Prognosis following an extended duration of adjuvant gemcitabine plus S‐1 chemotherapy in patients with pancreatic ductal adenocarcinoma: analysis using inverse probability of treatment weighting
Prognosis following an extended duration of adjuvant gemcitabine plus S‐1 chemotherapy in patients with pancreatic ductal adenocarcinoma: analysis using inverse probability of treatment weighting
复制标题
胰腺导管腺癌患者长期接受吉西他滨辅助 S-1 化疗后的预后：使用治疗权重逆概率进行分析
DOI：
10.1002/jhbp.1151
复制
发表时间：
2022
影响因子：
3
通讯作者：
Takahashi Shinya
中科院分区：
文献类型：
--
作者：
Kondo Naru;Uemura Kenichiro;Sumiyoshi Tatsuak;Okada Kenjiro;Seo Shingo;Otsuka Hiroyuki;Kawano Reo;Murakami Yoshiaki;Takahashi Shinya
背景/目的本研究的目的是评估辅助吉西他滨联合S-1（GS）化疗的持续时间是否对胰腺导管腺癌（PDAC）患者的生存率有任何影响。方法在290例接受辅助GS化疗的患者中，100例（34%）接受标准持续时间（20 - 29周），190例（66%）接受延长持续时间（≥30周）。为了减少选择偏倚，使用治疗加权逆概率（IPTW）分析了基于辅助GS化疗持续时间的预后影响（无复发生存期[RFS]和总生存期[OS]）。此外，为了减少不朽的时间偏差，时间依赖的多变量分析，其中辅助GS化疗的实施作为随时间变化的协变量也被处理covariable.ResultsExtended辅助GS化疗的持续时间延长与延长RFS（P< .001）和OS（P< .001）IPTW调整后显着相关。时间依赖性多变量分析显示，GS辅助化疗持续时间延长是RFS（HR 0.58，P = 0.002）和OS（HR 0.56，P = 0.005）延长的独立预后因素。结论PDAC患者GS辅助化疗持续时间延长（≥30周）与预后改善相关。这些发现证明了对PDAC进行进一步的前瞻性试验，以研究延长辅助化疗的生存益处。
Background/PurposeThe aim of this study was to assess whether the duration of adjuvant gemcitabine plus S‐1 (GS) chemotherapy has any effect on survival in patients with pancreatic ductal adenocarcinoma (PDAC).MethodsOf the 290 patients who received adjuvant GS chemotherapy, 100 (34%) received the standard duration (20‐29 weeks) and 190 (66%) received an extended duration (≥30 weeks). To reduce selection bias, the prognostic impact (recurrence‐free survival [RFS] and overall survival [OS]) based on the duration of adjuvant GS chemotherapy was analyzed using inverse probability of treatment weighting (IPTW). Moreover, to reduce immortal time bias, time‐dependent multivariate analyses in which implementation of adjuvant GS chemotherapy was treated as time‐varying covariate was also performed.ResultsExtended duration of adjuvant GS chemotherapy was significantly correlated with prolonged RFS (P< .001) and OS (P< .001) after IPTW adjustment. Time‐dependent multivariate analyses revealed that extended duration of adjuvant GS chemotherapy was an independent prognostic factor for prolonged RFS (hazard ratio [HR], 0.58,P= .002) and OS (HR, 0.56,P= .005).ConclusionExtended duration (≥30 weeks) of adjuvant GS chemotherapy in patients with PDAC was associated with an improved prognosis. These findings warrant a further prospective trial on PDAC to investigate the survival benefit of extended adjuvant chemotherapy.