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A SEER population analysis of stage IB resected gastric cancer: who can benefit from adjuvant therapy?

IB 期切除胃癌的 SEER 人群分析: 谁能从辅助治疗中获益?

  • 影响因子:2.03
  • DOI:10.1080/00365521.2020.1716062
  • 作者列表:"Wang Y","Guo S","Zhang J","Meng XY","Zheng ZC","Zhao Y
  • 发表时间:2020-01-24
Abstract

:Objective: The benefit of adjuvant therapy (AT) remains controversial in stage IB gastric cancer (GC). This study aimed to offer a reference for the rational indications of AT.Methods: We retrospectively included 1216 stage IB GC who experienced curative surgery from the SEER database between 2004 and 2015. These patients were allocated into two groups: Group AT and Group surgery alone (Group SA). We established a nomogram to predict OS and then divided whole cohort into low-risk and high-risk groups based on the OS predicted by the nomogram.Results: Six variables, which were significantly related with OS of entire patients after matched, were incorporated in the nomogram. These variables were age, examined lymph nodes, tumor site, marital, family income and stage IB. The C-index of the model was 0.637 and the calibration curve showed that the anticipated values were in accordance with the actual values. The decision curve demonstrated that the optimal clinical impact was achieved when the threshold possibility was 0-56%. Then, the entire cohort was separated into low-risk (≤159 points) as well as high-risk (>159 points) groups based on the projected 5-year OS of recursive partitioning analysis. Group SA revealed a significantly poorer OS than Group AT for high-risk patients (p < .001); on the other hand, there was a comparable OS for low-risk patients (p = .361).Conclusions: We have developed an effective, intuitional and applied prognostic tool to clinical decision-making. For stage IB GC after surgical resection, AT was only recommended for high-risk patients. However, AT may be dispensable for low-risk patients.

摘要

目的: IB 期胃癌 (GC) 辅助治疗 (AT) 的获益仍存在争议。本研究旨在为 AT 的合理适应症提供参考。方法: 我们回顾性纳入了 1216 例 IB 期 GC,他们经历了来自 SEER 数据库 2004年和 2015 的治愈性手术。将这些患者分为两组: AT 组和单纯手术组 (SA 组)。我们建立了预测 OS 的列线图,然后根据列线图预测的 OS 将整个队列分为低风险和高风险组。结果: 在匹配后,与整个患者的 OS 显著相关的 6 个变量被纳入列线图。这些变量是年龄、检查的淋巴结、肿瘤部位、婚姻、家庭收入和 IB 期。模型的 C 指数为 0.637,校准曲线显示预期值与实际值一致。决策曲线表明,当阈值可能性为 0-56% 时,达到最佳临床影响。然后,将整个队列分为低风险 (≤ 159 分) 和高风险 (&gt; 159 分) 基于递归分区分析的预计 5 年 OS 进行分组。SA 组显示高危患者的 OS 显著低于 AT 组 (p

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DOI:10.1002/mc.23158
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影响因子:1.71
发表时间:2020-01-28
DOI:10.2217/fon-2019-0649
作者列表:["Jing JJ","Li H","Wang ZY","Zhou H","Sun LP","Yuan Y"]

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影响因子:3.89
发表时间:2020-01-28
DOI:10.1002/jcp.29562
作者列表:["Daryabari SS","Fathi M","Mahdavi M","Moaddab Y","Hosseinpour Feizi MA","Shokoohi B","Safaralizadeh R"]

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