https://scholars.lib.ntu.edu.tw/handle/123456789/637077
標題: | Optimal Timing for Postsurgical Adjuvant Therapy in Patients with Gastric Cancer: A Propensity Score Matching Study | 作者: | Huang, Shih-Ming Chen, Yen-Chao WAN-YU CHEN Yang, Lan-Yan Tsan, Din-Li Tsang, Ngan-Ming Yap, Wing-Keen Tsai, Chien-Sheng Leung, Wai-Man Hong, Ji-Hong Chang, Joseph Tung-Chieh Yeh, Ta-Sen Wu, Tsung-Han Chen, Yi-Chan Lin, Yun-Hsuan Huang, Bing-Shen |
關鍵字: | adjuvant therapy; gastrectomy; gastric cancer; propensity score; survival | 公開日期: | 2019 | 卷: | 10 | 期: | 2 | 來源出版物: | Journal of Cancer | 摘要: | Background: In clinical trials, adjuvant therapy (AT) has been shown to improve the prognosis in patients with gastric adenocarcinoma who undergo curative gastrectomy and adequate lymph node dissection. However, the optimal timing for initiating AT is still unclear. Method: We collected data from 538 patients with stage II-III gastric cancer who underwent curative gastrectomy and AT in two tertiary hospitals from 2006 to 2013. Patients were divided into the early group (≤8 weeks, n=393) and the late group (>8 weeks, n=145), based on the interval between gastrectomy and initiation of AT. Propensity score matching was applied according to baseline characteristics. Results: After 1:1 propensity score matching, an even distribution of characteristics in both groups (143:143) was achieved. The 5-year overall survival (OS) rates were 56.6% and 40.2% in the matched early and late groups, respectively (p=0.062), while the corresponding 5-year recurrence-free survival (RFS) rates were 57.6% and 46.4%, respectively (p=0.028). The time to AT initiation was correlated with RFS and had a positive association with OS. The 5-year distant metastasis-free survival was also significantly better (HR 0.682, 95% CI 0.472-0.985, p=0.040), suggesting an early AT results in a better outcome in patients. Conclusion: We observed that initiation of AT within 8 weeks of curative gastrectomy produces better disease control and may contribute to better overall survival. |
URI: | https://scholars.lib.ntu.edu.tw/handle/123456789/637077 | ISSN: | 1837-9664 | DOI: | 10.7150/jca.27753 |
顯示於: | 醫學院附設醫院 (臺大醫院) |
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