Oncological outcomes in patients with pT1N0?3 or pT2?3N0 gastric cancer after curative resection without adjuvant chemotherapy
Oncological outcomes in patients with pT1N0?3 or pT2?3N0 gastric cancer after curative resection without adjuvant chemotherapy
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pT1N0?3 或 pT2?3N0 胃癌患者在不进行辅助化疗的情况下进行根治性切除后的肿瘤学结果
DOI：
10.1007/s00423-021-02084-1
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Sano Takeshi
中科院分区：
文献类型：
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作者：
Yagi Shusuke;Nunobe Souya;Makuuchi Rie;Ida Satoshi;Kumagai Koshi;Ohashi Manabu;Sano Takeshi
目的pT 1 N 0 -3或pT 2 - 3 N 0胃癌根治性切除后不用辅助化疗的生存率较好。然而，一些患者会复发，这些复发的细节仍不清楚。本研究旨在评估pT 1 N 0 -3或pT 2 - 3 N 0胃癌患者的预后因素。方法我们回顾性分析了1219例pT 1 N 0 -3或pT 2 - 3 N 0胃癌患者的病历，这些患者在2007年4月至2012年3月期间在癌症研究所医院接受了根治性胃切除术，未接受新辅助或辅助化疗。73例pT 1 N1、23例pT 1 N2、6例pT 1 N3、130例pT 2N 0和92例pT 3 N 0患者。pT 1 N 0 -3和pT 2 - 3 N 0胃癌的5年总生存率（OS）和5年无复发生存率（RFS）分别为98.9%（95%CI 98.1-99.4）和97.7%（95%CI 96.7-98.4）。在RFS的多变量分析中，年龄（HR 3.56，95% CI 2.10-6.03）和淋巴血管受累（风险比（HR）2.98，95% CI 1.76-5.04）是独立的预后因素。结论pT 1 N 0 -3和pT 2 - 3 N 0的5年无瘤生存率较高，即使在年龄> 75岁或淋巴血管受累的危险因素中也是如此，pT 1 N 0 -3和pT 2 - 3 N 0的5年无瘤生存率分别为94.4%（95%CI 89.8-97.0）和95.1%（95%CI 92.5-96.8）。但T1 N3胃癌的样本量较小，因此需要进行更大的样本量和危险因素分析。
PurposeThe survival outcomes of pT1N0–3 or pT2–3N0 gastric cancer after curative resection are favorable without adjuvant chemotherapy. However, some patients develop recurrence and details of these recurrences remain unclear. This study aimed to evaluate the prognostic factors in patients with pT1N0–3 or pT2–3N0 gastric cancer.MethodsWe retrospectively reviewed the medical records of 1219 patients with pT1N0–3 or pT2–3N0 gastric cancer who underwent curative gastrectomy without neoadjuvant or adjuvant chemotherapy between April 2007 and March 2012 at Cancer Institute Hospital.ResultsThis cohort included 895 pT1N0, 73 pT1N1, 23 pT1N2, 6 pT1N3, 130 pT2N0, and 92 pT3N0 patients. The 5-year overall survival (OS) and 5-year relapse-free survival (RFS) for pT1N0–3 and pT2–3N0 gastric cancer were 98.9% (95% CI 98.1–99.4) and 97.7% (95% CI 96.7–98.4), respectively. Age (HR 3.56, 95% CI 2.10–6.03) and lymphovascular involvement (hazard ratio (HR) 2.98, 95% CI 1.76–5.04) were independent prognostic factors in a multivariate analysis for RFS. The 5-year RFS for patients aged ≥75 years or with lymphovascular involvement were 94.4% (95% CI 89.8–97.0) and 95.1% (95% CI 92.5–96.8), respectively.ConclusionThe survival outcomes of pT1N0-3 and pT2-3N0 were excellent, even in patients with aged >75 years or lymphovascular involvement which were risk factors. However, the sample size of T1N3 gastric cancer is small, so larger sample size and risk factor analysis are required.