Yao YH, Zhang H, Xiao Y, Liu ZT, Shi YY, Yu JY, Li Q, Cao BS. Systematic treatment in gastric cancer patients with overt bleeding: A propensity score matching analysis. World J Clin Oncol 2024; 15(9): 1177-1187 [DOI: 10.5306/wjco.v15.i9.1177]
Corresponding Author of This Article
Bao-Shan Cao, MD, Chief Physician, Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China. caobaoshan0711@aliyun.com
Research Domain of This Article
Gastroenterology & Hepatology
Article-Type of This Article
Clinical Trials Study
Open-Access Policy of This Article
This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Yan-Hong Yao, Yu Xiao, Zhen-Tao Liu, Jin-Yu Yu, Qian Li, Bao-Shan Cao, Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, Beijing 100191, China
Yan-Hong Yao, Bao-Shan Cao, Department of Cancer Center, Peking University Third Hospital, Beijing 100191, China
Hua Zhang, Yan-Yan Shi, Research Center of Clinical Epidemiology, Peking University Third Hospital, Beijing 100191, China
Author contributions: Cao BS and Yao YH conceived and designed the study; Yao YH, Liu ZT, Yu JY, Xiao Y and Li Q performed data collection; Yao YH and Zhang H performed statistical analysis; All the authors contributed to the data interpretation; Yao YH written the first draft of the manuscript; All the authors revised and edited the final manuscript.
Institutional review board statement: This study was approved by the Peking University Third Hospital Medical Science Research Ethics Committee (IRB00006761-M2023544).
Clinical trial registration statement: The study has been registered in clinicaltrials.gov. The registration identification number is NCT06522542.
Informed consent statement: A waiver of informed consent was granted by the Ethics Committee.
Conflict-of-interest statement: The authors declare that they have no conflicts of interest.
Data sharing statement: The datasets analyzed during the study are available from the corresponding author on reasonable request.
CONSORT 2010 statement: The authors have read the CONSORT 2010 statement, and the manuscript was prepared and revised according to the CONSORT 2010 statement.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Bao-Shan Cao, MD, Chief Physician, Department of Medical Oncology and Radiation Sickness, Peking University Third Hospital, No. 49 North Garden Road, Haidian District, Beijing 100191, China. caobaoshan0711@aliyun.com
Received: March 22, 2024 Revised: July 12, 2024 Accepted: July 31, 2024 Published online: September 24, 2024 Processing time: 160 Days and 5 Hours
Abstract
BACKGROUND
Hemorrhage, which is not a rare complication in patients with gastric cancer (GC)/gastroesophageal junction cancer (GEJC), can lead to a poor prognosis. However, no study has examined the effectiveness and safety of chemotherapy as an initial therapy for GC/GEJC patients with overt bleeding (OB).
AIM
To investigate the impact of OB on the survival and treatment-related adverse events (TRAEs) of GC/GEJC patients.
METHODS
Patients with advanced or metastatic GC/GEJC who received systematic treatment at Peking University Third Hospital were enrolled in this study. Propensity score matching (PSM) analysis was performed.
RESULTS
After 1:2 PSM analysis, 93 patients were assessed, including 32 patients with OB before treatment (OBBT) and 61 patients without OBBT. The disease control rate was 90.6% in the group with OBBT and 88.5% in the group without OBBT, and this difference was not statistically significant. There was no difference in the incidence of TRAEs between the group with OBBT and the group without OBBT. The median overall survival (mOS) was 15.2 months for patients with OBBT and 23.7 months for those without OBBT [hazard ratio (HR) = 1.101, 95% confidence interval (CI): 0.672-1.804, log rank P = 0.701]. The mOS was worse for patients with OB after treatment (OBAT) than for those without OBAT (11.4 months vs 23.7 months, HR = 1.787, 95%CI: 1.006-3.175, log rank P = 0.044).
CONCLUSION
The mOS for GC/GEJC patients with OBBT was similar to that for those without OBBT, but the mOS for patients with OBAT was worse than that for those without OBAT.
Core Tip: Overt bleeding (OB) is a dangerous condition in patients with advanced or metastatic gastric cancer (GC)/gastroesophageal junction cancer (GEJC). Are these patients at significant risk for systematic treatment? This study retrospectively assessed the survival and treatment-related adverse events (TRAEs) of GC/GEJC patients with OB. The median overall survival (mOS) of patients with OB before treatment (OBBT) was similar to that of patients without OBBT. Nevertheless, the mOS was worse for patients with OB after treatment (OBAT) than for those without OBAT. The incidence of grade 3-4 TRAEs between the groups with OBBT and without OBBT was similar.
