性别、治疗时期、肿瘤分期及病理学特征等亚组中分别描述。结果:接受手术切除的胃癌患者经中位50.99个月随访后,5年OS率和Ⅰ~Ⅲ期患者5年DFS率分别为70.37%和69.46%。Ⅰ期、Ⅱ期、Ⅲ期和Ⅳ期胃癌患者的5年OS率分别为94.32%、82.56%、51.01%和23.97%。不同年龄、部位、大体分型、Borrmann分型和Lauren分型的患者生存有显著差异。结论:肿瘤分期是影响胃癌患者生存的重要因素,应加强人群(尤其是高危人群)胃癌的筛查和早诊早治,进一步改善患者的生存。Background and purpose:Follow-up data of 6737 patients undergoing surgery for gastric cancer were collected based on hospital registration,and the 1-,3-and 5-years observed overall survival(OS)rates and disease-free survival(DFS)rates were analyzed to provide real-world research evidence for the prevention and control of gastric cancer and policy making in China.Methods:A total of 6737 gastric cancer patients who underwent surgical treatment at Fudan University Shanghai Cancer center from 2015 to 2020 were included in this study.Clinical information and the follow-up endpoint data were collected through medical records review,telephone visits and death registry data linkage.The last follow-up date was November 30,2023.Kaplan-Meier method was applied in evaluating the 1-,3-and 5-year OS rate and DFS rate,and survival data were described by different subgroups including age group,gender,treatment period,tumor staging,and pathological characteristics.Results:With a median follow-up time of 50.99 months,the 5-year OS rate of surgically resected gastric cancer patients was 70.37%,and 5-year DFS rate inⅠ-Ⅲstage cases was 69.46%.The 5-year OS rates of stageⅠ,Ⅱ,ⅢandⅣwere 94.32%,82.56%,51.01%and 23.97%,respectively.The differences in survival among patients with different age,tumor location,gross classification,Borrmann classification and Lauren classification were significant.Conclusion:Staging is an important factor directly affecting the survival of gastric cancer patients.Screening and early diagnosis and treatment in large population,especially high-risk group,should be strengthened to further improve the patients’survival.

关 键 词：胃癌 总生存率 无病生存率 医院登记 

分 类 号：R735.2[医药卫生—肿瘤]