Dataset Information

Different prognostic implication of ypTNM stage and pTNM stage for gastric cancer: a propensity score-matched analysis.

ABSTRACT:

Background

Pathological stage is considered as the best prognosis indicator for gastric cancer. With the increasing use of neoadjuvant chemotherapy (NACT), the latest TNM staging included a new pathological stage of ypTNM for patients with NACT. However, no study has investigated if ypTNM stage has the same prognostic implication as pTNM stage for gastric cancer.

Methods

We retrospectively selected eligible patients within a prospectively maintained database containing all patients treated with gastric cancer in Peking University Cancer Hospital from 2007 to 2015 using overall survival as the outcome. Patients using ypTNM and pTNM were 1:1 matched by propensity scores (PS) calculated from a model containing variables associated with ypTNM use or survival. Overall survival was compared by unconditional Cox regression. Conventional multivariate analysis was conducted to corroborate PS matching results.

Results

1441 patients were included in the analysis with a median follow-up of 37?months (range?=?2-106). The matched sample contained 756 patients. After PS matching, patients with specific ypTNM stage were 1.34 (95%CI?=?1.05-1.72, P?=?0.019) times more likely to die than patients with the same pTNM stage. Similar to the results of PS matching, multivariate Cox regression yielded a hazard ratio (HR) of 1.35 (95%CI?=?1.09-1.67, P?=?0.006). Subgroup analysis indicated this survival difference between ypTNM and pTNM stage varied by the specific TNM stage of patients. The HR was 3.44 (95%CI?=?1.06-11.18, P?=?0.040) and 1.28 (95%CI?=?1.00-1.62, P?=?0.048) for patients in stage I and III, respectively; whereas for stage II patients, no significant difference was observed (HR?=?1.37, 95%CI?=?0.78-2.38, P?=?0.27).

Conclusion

Gastric cancer patients with specific ypTNM stage had worse prognosis compared to those at the same stage defined by pTNM.

SUBMITTER: Li Z

PROVIDER: S-EPMC6335703 | biostudies-literature | 2019 Jan

REPOSITORIES: biostudies-literature

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Publications

Different prognostic implication of ypTNM stage and pTNM stage for gastric cancer: a propensity score-matched analysis.

Li Ziyu Z Wang Yinkui Y Ying Xiangji X Shan Fei F Wu Zhouqiao Z Zhang Lianhai L Li Shuangxi S Jia Yongning Y Ren Hui H Ji Jiafu J

BMC cancer 20190116 1

<h4>Background</h4>Pathological stage is considered as the best prognosis indicator for gastric cancer. With the increasing use of neoadjuvant chemotherapy (NACT), the latest TNM staging included a new pathological stage of ypTNM for patients with NACT. However, no study has investigated if ypTNM stage has the same prognostic implication as pTNM stage for gastric cancer.<h4>Methods</h4>We retrospectively selected eligible patients within a prospectively maintained database containing all patient ...[more]

PMID: 30651085

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Project description:BackgroundWhether young patients with metastatic gastric cancer (GC) had distinct metastasis patterns and survival outcomes from older patients remains controversial. The aim of the present study was to explore the metastasis patterns and prognostic factors in young patients and evaluate the survival outcome in comparison to their older counterparts.Materials and methodsWe identified patients with metastatic GC in the surveillance, epidemiology, and end results (SEER) database from 2010 to 2015. The patients were divided into two groups based on age at diagnosis: younger (≤40 years old) and older (>40 years old). We employed the chi-squared test to compare the clinicopathological characteristics between the two age groups. Furthermore, we conducted survival analyses using Kaplan-Meier and Cox regression analyses. To balance disparities in baseline characteristics, we employed propensity score matching (PSM).ResultsWe identified 5,580 metastatic GC patients from the SEER database, with 237 (4.2%) classified as younger and 5343 (95.8%) as older patients. A total of 237 pairs of patients were generated after adjustment by PSM. Patients in the younger group exhibited a higher proportion of bone-only metastases and a lower proportion of liver-only metastases compared with patients in the older group. Multivariate Cox regression analysis demonstrated that youth was an independent protective factor for overall survival (OS) before and after PSM, but not for gastric cancer-specific survival (GCSS). Among the younger group, patients with liver-only metastasis demonstrated the best prognosis, whereas patients with lung-only metastasis exhibited significantly worse survival outcomes compared with liver-only metastases, even comparable to that of bone metastasis.ConclusionsCompared with the older group, the metastatic GC patients in the younger group exhibited more aggressive tumors but better prognoses. The metastasis pattern and its effect on the prognosis of GC varied by age group.

Dataset Information

Different prognostic implication of ypTNM stage and pTNM stage for gastric cancer: a propensity score-matched analysis.

Background

Methods

Results

Conclusion

Publications

Different prognostic implication of ypTNM stage and pTNM stage for gastric cancer: a propensity score-matched analysis.

Similar Datasets

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