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Abstract：
UNASSIGNED: Studies on survival and prognostic factors in individuals with remnant gastric cancer (RGC) after gastric cancer (GC) are rare. It is debatable whether prognosis of RGC after GC is worse than that of only primary GC (OPGC). The objective of this study is to compare the survival outcomes between post-GC RGC and OPGC undergoing surgical resection and to identify the prognostic factors of disease-specific survival (DSS) for RGC.
UNASSIGNED: We retrospectively collected data from the Surveillance, Epidemiology, and End Results (SEER) database among patients who underwent GC surgery in 1988-2020. Propensity score matching (PSM) was conducted to balance baseline characteristics. Kaplan-Meier (KM) survival analysis was performed to compare their overall survival (OS) and DSS. Multivariable Cox analyses were performed to identify the independent prognostic factors of DSS for post-GC RGC by estimating hazard ratios (HRs) with 95% confidence intervals (CIs).
UNASSIGNED: There were 76 patients with RGC and 32,763 patients with OPGC included and analyzed. After balancing the baseline characteristics by PSM, no significant difference existed between OPGC and RGC groups in both OS (P=0.65) and DSS (P=0.28). Fixed-time analyses also showed no difference between the two groups for the 5-year (60.0%, RGC vs. 53.3%, OPGC, P=0.38) and 10-year DSS (56.7%, RGC vs. 48.3%, OPGC, P=0.34). Multivariable analysis revealed that area of lower income ($75,000+ vs. <$55,000, HR =0.21, 95% CI: 0.05-0.89, P=0.03), cardiac tumor [middle vs. cardia, HR =0.16, 95% CI: 0.03-0.77, P=0.02; distal vs. cardia, HR =0.10, 95% CI: 0.02-0.58, P=0.01; not otherwise specified (NOS) vs. cardia, HR =0.11, 95% CI: 0.03-0.51, P=0.004], deeper invasion (T3-4 vs. Tis-2, HR =5.19, 95% CI: 1.21-22.15, P=0.03), higher grade (G3 vs. G1-2, HR =7.35, 95% CI: 1.41-38.48, P=0.02) and not receiving chemotherapy (yes vs. no/unknown, HR =0.16, 95% CI: 0.04-0.60, P=0.007) were independent risk factors for postsurgical DSS in patients with post-GC RGC.
UNASSIGNED: The prognosis of post-GC RGC was comparable to that of OPGC following surgical resection. The independent prognostic factors for RGC are similar to those established for OPGC. Our findings suggest that RGC following first GC might be the same entity to OPGC and curative resection should be considered in selected patients.
UNASSIGNED: We retrospectively collected data from the Surveillance, Epidemiology, and End Results (SEER) database among patients who underwent GC surgery in 1988-2020. Propensity score matching (PSM) was conducted to balance baseline characteristics. Kaplan-Meier (KM) survival analysis was performed to compare their overall survival (OS) and DSS. Multivariable Cox analyses were performed to identify the independent prognostic factors of DSS for post-GC RGC by estimating hazard ratios (HRs) with 95% confidence intervals (CIs).
UNASSIGNED: There were 76 patients with RGC and 32,763 patients with OPGC included and analyzed. After balancing the baseline characteristics by PSM, no significant difference existed between OPGC and RGC groups in both OS (P=0.65) and DSS (P=0.28). Fixed-time analyses also showed no difference between the two groups for the 5-year (60.0%, RGC vs. 53.3%, OPGC, P=0.38) and 10-year DSS (56.7%, RGC vs. 48.3%, OPGC, P=0.34). Multivariable analysis revealed that area of lower income ($75,000+ vs. <$55,000, HR =0.21, 95% CI: 0.05-0.89, P=0.03), cardiac tumor [middle vs. cardia, HR =0.16, 95% CI: 0.03-0.77, P=0.02; distal vs. cardia, HR =0.10, 95% CI: 0.02-0.58, P=0.01; not otherwise specified (NOS) vs. cardia, HR =0.11, 95% CI: 0.03-0.51, P=0.004], deeper invasion (T3-4 vs. Tis-2, HR =5.19, 95% CI: 1.21-22.15, P=0.03), higher grade (G3 vs. G1-2, HR =7.35, 95% CI: 1.41-38.48, P=0.02) and not receiving chemotherapy (yes vs. no/unknown, HR =0.16, 95% CI: 0.04-0.60, P=0.007) were independent risk factors for postsurgical DSS in patients with post-GC RGC.
UNASSIGNED: The prognosis of post-GC RGC was comparable to that of OPGC following surgical resection. The independent prognostic factors for RGC are similar to those established for OPGC. Our findings suggest that RGC following first GC might be the same entity to OPGC and curative resection should be considered in selected patients.
摘要：
■关于胃癌（GC）后残留胃癌（RGC）患者的生存和预后因素的研究很少。GC后RGC的预后是否比仅原发性GC（OPGC）差，尚有争议。这项研究的目的是比较接受手术切除的GC后RGC和OPGC之间的生存结果，并确定RGC的疾病特异性生存（DSS）的预后因素。
■我们回顾性地收集了监测数据，流行病学,1988-2020年接受GC手术的患者的最终结果（SEER）数据库。进行倾向评分匹配(PSM)以平衡基线特征。进行Kaplan-Meier(KM)生存分析以比较其总生存(OS)和DSS。多变量Cox分析通过95%置信区间（CIs）估计风险比（HRs）来确定DSS对GC后RGC的独立预后因素。
■纳入76例RGC患者和32,763例OPGC患者并进行分析。通过PSM平衡基线特征后，OPGC组和RGC组的OS(P=0.65)和DSS(P=0.28)差异无统计学意义。固定时间分析也显示两组在5年内没有差异(60.0%，RGCvs.53.3%,OPGC,P=0.38)和10年期DSS(56.7%，RGCvs.48.3%,OPGC,P=0.34）。多变量分析显示，低收入领域(75,000美元以上与<$55,000，HR=0.21，95%CI：0.05-0.89，P=0.03），心脏肿瘤[中间vs.贲门,HR=0.16，95%CI：0.03-0.77，P=0.02；远端vs.贲门,HR=0.10，95％CI：0.02-0.58，P=0.01；未另作说明（NOS）与贲门,HR=0.11,95%CI:0.03-0.51,P=0.004],更深的入侵(T3-4vs.Tis-2，HR=5.19，95%CI：1.21-22.15，P=0.03），更高年级(G3与G1-2，HR=7.35，95％CI：1.41-38.48，P=0.02）且未接受化疗（是与没有/未知,HR=0.16，95％CI：0.04-0.60，P=0.007）是GC后RGC患者术后DSS的独立危险因素。
■GC后RGC的预后与手术切除后的OPGC的预后相当。RGC的独立预后因素与OPGC的独立预后因素相似。我们的发现表明，首次GC后的RGC可能与OPGC相同，并且在选定的患者中应考虑根治性切除。
■我们回顾性地收集了监测数据，流行病学,1988-2020年接受GC手术的患者的最终结果（SEER）数据库。进行倾向评分匹配(PSM)以平衡基线特征。进行Kaplan-Meier(KM)生存分析以比较其总生存(OS)和DSS。多变量Cox分析通过95%置信区间（CIs）估计风险比（HRs）来确定DSS对GC后RGC的独立预后因素。
■纳入76例RGC患者和32,763例OPGC患者并进行分析。通过PSM平衡基线特征后，OPGC组和RGC组的OS(P=0.65)和DSS(P=0.28)差异无统计学意义。固定时间分析也显示两组在5年内没有差异(60.0%，RGCvs.53.3%,OPGC,P=0.38)和10年期DSS(56.7%，RGCvs.48.3%,OPGC,P=0.34）。多变量分析显示，低收入领域(75,000美元以上与<$55,000，HR=0.21，95%CI：0.05-0.89，P=0.03），心脏肿瘤[中间vs.贲门,HR=0.16，95%CI：0.03-0.77，P=0.02；远端vs.贲门,HR=0.10，95％CI：0.02-0.58，P=0.01；未另作说明（NOS）与贲门,HR=0.11,95%CI:0.03-0.51,P=0.004],更深的入侵(T3-4vs.Tis-2，HR=5.19，95%CI：1.21-22.15，P=0.03），更高年级(G3与G1-2，HR=7.35，95％CI：1.41-38.48，P=0.02）且未接受化疗（是与没有/未知,HR=0.16，95％CI：0.04-0.60，P=0.007）是GC后RGC患者术后DSS的独立危险因素。
■GC后RGC的预后与手术切除后的OPGC的预后相当。RGC的独立预后因素与OPGC的独立预后因素相似。我们的发现表明，首次GC后的RGC可能与OPGC相同，并且在选定的患者中应考虑根治性切除。
