文章：

局部晚期胃腺癌新辅助放化疗：长期结果及预测个体复发风险的统计算法

Neoadjuvant Chemoradiotherapy in Locally Advanced Gastric Adenocarcinoma: Long-Term Results and Statistical Algorithm to Predict Individual Risk of Relapse

原文发布日期：30 April 2025

DOI: 10.3390/cancers17091530

类型: Article

开放获取: 是

英文摘要：

Background: The purpose of this study was to evaluate the long-term outcomes of patients with locally advanced gastric adenocarcinoma (LAGC) intended to receive induction chemotherapy, chemoradiation and surgery and to develop an algorithm to estimate the individual risk of relapse in a population-based setting. Methods: Patients with LAGC (cT3-4 and/or N+) were retrospectively evaluated. A pathological response was graded according to the Becker criteria. The nodal regression grade was assessed by a 4-point scale (A–D). A comprehensive analysis of 155 individual patient variables was performed, and logistic regression (LR) was utilized to develop a predictive model for relapse risk. Results: From 2010 to 2024, 48 patients were analyzed. After a median follow-up of 49 months (range, 12–212), the 5-year actuarial PFS and OS rates were 44% and 48%, respectively. Four variables were identified as the most relevant features for training the LR model. Scores for the model accuracy, sensitivity and specificity (mean +/− sd) were 0.79 +/− 0.12, 0.74 +/− 0.221 and 0.88 +/− 0.14, respectively. For a validation dataset, the figures were 0.78, 0.88 and 0.73, respectively. Conclusions: This neoadjuvant strategy seems to correlate with a favorable long-term outcome in a subset of intestinal-type LAGA patients who achieve ypN0 features.

摘要翻译： 

背景：本研究旨在评估拟接受诱导化疗、放化疗及手术的局部进展期胃腺癌（LAGC）患者的长期预后，并基于人群数据构建个体复发风险预测模型。方法：回顾性分析LAGC（cT3-4和/或N+）患者病例。病理反应依据Becker标准分级，淋巴结消退程度采用四级量表（A–D）评估。通过对155项患者变量进行综合分析，运用逻辑回归（LR）构建复发风险预测模型。结果：2010年至2024年间共纳入48例患者分析。中位随访49个月（范围12-212个月）后，5年精算无进展生存率（PFS）与总生存率（OS）分别为44%和48%。研究确定四项变量为训练LR模型的核心特征，模型准确度、灵敏度及特异度评分（均值±标准差）分别为0.79±0.12、0.74±0.221和0.88±0.14。验证数据集对应指标分别为0.78、0.88和0.73。结论：对于达到ypN0状态的肠型LAGA患者亚群，该新辅助治疗策略与良好的长期预后存在相关性。

原文链接：

Neoadjuvant Chemoradiotherapy in Locally Advanced Gastric Adenocarcinoma: Long-Term Results and Statistical Algorithm to Predict Individual Risk of Relapse