Chemotherapy Use and Survival Among Young and Middle-Aged Patients With Gastric Cancer.
Chemotherapy Use and Survival Among Young and Middle-Aged Patients With Gastric Cancer.
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中青年胃癌患者的化疗使用和生存情况
DOI：
10.14309/ctg.0000000000000253
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发表时间：
2020-10
影响因子：
3.6
通讯作者：
Li G
中科院分区：
文献类型：
--
作者：
Jiang Y;Xie J;Huang W;Chen H;Xi S;Li T;Chen C;Sun Z;Hu Y;Liu W;Yu J;Zhou Z;Cai S;Li G
年轻胃癌（GC）患者的治疗方法仍不明确，其对生存率的影响也不确定。我们的目的是调查不同年龄组（18-49岁、50-64岁和65-85岁）接受化疗的情况，并探讨化疗的年龄差异是否与GC患者的生存率增加相匹配。从中国多机构数据库和监测、流行病学和最终结果数据库中纳入组织学诊断为GC的患者。2000年至2014年间，分别有5，122名和31，363名18-85岁患者接受治疗。评估了总生存率和接受化疗的分期特异性可能性。在中国和监测、流行病学和最终结果数据集中的5，122和31，363例患者中，分别有3，489例（68.1%）和18，115例（57.8%）为男性。与老年患者（65-85岁）相比，年轻（18-49岁）和中年（50-64岁）患者更有可能接受化疗（来自中国数据集的3组分别为64.9%、56.7%和45.4%）。在仅接受手术治疗的患者中，年轻和中年患者的预后明显优于老年患者;然而，在接受手术和化疗的患者中，各年龄亚组的总生存期无显著差异，尤其是在中国数据集中。与年轻和中年II期和III期患者相比，老年患者化疗的生存获益上级（均P < 0.0001）。在年轻和中年胃癌患者中发现了潜在的化疗过度使用，但增加化疗并没有带来匹配的生存改善，特别是在中国数据集中。
Treatments for young patients with gastric cancer (GC) remain poorly defined, and their effects on survival are uncertain. We aimed to investigate the receipt of chemotherapy by age category (18–49, 50–64, and 65–85 years) and explore whether age differences in chemotherapy matched survival gains in patients with GC. Patients who were histologically diagnosed with GC were included from a Chinese multi-institutional database and the Surveillance, Epidemiology, and End Results database. There were 5,122 and 31,363 patients aged 18–85 years treated between 2000 and 2014, respectively. Overall survival and stage-specific likelihood of receiving chemotherapy were evaluated. Of the 5,122 and 31,363 patients in China and Surveillance, Epidemiology, and End Result data sets, 3,489 (68.1%) and 18,115 (57.8%) were men, respectively. Younger (18–49 years) and middle-aged (50–64 years) patients were more likely to receive chemotherapy compared with older patients (65–85 years) (64.9%, 56.7%, and 45.4% in the 3 groups from the China data set). Among patients treated with surgery alone, a significantly better prognosis was found in younger and middle-aged patients than their older counterparts; however, no significant differences were found in overall survival among age subgroups in patients who received both surgery and chemotherapy, especially in the China data set. The survival benefit from chemotherapy was superior among older patients (all P < 0.0001) compared with that among younger and middle-aged patients in stage II and III disease. Potential overuse of chemotherapy was found in younger and middle-aged patients with GC, but the addition of chemotherapy did not bring about matched survival improvement, especially in the China data set.