中国实用外科杂志2024，Vol.44Issue(1)：89-97,9.DOI:10.19538/j.cjps.issn1005-2208.2024.01.15
基于真实世界数据的胃癌肝转移全国多中心回顾性队列研究(RECORD研究)年度报告
Annual report of a multi-centered retrospective cohort study of treatment and prognosis of gastric cancer liver metastasis based on real-world data
摘要
Abstract
Objective To explore and describe the global clinicopathological features,treatment,clinical classification and prognosis of patients with gastric cancer liver metastasis across China under real-world condition.Methods A retrospectively-established database was built to collect real-world gastric cancer liver metastasis(GCLM)cases from 10 gastric cancer comprehensive treatment institutions including Chinese PLA General Hospital,Shandong Provincial Hospital Affiliated to Shandong First Medical University,etc.The inclusion criteria of this study were as follows:(1)aged from 18-and 80-year old;(2)patients diagnosed with gastric cancer by endoscopic biopsy or surgical pathology;hepatic metastases indicated by imaging or biopsy;(3)in-hospital patients between January 2010 and December 2019.The exclusion criteria were:(1)cases diagnosed with other neoplasms simultaneously or in the previous 5 years;(2)cases with poor performance score(ECOG＞3)or life expectance less than 1 month;(3)cases with insufficient data for analysis.Results Finally,1901 patients diagnosed with gastric cancer liver metastasis were included in this study with initially unresectable(type Ⅲ)patients accounting for more than half of the total population(type Ⅰ:368 patients,19.4％;typeⅡ:475 patients,25.0％;type Ⅲ:1058 patients,55.6％).Most patients were male(82.2％)and the median age was 62 years[interquartile range(IQR)54-68].Synchronic liver metastasis accounted for the vast majority population(1512 cases,80.1％).The most frequent primary location of tumor was the distal stomach(36.7％)compared with the proximal(29.3％)and middle stomach(24.1％).Moreover,the right hepatic lobe(20.5％)appeared to be a more vulnerable metastatic target compared with the left lobe(15.4％),while dispersed metastasis in all lobes(60.4％)was the main pattern.In general,the 1-and 3-year overall survival(OS)of gastric cancer patients with liver metastasis was 42.0％and 16.4％,respectively.And the 3-year OS of type Ⅰ,Ⅱ,and Ⅲ patients was 33.0％,24.5％,and 6.4％,respectively.Distinct survival differences were observed among the three groups(Log-rank test,P＜0.001).Multivariate Cox analysis demonstrated that the C-GCLM classification was an independent risk factor for prognosis(Type Ⅲ vs.Ⅰ,HR=2.35,95％CI 2.00-2.76,P＜0.001;type Ⅱ vs.Ⅰ,HR=1.29,95％CI 1.07-1.54,P=0.006).Conclusion At the time of the first diagnosis,the initially unresectable patients(C-GCLM Ⅲ)accounted for the majority of total patients with gastric cancer liver metastasis in China.Chemotherapy remains the cornerstone of systemic treatment model for patients with GCLM.The surgical interventions were more applied in initially resectable(type Ⅰ)and potentially resectable(type Ⅱ)C-GCLM patients.The Chinese consensus classification system of gastric cancer liver metastasis(C-GCLM)demonstrated excellent prognostic discrimination value,which may promote individualized therapy for such patients.关键词
胃癌/肝转移/胃癌肝转移中国专家共识分型(C-GCLM)系统/临床病理特征/总体生存率Key words
gastric cancer/liver metastasis/C-GCLM classification system/clinicopathological features/overall survival分类
医药卫生引用本文复制引用
高云鹤,王鑫鑫,汪学非,李国新,薛侃,臧潞,梁寒,黄昌明,陆俊,黄华,田艳涛,郗洪庆,李子禹,孙益红,李乐平,陈凛,商亮,唐兆庆,余江,卫勃,唐云,乔治,周静..基于真实世界数据的胃癌肝转移全国多中心回顾性队列研究(RECORD研究)年度报告[J].中国实用外科杂志,2024,44(1):89-97,9.基金项目
国家重点研发计划课题项目(No.2016YFC0905302,No.2017YFC0908305) （No.2016YFC0905302,No.2017YFC0908305）
国家自然科学基金项目(No.81972790,No.82273231,No.82073192) （No.81972790,No.82273231,No.82073192）
