The role of chemotherapy in patients with stage IB gastric adenocarcinoma: a real-world competing risk analysis

World J Surg Oncol. 2022 Apr 17;20(1):123. doi: 10.1186/s12957-022-02591-5.

Abstract

Background: This study aimed to investigate the potential effect of adjuvant chemotherapy in patients diagnosed with stage IB gastric adenocarcinoma (GAC).

Method: A total of 1727 patients were included in the Surveillance, Epidemiology, and End Results (SEER) database from 2004 to 2015 and divided into the chemotherapy and no-chemotherapy groups. Then, the methods of Kaplan-Meier analysis, propensity score matching (PSM), and competing risk analysis were implemented.

Results: After PSM, no significant difference was found in the chemotherapy and no-chemotherapy groups in overall survival (OS) (p=0.4) and cancer-specific survival (CSS) (p=0.12) in survival curves. The competing risk analysis presented that the 5-year cumulative incidence of cancer-specific death (CSD) was significantly lower in patients receiving chemotherapy (11.5% vs. 20.8%, p=0.007), while no significant discrepancy was observed in other causes of death (OCD) in both groups (10.6% vs. 10.9%, p=0.474). Multivariable competing risks regression models presented a significant correlation between chemotherapy and CSD (HR, 0.51; 95%CI, 0.31-0.82; p=0.007).

Conclusion: The stage IB GAC patients can benefit from adjuvant chemotherapy based on this competing risk analysis.

Keywords: Chemotherapy; Competing risk analysis; Stage IB gastric cancer.

MeSH terms

  • Adenocarcinoma* / pathology
  • Chemotherapy, Adjuvant
  • Humans
  • Neoplasm Staging
  • Propensity Score
  • Risk Assessment
  • SEER Program
  • Stomach Neoplasms* / pathology