Abstract：
BACKGROUND: The impact of economic engagement on the health of cancer survivors is notable. Our study aims to explore the association between early loss of economic activity (EA) and the risk of all-cause mortality among gastric cancer survivors.
METHODS: This retrospective cohort study utilized data from Korea\'s National Health Insurance Service, focusing on 30-59-year-old gastric cancer patients who received either surgery or endoscopic procedures from January 2009 to December 2013. The primary outcome measure was all-cause mortality. Early loss of EA was identified when a patient\'s insurance status shifted to dependent within one year following treatment. Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality were estimated using multivariable Cox proportional hazards models, conducting separate analyses for surgical and endoscopic groups.
RESULTS: Among 24,159 patients (median follow-up, 9.9 years), 2976 (12.3%) experienced all-cause mortality. Specifically, 2835 of these deaths occurred in patients who underwent surgery, while 141 were in the endoscopic procedure group. Early loss of EA was recorded in 14.4% of the surgery group and 7.7% of the endoscopic procedure group. Adjusted HRs (95% CI) for all-cause mortality associated with early loss of EA were 1.39 (1.27-1.54) for the surgery group and 2.27 (1.46-3.52) for the endoscopic procedure group.
CONCLUSIONS: This study highlights a significant association between the early loss of EA and an increased risk of all-cause mortality in those who have undergone curative treatments for gastric cancer. It underscores the crucial role of sustaining EA in enhancing the health outcomes of these survivors.
METHODS: This retrospective cohort study utilized data from Korea\'s National Health Insurance Service, focusing on 30-59-year-old gastric cancer patients who received either surgery or endoscopic procedures from January 2009 to December 2013. The primary outcome measure was all-cause mortality. Early loss of EA was identified when a patient\'s insurance status shifted to dependent within one year following treatment. Adjusted hazard ratios (HRs) and 95% confidence intervals (CI) for all-cause mortality were estimated using multivariable Cox proportional hazards models, conducting separate analyses for surgical and endoscopic groups.
RESULTS: Among 24,159 patients (median follow-up, 9.9 years), 2976 (12.3%) experienced all-cause mortality. Specifically, 2835 of these deaths occurred in patients who underwent surgery, while 141 were in the endoscopic procedure group. Early loss of EA was recorded in 14.4% of the surgery group and 7.7% of the endoscopic procedure group. Adjusted HRs (95% CI) for all-cause mortality associated with early loss of EA were 1.39 (1.27-1.54) for the surgery group and 2.27 (1.46-3.52) for the endoscopic procedure group.
CONCLUSIONS: This study highlights a significant association between the early loss of EA and an increased risk of all-cause mortality in those who have undergone curative treatments for gastric cancer. It underscores the crucial role of sustaining EA in enhancing the health outcomes of these survivors.
摘要：
背景：经济参与对癌症幸存者健康的影响是显著的。我们的研究旨在探讨早期经济活动丧失（EA）与胃癌幸存者全因死亡风险之间的关系。
方法：这项回顾性队列研究利用了韩国国民健康保险服务的数据，重点关注2009年1月至2013年12月接受手术或内镜手术的30-59岁胃癌患者.主要结局指标是全因死亡率。当患者的保险状态在治疗后一年内转变为依赖者时，可以确定EA的早期损失。使用多变量Cox比例风险模型估计全因死亡率的调整风险比(HR)和95%置信区间(CI)。分别对手术组和内窥镜组进行分析。
结果：在24,159例患者中（中位随访，9.9年)，2976人（12.3%）出现全因死亡率。具体来说,这些死亡中有2835例发生在接受手术的患者中，而141人属于内镜手术组。在手术组的14.4％和内镜手术组的7.7％中记录到早期EA丢失。与早期EA丢失相关的全因死亡率的校正HR（95％CI）在手术组为1.39（1.27-1.54），在内镜手术组为2.27（1.46-3.52）。
结论：这项研究强调了在接受胃癌治疗的患者中，早期EA丧失与全因死亡风险增加之间的显著关联。它强调了维持EA在增强这些幸存者的健康结果方面的关键作用。
方法：这项回顾性队列研究利用了韩国国民健康保险服务的数据，重点关注2009年1月至2013年12月接受手术或内镜手术的30-59岁胃癌患者.主要结局指标是全因死亡率。当患者的保险状态在治疗后一年内转变为依赖者时，可以确定EA的早期损失。使用多变量Cox比例风险模型估计全因死亡率的调整风险比(HR)和95%置信区间(CI)。分别对手术组和内窥镜组进行分析。
结果：在24,159例患者中（中位随访，9.9年)，2976人（12.3%）出现全因死亡率。具体来说,这些死亡中有2835例发生在接受手术的患者中，而141人属于内镜手术组。在手术组的14.4％和内镜手术组的7.7％中记录到早期EA丢失。与早期EA丢失相关的全因死亡率的校正HR（95％CI）在手术组为1.39（1.27-1.54），在内镜手术组为2.27（1.46-3.52）。
结论：这项研究强调了在接受胃癌治疗的患者中，早期EA丧失与全因死亡风险增加之间的显著关联。它强调了维持EA在增强这些幸存者的健康结果方面的关键作用。
