膀胱腺癌姑息化疗的疗效:一项多中心队列研究

IF 3.4 3区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY Gut and Liver Pub Date : 2024-07-15 Epub Date: 2023-12-22 DOI:10.5009/gnl230164
Dong Kee Jang, So Jeong Kim, Hwe Hoon Chung, Jae Min Lee, Seung Bae Yoon, Jong-Chan Lee, Dong Woo Shin, Jin-Hyeok Hwang, Min Kyu Jung, Yoon Suk Lee, Hee Seung Lee, Joo Kyung Park
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引用次数: 0

摘要

背景/目的: :晚期瓦特氏腺癌(AA)患者的姑息化疗(PC)尚未标准化。这项多中心回顾性研究评估了AA患者的一线PC疗效:2010年1月至2020年12月期间确诊为AA并接受PC治疗的患者来自10家医疗机构。根据化疗方案分析总生存期(OS)和无进展生存期(PFS):255名患者(平均年龄为64.0±10.0岁,男性占57.6%)中,14人(5.5%)为局部晚期AA,241人(94.5%)为转移性AA。192名患者(75.3%)接受了吉西他滨加顺铂(GP)一线化疗,39名患者(15.3%)接受了卡培他滨加奥沙利铂(CAPOX)一线化疗。所有患者的中位OS为19.8个月(95%置信区间[CI],17.3至22.3),接受GP和CAPOX治疗的患者的中位OS分别为20.4个月(95%置信区间[CI],17.2至23.6)和16.0个月(95%置信区间[CI],11.2至20.7)。GP和CAPOX患者的中位PFS分别为8.4个月(95% CI,7.1至9.7)和5.1个月(95% CI,2.5至7.8)。与包括AA的传统胆管癌相比,PC治疗AA患者的OS和PFS中位预后均有所改善:尽管之前的研究显示,将AA与其他胆管癌放在一起分析时,预后结果不一,但我们的研究揭示了AA在大规模全身抗癌治疗中的独特临床预后。这些研究结果表明,AA是一种有别于其他胆道癌的独特肿瘤类型,AA本身有望对PC产生良好的反应。
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Outcomes of Palliative Chemotherapy for Ampulla of Vater Adenocarcinoma: A Multicenter Cohort Study.

Background/aims: : Palliative chemotherapy (PC) is not standardized for patients with advanced ampulla of Vater adenocarcinoma (AA). This multicenter, retrospective study evaluated first-line PC outcomes in patients with AA.

Methods: : Patients diagnosed with AA between January 2010 and December 2020 who underwent PC were enrolled from 10 institutions. Overall survival (OS) and progression-free survival (PFS) according to the chemotherapy regimen were analyzed.

Results: : Of 255 patients (mean age, 64.0±10.0 years; male, 57.6%), 14 (5.5%) had locally advanced AA and 241 (94.5%) had metastatic AA. Gemcitabine plus cisplatin (GP) was administered as first-line chemotherapy to 192 patients (75.3%), whereas capecitabine plus oxaliplatin (CAPOX) was administered to 39 patients (15.3%). The median OS of all patients was 19.8 months (95% confidence interval [CI], 17.3 to 22.3), and that of patients who received GP and CAPOX was 20.4 months (95% CI, 17.2 to 23.6) and 16.0 months (95% CI, 11.2 to 20.7), respectively. The median PFS of GP and CAPOX patients were 8.4 months (95% CI, 7.1 to 9.7) and 5.1 months (95% CI, 2.5 to 7.8), respectively. PC for AA demonstrated improved median outcomes in both OS and PFS compared to conventional bile duct cancers that included AA.

Conclusions: : While previous studies have shown mixed prognostic outcomes when AA was analyzed together with other biliary tract cancers, our study unveils a distinct clinical prognosis specific to AA on a large scale with systemic anticancer therapy. These findings suggest that AA is a distinct type of tumor, different from other biliary tract cancers, and AA itself could be expected to have a favorable response to PC.

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来源期刊
Gut and Liver
Gut and Liver 医学-胃肠肝病学
CiteScore
7.50
自引率
8.80%
发文量
119
审稿时长
6-12 weeks
期刊介绍: Gut and Liver is an international journal of gastroenterology, focusing on the gastrointestinal tract, liver, biliary tree, pancreas, motility, and neurogastroenterology. Gut and Liver delivers up-to-date, authoritative papers on both clinical and research-based topics in gastroenterology. The Journal publishes original articles, case reports, brief communications, letters to the editor and invited review articles in the field of gastroenterology. The Journal is operated by internationally renowned editorial boards and designed to provide a global opportunity to promote academic developments in the field of gastroenterology and hepatology. Gut and Liver is jointly owned and operated by 8 affiliated societies in the field of gastroenterology, namely: the Korean Society of Gastroenterology, the Korean Society of Gastrointestinal Endoscopy, the Korean Society of Neurogastroenterology and Motility, the Korean College of Helicobacter and Upper Gastrointestinal Research, the Korean Association for the Study of Intestinal Diseases, the Korean Association for the Study of the Liver, the Korean Pancreatobiliary Association, and the Korean Society of Gastrointestinal Cancer.
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