中国普通外科杂志2024，Vol.33Issue(7)：1133-1141,9.DOI:10.7659/j.issn.1005-6947.2024.07.012
手术治疗对胃鳞状细胞癌患者预后的影响:基于SEER数据库的倾向评分匹配分析
Impact of surgical treatment on the prognosis of gastric squamous cell carcinoma patients:a propensity score matching analysis based on the SEER database
摘要
Abstract
Background and Aims:Gastric squamous cell carcinoma(GSCC)is a rare malignant tumor of the stomach.There is a lack of large-scale clinical data studies on this patient population,and the prognostic value of surgical treatment remains unclear.Therefore,this study was conducted to investigate the impact of surgical treatment on the prognosis of GSCC patients. Methods:The clinical data of GSCC patients pathologically diagnosed between 2000 and 2019 were extracted from the SEER database.The impact of surgical treatment on the overall survival(OS)and cancer-specific survival(CSS)of GSCC patients were analyzed,and the influencing factors for OS and CSS,as well as the value of surgical treatment for GSCC patients with different clinicopathologic characteristics,were determined. Results:A total of 334 GSCC patients were included,among whom 83(24.85％)underwent surgical treatment,while 251(75.15％)did not.After 1:1 propensity score matching to balance baseline data,each group consisted of 81 patients.Survival analysis showed that the 5-year OS rate(32.07％vs.11.08％,x2=20.30,P＜0.001)and CSS rate(41.93％vs.18.45％,x2=17.10,P＜0.001)in the surgery group were significantly better than those in the non-surgery group.Cox multivariate analysis indicated that marital status,pathological differentiation,SEER stage,surgical treatment,and radiotherapy were independent factors for OS and CSS in GSCC patients(all P＜0.05).Further stratified analysis based on clinicopathologic characteristics showed that the OS was significantly improved in those married(HR=0.42,95％CI=0.251-0.70,P=0.001),with highly differentiated tumor(HR=0.09,95％CI=0.01-0.84,P=0.035),with localized tumor(HR=0.33,95％CI=0.17-0.65,P=0.001),and receiving radiotherapy(HR=0.35,95％CI=0.21-0.58,P＜0.001)who underwent surgery.Similarly,CSS was significantly improved in those married(HR=0.44,95％CI=0.25-0.78,P=0.005),with highly differentiated tumor(HR=0.09,95％CI=0.01-0.84,P=0.035),with localized tumor(HR=0.34,95％CI=0.15-0.75,P=0.007),and receiving radiotherapy(HR=0.31,95％CI=0.18-0.55,P＜0.001)who underwent surgery. Conclusion:Surgical treatment can effectively improve the prognosis of GSCC patients.Particularly,those who are married,have highly differentiated tumors and localized tumors,and receive radiotherapy are the best beneficiaries of surgical treatment.关键词
胃肿瘤/癌,鳞状细胞/外科手术/预后/SEER规划/倾向性评分Key words
Stomach Neoplasms/Carcinoma,Squamous Cell/Surgical Procedures,Operative/Prognosis/SEER Program/Pro-pensity Score分类
医药卫生引用本文复制引用
陈鑫明,赵平武,唐红,何运胜,彭宣福,黄坤,赵攀,刘洋..手术治疗对胃鳞状细胞癌患者预后的影响:基于SEER数据库的倾向评分匹配分析[J].中国普通外科杂志,2024,33(7):1133-1141,9.基金项目
四川省中医药管理局科学技术研究专项基金资助项目(2021MS268). （2021MS268）
