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Impact of time from diagnosis to chemotherapy in advanced gastric cancer: A Propensity Score Matching Study to Balance Prognostic Factors

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World Journal of Gastrointestinal Oncology 2019年第1期11卷 28-38页

作者： Tsutomu Nishida Aya Sugimoto Ryo Tomita yu higaki Naoto Osugi Kei Takahashi Kaori Mukai Tokuhiro Matsubara Dai Nakamatsu Shiro Hayashi Masashi Yamamoto Sachiko Nakajima Koji Fukui Masami Inada Department of Gastroenterology Toyonaka Municipal Hospital

BACKGROUND It is unclear whether treatment delay affects the clinical outcomes of chemotherapy in advanced gastric cancer(A-GC).AIM To assess whether treatment delay affects the clinical outcomes of chemotherapy in A-GC.METHODS This single-center retrospective study examined consecutive patients with A-GC between April 2012 and July 2018. In total, 110 patients with stage Ⅳ A-GC who underwent chemotherapy were enrolled. We defined the wait time(WT) as the interval between diagnosis and chemotherapy initiation. We evaluated the influence of WT on overall survival(OS).RESULTS The mean OS was 303 d. The median WT was 17 d. We divided the patients into early and elective WT groups, with a 2-wk cutoff point. There were 46 and 64 patients in the early and elective WT groups, respectively. Compared with the elective WT group, the early WT group had significantly lower albumin(Alb)levels and higher neutrophil/lymphocyte ratios and C-reactive protein(CRP)levels but not a lower performance status. The elective WT group underwent more combination chemotherapy than did the early WT group. OS was different between the two groups(230 d vs 340 d, respectively). Multivariate analysis revealed that higher CRP levels, lower Alb levels and monotherapy were significantly related to a poor prognosis. To minimize potential selection bias,patients in the elective WT group were 1:1 propensity score matched with patients in the early WT group; no significant difference in OS was found(303 d vs 311 d, respectively, log-rank P = 0.9832).CONCLUSION A longer WT in patients with A-GC does not appear to be associated with a worse prognosis.

关键词： Advanced gastric cancer Waiting time Chemotherapy Prognosis Overall survival

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