Tumor deposit serves as a prognostic marker in gastric cancer: A propensity score-matched analysis comparing survival outcomes
Tumor deposit serves as a prognostic marker in gastric cancer: A propensity score-matched analysis comparing survival outcomes
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肿瘤沉积物作为胃癌的预后标志物：比较生存结果的倾向评分匹配分析
DOI：
10.1002/cam4.2963
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发表时间：
2020-05-01
期刊：
影响因子：
4
通讯作者：
Chen Lin
中科院分区：
文献类型：
--
作者：
Liang Wenquan;Liu Yuhua;Chen Lin
背景胃癌（GC）的治疗取决于准确的肿瘤分期。方法回顾性分析2014年7月至2016年6月解放军总医院普外科收治的胃癌患者的临床资料。结果1034例胃癌患者中，240例（23.21%）存在TD，TD与年龄、肿瘤大小有关（P <0.05）。TD阳性患者在匹配前（P <0.001）和匹配后（P = 0.017）的生存率低于TD阴性患者。多因素分析显示，TD患者的死亡风险分别增加了58%、62%、37%和40%，（HR = 1.58，95% CI 1.32-1.89，P < .001），校正I（HR = 1.62，95% CI 1.35-1.94，P < .001），调整后II（HR = 1.37，95%CI 1.13-1.66，P = 0.001）和匹配前调整的III（HR = 1.40，95%CI 1.16-1.68，P <0.001）模型。类似地，在PSM队列中，TD患者在粗（HR = 1.32，95% CI 1.07-1.63，P = 0.011），调整后I（HR = 1.35，95% CI 1.09-1.67，P = 0.005）、调整后II（HR = 1.26，95% CI 1.00-1.58，P = 0.049）和调整后III（HR = 1.33，95% CI 1.07-1.65，P = 0.010）模型。结论在胃癌患者中，TD与生存率相关，并可能在胃癌分期中起一定作用。
Background Gastric cancer (GC) treatment is determined by accurate tumor staging. The value of tumor deposit (TD) in prognostic prediction staging system is not yet determined.Methods We retrospectively analyzed clinical information on GC patients who underwent gastrectomy at the Department of General Surgery of the Chinese PLA General Hospital from July 2014 to June 2016. Propensity score matching (PSM) was performed to reduce the possibility of selection bias according to the presence of TD.Results Of the 1034 GC patients, 240 (23.21%) presented with TD, which was associated with younger age and larger tumor size (all P < .05). TD-positive patients had a worse survival than TD-negative patients before (P < .001) and after (P = .017) matching. Multivariable analysis showed that mortality risk of patients with TD increased by 58%, 62%, 37%, and 40% in the crude (HR = 1.58, 95% CI 1.32-1.89, P < .001), adjusted I (HR = 1.62, 95% CI 1.35-1.94, P < .001), adjusted II (HR = 1.37, 95% CI 1.13-1.66, P = .001), and adjusted III (HR = 1.40, 95% CI 1.16-1.68, P < .001) models before matching. Similarly, in the PSM cohort patients with TD had worse prognosis in the crude (HR = 1.32, 95% CI 1.07-1.63, P = .011), adjusted I (HR = 1.35, 95% CI 1.09-1.67, P = .005), adjusted II (HR = 1.26, 95% CI 1.00-1.58, P = .049), and adjusted III (HR = 1.33, 95% CI 1.07-1.65, P = .010) models. TD had a similar value range between N1 and N2 stages among different models.Conclusions Among GC patients, TD is associated with survival and may have a role in the staging of patients.