The role of chemotherapy in patients with stage IB gastric adenocarcinoma: a real-world competing risk analysis

• Published in: World journal of surgical oncology Vol. 20; no. 1; p. 123
• Main Authors: Xie, Yangyang, Du, Danwei, Song, Xue, Li, Xiaowen, Ni, Zhongkai, Huang, Hai
• Format: Journal Article
• Language: English
• Published: England BioMed Central Ltd 17.04.2022; BioMed Central; BMC
• Subjects: Adenocarcinoma; Adenocarcinoma - pathology; Adjuvant treatment; Age; Cancer; Cancer therapies; Chemotherapy; Chemotherapy, Adjuvant; Clinical trials; Competing risk analysis; Development and progression; Diagnosis; Epidemiology; Gastric cancer; Gastrointestinal surgery; Humans; Medical prognosis; Metastasis; Neoplasm Staging; Patient outcomes; Patients; Propensity Score; Radiation; Regression analysis; Regression models; Risk analysis; Risk Assessment; SEER Program; Software; Stage IB gastric cancer; Stomach cancer; Stomach Neoplasms - pathology; Survival; Survival analysis; China; Competing risk analysis; Stage IB gastric cancer; Chemotherapy
• ISSN: 1477-7819; 1477-7819
• DOI: 10.1186/s12957-022-02591-5

This study aimed to investigate the potential effect of adjuvant chemotherapy in patients diagnosed with stage IB gastric adenocarcinoma (GAC). A total of 1727 patients were included in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 and divided into the chemotherapy and no-chemotherapy groups. Then, the methods of Kaplan-Meier analysis, propensity score matching (PSM), and competing risk analysis were implemented. After PSM, no significant difference was found in the chemotherapy and no-chemotherapy groups in overall survival (OS) (p=0.4) and cancer-specific survival (CSS) (p=0.12) in survival curves. The competing risk analysis presented that the 5-year cumulative incidence of cancer-specific death (CSD) was significantly lower in patients receiving chemotherapy (11.5% vs. 20.8%, p=0.007), while no significant discrepancy was observed in other causes of death (OCD) in both groups (10.6% vs. 10.9%, p=0.474). Multivariable competing risks regression models presented a significant correlation between chemotherapy and CSD (HR, 0.51; 95%CI, 0.31-0.82; p=0.007). The stage IB GAC patients can benefit from adjuvant chemotherapy based on this competing risk analysis.