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Published in: BMC Cancer 1/2023

Open Access 01-12-2023 | Gastric Cancer | Research

Evaluation of dynamic recurrence risk for locally advanced gastric cancer in the clinical setting of adjuvant chemotherapy: a real-world study with IPTW-based conditional recurrence analysis

Authors: Dong Wu, Jun Lu, Zhen Xue, Qing Zhong, Bin-bin Xu, Hua-Long Zheng, Guo-sheng Lin, Li-li Shen, Jia Lin, Jiao-bao Huang, Davit Hakobyan, Ping Li, Jia-Bin Wang, Jian-Xian Lin, Qi-Yue Chen, Long-Long Cao, Jian-Wei Xie, Chang-Ming Huang, Chao-Hui Zheng

Published in: BMC Cancer | Issue 1/2023

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Abstract

Background

The long-term dynamic recurrence hazard of locally advanced gastric cancer (LAGC) in the clinical setting of adjuvant chemotherapy (ACT) remains unclear.

Purpose

This study aimed to investigate the dynamic recurrence risk of LAGC in patients who received ACT or not.

Methods

The study assessed data from patients with LAGC who underwent radical gastrectomy between January, 2010 and October, 2015. Inverse probability of treatment weighting (IPTW) was performed to reduce selection bias between the ACT and observational (OBS) groups. Conditional recurrence-free survival (cRFS) and restricted mean survival time (RMST) were used to assess the survival differences.

Results

In total, 1,661 LAGC patients were included (ACT group, n = 1,236 and OBS group, n = 425). The recurrence hazard gradually declined; in contrast, cRFS increased with RFS already accrued. Following IPTW adjustment, the cRFS rates were higher in the ACT group than those in the OBS group for patients at baseline or with accrued RFS of 1 and 2 years (p˂0.05). However, the cRFS rates of the ACT group were comparable with those of the OBS group for patients with accrued RFS of 3 or more years (p > 0.05). Likewise, the 5-year △RMST between the ACT and OBS groups demonstrated a similar trend. Moreover, the hematological metastasis rate of the ACT group was significantly lower than that of the OBS group for patients at baseline or with accrued RFS of 1 and 2 years, respectively (p˂0.05).

Conclusions

Although ACT could provide substantial benefits for patients with LAGC, the differences in recurrence hazard between the ACT and OBS groups may attenuate over time, which could help guide surveillance and alleviate patients’ anxiety. Further prospective large-scale studies are warranted.
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Metadata
Title
Evaluation of dynamic recurrence risk for locally advanced gastric cancer in the clinical setting of adjuvant chemotherapy: a real-world study with IPTW-based conditional recurrence analysis
Authors
Dong Wu
Jun Lu
Zhen Xue
Qing Zhong
Bin-bin Xu
Hua-Long Zheng
Guo-sheng Lin
Li-li Shen
Jia Lin
Jiao-bao Huang
Davit Hakobyan
Ping Li
Jia-Bin Wang
Jian-Xian Lin
Qi-Yue Chen
Long-Long Cao
Jian-Wei Xie
Chang-Ming Huang
Chao-Hui Zheng
Publication date
01-12-2023
Publisher
BioMed Central
Published in
BMC Cancer / Issue 1/2023
Electronic ISSN: 1471-2407
DOI
https://doi.org/10.1186/s12885-023-11143-3

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