Comparison of gastric cancer survival after R0 resection in the US and China.
Comparison of gastric cancer survival after R0 resection in the US and China.
复制标题
DOI：
10.1002/jso.25220
复制
发表时间：
2018-11
影响因子：
2.5
通讯作者：
Strong VE
中科院分区：
文献类型：
--
作者：
Li P;Huang CM;Zheng CH;Russo A;Kasbekar P;Brennan MF;Coit DG;Strong VE
即使在控制致病因素的情况下，亚洲和西方国家的胃癌结局也存在差异，但这种差异是否适用于中国仍未得到充分研究。我们试图比较美国和中国接受治愈意图（R0）切除术的胃癌（GC）患者的表现、治疗和结局，并确定地理/机构是否是DSS的独立预测因子。我们分析了2000年至2014年间在美国（Memorial Sloan Kettering cancer Center [MSKCC], n= 1378）和中国（福建医科大学联合医院[FMUUH]， n= 4262）的高容量癌症中心接受R0切除术的胃癌患者的数据。通过多变量分析检查与疾病特异性生存（DSS）相关的因素。所有MSKCC患者的5年DSS （p < 0.001）优于FMUUH患者，即使在未接受术前化疗的患者中也是如此（p < 0.001），但分期分层消除了这种差异（p < 0.05）。与DSS独立相关的因素包括年龄、组织学、肿瘤大小、T类、N类、胃切除术类型和术前化疗，但与机构无关。虽然胃癌患者在MSKCC和FMUUH之间的表现不同，但在匹配临床分期时，治愈性切除胃癌患者的生存率是相似的。
Gastric cancer outcomes differ between Asian and Western countries, even when controlling for contributing factors, but whether this difference holds true for China remains inadequately studied. We sought to compare the presentation, treatment, and outcomes of patients with gastric cancer (GC) undergoing curative intent (R0) resection between the U.S. and China, and to ascertain whether geography/ institution is an independent predictor of DSS. Data were analyzed from patients with GC undergoing R0 resection at high-volume cancer centers in the U.S. (Memorial Sloan Kettering Cancer Center [MSKCC], n=1,378) and China (Fujian Medical University Union Hospital [FMUUH], n=4,262) between 2000 and 2014. Factors associated with disease-specific survival (DSS) were examined by multivariate analysis. The 5-year DSS (p < 0.001) for all patients was better at MSKCC than at FMUUH, even among patients not receiving preoperative chemotherapy (p < 0.001), but stratification by sub-stage eliminated this difference (p > 0.05). Factors independently associated with DSS included age, histology, tumor size, T category, N category, gastrectomy type, and preoperative chemotherapy, but not institution. Although the presentation of GC patients between MSKCC and FMUUH differs, survival of patients with curatively resected GC, when matched for clinical stage, is comparable.