Conditional Survival after Surgical Resection of Gastric Cancer: A Multi-Institutional Analysis of the US Gastric Cancer Collaborative
Conditional Survival after Surgical Resection of Gastric Cancer: A Multi-Institutional Analysis of the US Gastric Cancer Collaborative
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DOI：
10.1245/s10434-014-4116-5
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发表时间：
2015-02-01
影响因子：
3.7
通讯作者：
Pawlik, Timothy M.
中科院分区：
文献类型：
--
作者：
Kim, Yuhree;Ejaz, Aslam;Pawlik, Timothy M.
传统上，胃腺癌手术切除后的存活率估计是指从手术之日起计算存活率。然而，通过考虑已经存活的时间，条件生存(CS)估计可能更具有临床相关性。我们评估了胃腺癌手术切除后的CS。我们分析了2000年至2012年在美国胃癌协作组的七个参与机构接受胃腺癌切除的807例患者。使用COX比例风险模型评估与总体生存相关的因素。术后“x”年的三年CS估计如下：CS3=S(x+3)/S-(X)。总体上，胃切除后1、3和5年的总生存率分别为42、34和30%。使用CS估计，考虑到患者在1年、3年和5年存活的概率分别为56%、71%和82%。基线风险较高的患者(即III或IV期疾病，淋巴血管侵犯)显示CS随时间的增加最大。胃腺癌手术切除后的生存估计是动态的；生存概率随着已经生存的时间的增加而增加。手术时预后较差的患者随着时间的推移CS增加最多。条件生存评估提供了有关生存概率随时间变化的重要信息，应用于切除胃腺癌的患者，以指导后续的随访策略。
Survival estimates following surgical resection of gastric adenocarcinoma are traditionally reported as survival from the date of surgery. Conditional survival (CS) estimates, however, may be more clinically relevant by accounting for time already survived. We assessed CS following surgical resection for gastric adenocarcinoma.We analyzed 807 patients who underwent resection for gastric adenocarcinoma from 2000 to 2012 at seven participating institutions in the U.S. Gastric Cancer Collaborative. Cox proportional hazards models were used to evaluate factors associated with overall survival. Three-year CS estimates at "x" year after surgery were calculated as follows: CS3 = S(x+3)/S-(x).Overall 1-, 3-, and 5-year overall survival rates after gastric resection were 42, 34, and 30 %, respectively. Using CS estimates, the probability of surviving an additional 3 years given that the patient had survived at 1, 3, and 5 years were 56, 71, and 82 %, respectively. Patients with higher risk at baseline (i.e., stage III or IV disease, lymphovascular invasion) demonstrated the greatest increase in CS over time.Survival estimates following surgical resection of gastric adenocarcinoma is dynamic; the probability of survival increases with time already survived. Patients with worse prognostic features at the time of surgery had the greatest increases in CS over time. Conditional survival estimates provide important information about the changing probability of survival over time and should be used among patients with resected gastric adenocarcinoma to guide subsequent follow-up strategies.