Prognosis of Young Survivors of Gastric Cancer in China and the U.S.: Determining Long-Term Outcomes Based on Conditional Survival

The oncologist

article

Qi-Yue Chen¹  Long-Long Cao¹  Mi Lin¹  Ru-Hong Tu¹  Ze-Ning Huang¹  Ju-Li Lin¹  Hua-Long Zheng¹  Zhi-Yu Liu¹  Chao-Hui Zheng¹  Jun-Sheng Peng³  Zhi-Wei Zhou⁴  Qing Zhong¹  Chang-Ming Huang¹  Wei Wang⁴  Shi Chen³  Ping Li¹  Jian-Wei Xie¹  Jia-Bing Wang¹  Jian-Xian Lin¹  Jun Lu¹ 

[1] Department of Gastric Surgery, Fujian Medical University Union Hospital;Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University;Department of Esophageal and Gastrointestinal Surgery, The Sixth Hospital Affiliated to Sun Yat-Sen University, Sun Yat-Sen University Research Center of Diagnosis and Treatment of Gastric Cancer;Department of Gastric Surgery, Sun Yat-sen University Cancer Center

关键词: Gastric cancer;    Young survivors;    Conditional survival;    China;    U.S.;   

DOI  :  10.1634/theoncologist.2018-0220

学科分类：地质学

来源: AlphaMed Press Incorporated

【 摘 要 】

Background Young survivors of gastric cancer (GC) have better prognoses than elderly patients, yet their disease-specific survival (DSS) has received little attention. Patients and Methods Data on young patients (aged ≤40 years) with GC undergoing resections at three Chinese institutions ( n = 542) and from the SEER database ( n = 533) were retrospectively analyzed. Three-year conditional disease-specific survival (CS3) was assessed. The effects of well-known prognostic factors over time were analyzed by time-dependent Cox regression. Results Overall, young Chinese patients with GC had a better 5-year DSS than U.S. patients (62.8% vs. 54.1%; p .05). Cox regression showed that for Chinese patients, site, size, T stage, and N stage were independent prognostic factors at baseline ( p .05). Although the 5-year DSS rates of young Chinese patients with T3 and T4a disease were significantly better than those of young U.S. patients, in each T stage, the CS3 of both regions trended toward consistency over time. Conclusion For young patients with GC, the factors that predict survival at baseline vary over time. Although the initial 5-year DSS is heterogeneous, insight into conditional survival will help clinicians evaluate the long-term prognoses of survivors while ignoring population differences. Implications for Practice With the increasing number of young survivors of gastric cancer (GC), it is essential for clinicians to understand the dynamic prognosis of these patients. Based on large data sets from China and the U.S., this study found that the prognostic factors that predict survival for young patients with GC at baseline vary over time. Although the initial 5-year disease-specific survival is heterogeneous, insight into conditional survival will help clinicians evaluate the long-term prognoses of survivors while ignoring population differences. This knowledge may be more effective in helping young patients with GC to manage future uncertainties, especially when they need to make important life plans.

【 授权许可】

CC BY|CC BY-NC