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首页> 外文期刊>Gastric cancer: official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association >Selective survival advantage associated with primary tumor resection for metastatic gastric cancer in a Western population
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Selective survival advantage associated with primary tumor resection for metastatic gastric cancer in a Western population

机译：西方人人群中转移胃癌原发性肿瘤切除相关的选择性存活优势

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Abstract Background The prognosis of metastatic gastric cancer (GC) remains dismal, with a median survival of 10?months. Historically, primary tumor resection was not thought to confer any survival benefit. Although high-level data exist guiding treatment of metastatic GC for patients in the East, no such data exist for Western patients despite inherent ethnic differences in GC biology. Methods The 2006–2012 National Cancer Database was queried for adult patients with metastatic gastric adenocarcinoma. Patients were classified into those who underwent primary tumor resection and chemotherapy (PTRaC) and those who received chemotherapy only. Groups were propensity score matched, and survival was compared using advanced statistical modeling. Results A total of 7026 patients met the inclusion criteria: 6129 (87%) patients were treated with chemotherapy alone and 897 (13%) patients were treated with PTRaC. After multivariable adjustment, patients who underwent PTRaC had a significantly better overall survival (OS) than patients who received systemic therapy only (HR, 0.60; 95% CI, 0.56–0.64; p ? p ? Conclusion Our data suggest that there exists a subset of patients with metastatic GC for which PTRaC may improve OS. As significant uncertainty still remains, our results support the need for further prospective trials investigating the influence of palliative gastrectomy on survival among Western patients.
机译：摘要背景转移性胃癌（GC）的预后仍然令人沮丧，中位存活率为10？数月。从历史上看，原发性肿瘤切除未被认为赋予任何生存效果。虽然在东部的患者中存在高级数据治疗转移性GC，但除了GC生物学中固有的民族差异，仍然没有为西方患者存在这些数据。方法针对成年患者询问2006-2012国家癌症数据库，用于转移性胃腺癌的成人患者。患者被分类为患者接受原发性肿瘤切除和化疗（PTRAC）的那些，以及仅接受化疗的人。群体是倾向得分匹配，并使用先进的统计建模比较生存。结果共有7026名患者达到纳入标准：6129（87％）患者单独用化疗治疗，897名（13％）患者用Ptrac治疗。经过多变的调整后，接受PTRAC的患者比仅接受全身治疗的患者具有显着更好的整体存活（OS）（HR，0.60; 95％CI，0.56-0.64; P？P？结论我们的数据表明存在子集转移GC的患者可以改善OS。随着显着的不确定性仍然存在，我们的结果支持需要进一步的前瞻性试验，调查姑息性胃切除术对西方患者的生存的影响。

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