Postoperative dynamic survival of gastric cancer patients: A multi‐institutional, international analysis of 22 265 patients

Abstract

Background: How to best evaluate the disease-specific survival (DSS) of gastric cancer (GC) survivors over time is unclear.Methods: Clinicopathological data from 22 265 patients who underwent curative intend resection for GC were retrospectively analyzed. Changes in the patients'3-year conditional disease-specific survival (CS3) were analyzed. We used timedependent Cox regression to analyze which variables had long-term effects on DSS and devised a dynamic predictive model based on the length of survival.Results: Based on 1-, 3-, and 5-year survivorships, the CS3 of the population increased gradually from 62% to 68.1%, 83.7%, and 90.6%, respectively. Subgroup analysis showed that the CS3 of patients who had poor prognostic factors initially demonstrated the greatest increase in postoperative survival time (eg, N3b: 26.6%-84.1%, Δ57.5% vs N0: 84.1%-93.3%, Δ9.2%). Timedependent Cox regression analysis showed the following predictor variables constantly affecting DSS: age, the number of examined lymph nodes (LNs), T stage, N stage, and site (P < .05). These variables served as the basis for a dynamic prediction model. Wang JB, Zhong Q contributed equally to this work and should be considered co-first authors. Conclusions: The influence of prognostic factors on DSS and CS3 changed dramatically over time. We developed an effective model for predicting the DSS of patients with GC based on the length of survival time. K E Y W O R D S conditional survival, disease-specific survival, gastric cancer, length of survivorship, predictive model SUPPORTING INFORMATION Additional supporting information may be found online in the Supporting Information section. How to cite this article: Wang J-B, Zhong Q, Wang W, et al. Postoperative dynamic survival of gastric cancer patients: A multi-institutional, international analysis of 22 265 patients. J

Prospective, observational, multicenter study on minimally invasive gastrectomy for gastric cancer: robotic, laparoscopic and open surgery compared on operative and follow-up outcomes - IMIGASTRIC II study protocol: IMIGASTRIC II

“…The most important issue is ensuring proper oncological surgery by performing an adequate lymphadenectomy with minimally invasive approaches. Researchers still regard nodal clearance as an important factor in uencing long-term survival [6][7][8][9][10][11][12][13]. In randomized trials [3], laparoscopy demonstrated the removal of at least 15 lymph nodes, as required by international guidelines [14]; however, a signi cant difference in favor of open surgery resulted in the total number of lymph nodes harvested.…”