Postoperative dynamic survival of gastric cancer patients: A multi-institutional, international analysis of 22 265 patients.
Adenocarcinoma
/ mortality
Adult
Aged
Databases, Factual
Female
Gastrectomy
/ mortality
Humans
International Agencies
Lymph Node Excision
/ mortality
Male
Middle Aged
Neoplasm Staging
Postoperative Complications
/ mortality
Predictive Value of Tests
Retrospective Studies
Stomach Neoplasms
/ mortality
Survival Rate
conditional survival
disease-specific survival
gastric cancer
length of survivorship
predictive model
Journal
Journal of surgical oncology
ISSN: 1096-9098
Titre abrégé: J Surg Oncol
Pays: United States
ID NLM: 0222643
Informations de publication
Date de publication:
Sep 2019
Sep 2019
Historique:
received:
24
04
2019
accepted:
24
06
2019
pubmed:
19
7
2019
medline:
7
9
2019
entrez:
19
7
2019
Statut:
ppublish
Résumé
How to best evaluate the disease-specific survival (DSS) of gastric cancer (GC) survivors over time is unclear. Clinicopathological data from 22 265 patients who underwent curative intend resection for GC were retrospectively analyzed. Changes in the patients' 3-year conditional disease-specific survival (CS3) were analyzed. We used time-dependent Cox regression to analyze which variables had long-term effects on DSS and devised a dynamic predictive model based on the length of survival. Based on 1-, 3-, and 5-year survivorships, the CS3 of the population increased gradually from 62% to 68.1%, 83.7%, and 90.6%, respectively. Subgroup analysis showed that the CS3 of patients who had poor prognostic factors initially demonstrated the greatest increase in postoperative survival time (eg, N3b: 26.6%-84.1%, Δ57.5% vs N0: 84.1%-93.3%, Δ9.2%). Time-dependent Cox regression analysis showed the following predictor variables constantly affecting DSS: age, the number of examined lymph nodes (LNs), T stage, N stage, and site (P < .05). These variables served as the basis for a dynamic prediction model. The influence of prognostic factors on DSS and CS3 changed dramatically over time. We developed an effective model for predicting the DSS of patients with GC based on the length of survival time.
Sections du résumé
BACKGROUND
BACKGROUND
How to best evaluate the disease-specific survival (DSS) of gastric cancer (GC) survivors over time is unclear.
METHODS
METHODS
Clinicopathological data from 22 265 patients who underwent curative intend resection for GC were retrospectively analyzed. Changes in the patients' 3-year conditional disease-specific survival (CS3) were analyzed. We used time-dependent Cox regression to analyze which variables had long-term effects on DSS and devised a dynamic predictive model based on the length of survival.
RESULTS
RESULTS
Based on 1-, 3-, and 5-year survivorships, the CS3 of the population increased gradually from 62% to 68.1%, 83.7%, and 90.6%, respectively. Subgroup analysis showed that the CS3 of patients who had poor prognostic factors initially demonstrated the greatest increase in postoperative survival time (eg, N3b: 26.6%-84.1%, Δ57.5% vs N0: 84.1%-93.3%, Δ9.2%). Time-dependent Cox regression analysis showed the following predictor variables constantly affecting DSS: age, the number of examined lymph nodes (LNs), T stage, N stage, and site (P < .05). These variables served as the basis for a dynamic prediction model.
CONCLUSIONS
CONCLUSIONS
The influence of prognostic factors on DSS and CS3 changed dramatically over time. We developed an effective model for predicting the DSS of patients with GC based on the length of survival time.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
685-697Subventions
Organisme : 2017 Fujian Science and Technology Innovation Joint Fund Project
ID : 2017Y9004
Organisme : Construction Project of Fujian Province Minimally Invasive Medical Center
ID : [2017]171
Organisme : Scientific and Technological Innovation Joint Capital Projects of Fujian Province
ID : 2016Y9031
Organisme : The Second Batch of Special Support Funds for Fujian Province Innovation and Entrepreneurship Talents
ID : 2016B013
Organisme : CARIT Foundation (Fondazione Cassa di Risparmio di Terni e Nami)
ID : 0024137
Organisme : Youth Project of Fujian Provincial Health and Family Planning Commission
ID : 2016-1 to 41
Informations de copyright
© 2019 Wiley Periodicals, Inc.