| 陈 航,黄兴茂,陈 晗,等.围手术期化疗对比术后辅助化疗治疗局部进展期胃食管结合部腺癌疗效的研究——基于倾向性评分匹配分析[J].肿瘤学杂志,2025,31(5):435-442. |
| 围手术期化疗对比术后辅助化疗治疗局部进展期胃食管结合部腺癌疗效的研究——基于倾向性评分匹配分析 |
| Efficacy of Perioperative Chemotherapy and Postoperative Chemotherapy for Patients with Locally Advanced Adenocarcinoma of Esophagogastric Junction： A Propensity Score Matching Analysis |
| 投稿时间：2024-10-14 |
| DOI：10.11735/j.issn.1671-170X.2025.05.B009 |
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| 中文关键词: 胃肿瘤 胃食管结合部腺癌 药物疗法 围手术期化疗 术后辅助化疗 预后 |
| 英文关键词:gastric neoplasms adenocarcinoma of esophagogastric junction drug therapy periope-rative chemotherapy postoperative chemotherapy prognosis |
| 基金项目:浙江省卫生健康创新人才项目（2021KY103） |
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| 摘要点击次数: 10 |
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| 中文摘要: |
| 摘 要：［目的］ 探讨围手术期化疗和术后辅助化疗对局部进展期胃食管结合部腺癌（adenocarcinoma of esophagogastric junction，AEG）患者的临床疗效及预后影响因素。［方法］ 回顾性分析2014年1月至2022年12月浙江省肿瘤医院收治的357例局部进展期AEG患者的临床资料。根据治疗方案分为围手术期化疗组（A组，n=112）和术后辅助化疗组（B组，n=245），通过倾向性评分匹配后共纳入200例患者，A组和B组各100例，比较不同治疗方案的疗效及对预后的影响。［结果］ A组和B组的3年总生存率（overall survival，OS）分别为70.70%和72.80%，5年OS分别为62.70%和62.30%，差异均无统计学意义（P均>0.05）。两组共有46例患者行纵隔淋巴结清扫，行纵隔淋巴结清扫患者的生存率与未行纵隔淋巴结清扫患者比较差异无统计学意义（3年OS：82.70% vs 69.10%，5年OS：72.30% vs 61.00%，P均>0.05）。多因素分析表明脉管癌栓和R0切除是影响局部进展期AEG患者生存的独立危险因素。［结论］ 相比较术后辅助化疗，围手术期化疗未能有效改善局部进展期AEG患者的总体生存率。纵隔淋巴结的清扫也没有带来生存获益。 |
| 英文摘要: |
| Abstract： ［Objective］ To evaluate the efficacy of perioperative chemotherapy and postoperative adjuvant chemotherapy in patients with locally advanced adenocarcinoma of esophagogastric junction (AEG). ［Methods］ The clinical data of 357 patients with locally advanced AEG admitted to Zhejiang Cancer Hospital from January 2014 to December 2022 were retrospectively analyzed， including 112 cases receiving perioperative chemotherapy (Group A) and 245 cases receiving postoperative adjuvant chemotherapy (Group B). After propensity score matching， a total of 200 patients were included， with 100 patients in each group， and the efficacy and prognosis of different treatment regimens were compared. ［Results］ The 3-year and 5-year overall survival(OS) of group A and group B was 70.70%， 62.70% and 72.80%， 62.30%， respectively (P all>0.05). Forty six patients in each group underwent mediastinal lymph node dissection， and there was no significant difference in 3-year and 5-year OS between patients with or without mediastinal lymph node dissection (3-year OS： 82.70% vs 69.10%， 5-year OS： 72.30% vs 61.00%， P all>0.05). Multivariate analysis showed that vascular tumor thrombus and R0 resection were independent risk factors for survival of patients. ［Conclusion］ Compared to postoperative adjuvant chemotherapy， perioperative chemotherapy does not prolong the survival of patients with locally advanced AEG， and there is no survival benefit from mediastinal lymph node dissection. |
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