Skip to main content

Advertisement

SpringerLink
Log in

Radiotherapy benefited the survival of patients with intestinal-type gastric adenocarcinoma: a SEER population-based study

  • Research Article
  • Published:
Clinical and Translational Oncology Aims and scope Submit manuscript

Abstract

Background

Currently, the role of adjuvant radiotherapy (RT) in the treatment of patients with intestinal-type gastric adenocarcinoma (IGA) has not been well established. This study aimed to elucidate the survival impact of RT on such patients.

Methods

The Surveillance, Epidemiology, and End Results (SEER) database was utilized to select eligible patients. The recruited patients were dichotomized into those not received RT versus those received RT. The 1:1 propensity score matching (PSM) analysis was conducted to balance the confounding factors between the two comparison groups. The categorical variables were assessed by Chi-square test. Cancer-specific survival (CSS) and overall survival (OS) of the patients were compared by Kaplan–Meier (KM) methods. Cox proportional hazard models were used to identify prognostic factors associated with CSS.

Results

A total of 3572 eligible patients were enrolled for our analysis, of which, 2896(81.1%) patients did not receive RT and 676(18.9%) patients received RT. Before PSM, except race and tumor size, significant differences in patients’ baseline characteristics were observed in no RT versus RT group. The KM plots before PSM indicated that RT exerted significant survival benefits for the recruited patients (p < 0.001). After PSM, most confounders were well balanced between the two comparison groups. The KM plots showed significantly superior CSS and OS in the RT group (p < 0.05). Grade IV, stage II–IV, and N3 were identified as independent risk factors, while LN examined > 15 and RT were independent protective factors for favorable prognosis. Subgroup survival analysis revealed that RT brought a significant CSS advantage for the stage IV patients.

Conclusion

Based on PSM analysis of the cohort from SEER database, RT showed significant survival benefits for patients with IGA. Our study supports adjuvant RT for this specific cohort.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Ferlay J, Soerjomataram I, Dikshit R, et al. Cancer incidence and mortality worldwide: sources, methods and major patterns in GLOBOCAN 2012. Int J Cancer. 2015;136:E359–E386386.

    Article  CAS  Google Scholar 

  2. Siegel RL, Miller KD, Jemal A. Cancer statistics, 2019. CA Cancer J Clin. 2019;69:7e34.

    Article  Google Scholar 

  3. Picado O, Dygert L, Macedo FI, et al. The role of surgical resection for stage IV gastric cancer with synchronous hepatic metastasis. J Surg Res. 2018;232:422–9.

    Article  Google Scholar 

  4. Perrot-Applanat M, Vacher S, Pimpie C, et al. Differential gene expression in growth factors, epithelial mesenchymal transition and chemotaxis in the diffuse type compared with the intestinal type of gastric cancer. Oncol Lett. 2019;18:674–86.

    CAS  PubMed  PubMed Central  Google Scholar 

  5. Kim KY, Yi BR, Lee HR, et al. Stem cells with fused gene expression of cytosine deaminase and interferon-β migrate to human gastric cancer cells and result in synergistic growth inhibition for potential therapeutic use. Int J Oncol. 2012;40:1097–104.

    Article  CAS  Google Scholar 

  6. Pellino A, Riello E, Nappo F, et al. Targeted therapies in metastatic gastric cancer: Current knowledge and future perspectives. World J Gastroenterol. 2019;25:5773–888.

    Article  CAS  Google Scholar 

  7. Tian P, Liang C. Transcriptome profiling of cancer tissues in Chinese patients with gastric cancer by high-throughput sequencing. Oncol Lett. 2018;15:2057–64.

    PubMed  Google Scholar 

  8. Taki T, Hoya Y, Watanabe A, et al. Usefulness of chemoradiotherapy for inoperable gastric cancer. Ann R Coll Surg Engl. 2017;99:332–6.

    Article  CAS  Google Scholar 

  9. van den Ende T, Ter Veer E, Machiels M, et al. The efficacy and safety of (neo) adjuvant therapy for gastric cancer: a network meta-analysis. Cancers (Basel). 2019;11:E80.

    Article  Google Scholar 

  10. Qiu MZ, Shi SM, Chen M, et al. Comparison of HER2 and lauren classification between biopsy and surgical resection samples, primary and metastatic samples of gastric cancer. J Cancer. 2017;8:3531–7.

    Article  Google Scholar 

  11. Azimzadeh-Isfanjani A, Safaralizadeh R, Hosseinpour-Feizi M, et al. Expression of miR-520c in intestinal type gastric adenocarcinoma. J Gastrointest Oncol. 2018;9:1184–9.

    Article  Google Scholar 

  12. Ansari S, Gantuya B, Tuan VP, et al. Diffuse gastric cancer: a summary of analogous contributing factors for its molecular pathogenicity. Int J Mol Sci. 2018;19:E2424.

    Article  Google Scholar 

  13. Ikoma N, Das P, Hofstetter W, et al. Preoperative chemoradiation therapy induces primary-tumor complete response more frequently than chemotherapy alone in gastric cancer: analyses of the National Cancer Database 2006–2014 using propensity score matching. Gastric Cancer. 2018;21:1004–133.

    Article  Google Scholar 

  14. Macdonald JS, Smalley SR, Benedetti J, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med. 2001;345:725–30.

    Article  CAS  Google Scholar 

  15. Shridhar R, Almhanna K, Hoffe SE, et al. Increased survival associated with surgery and radiation therapy in metastatic gastric cancer: a surveillance, epidemiology, and end results database analysis. Cancer. 2013;119:1636–42.

    Article  Google Scholar 

  16. Stumpf PK, Amini A, Jones BL, et al. Adjuvant radiotherapy improves overall survival in patients with resected gastric adenocarcinoma: a national cancer data base analysis. Cancer. 2017;123:3402–9.

    Article  Google Scholar 

  17. Yang J, Chen J, Yang M, et al. Acupuncture for hypertension. Cochrane Database Syst Rev. 2018;11:CD008821.

    PubMed  Google Scholar 

  18. Ghidini M, Donida BM, Totaro L, et al. Prognostic factors associated with survival in a large cohort of gastric cancer patients resected over a decade at a single Italian center: the cremona experience. Clin Transl Oncol. 2019. https://doi.org/10.1007/s12094-019-02220-w.

    Article  PubMed  Google Scholar 

  19. Wang Y, Liu W, Yu Y, et al. Potential value of CT radiomics in the distinction of intestinal-type gastric adenocarcinomas. Eur Radiol. 2020;30:2934–44.

    Article  Google Scholar 

  20. Antonelli J, Cefalu M, Palmer N, et al. Doubly robust matching estimators for high dimensional confounding adjustment. Biometrics. 2018;74:1171–9.

    Article  Google Scholar 

Download references

Acknowledgements

This work was supported by the National Natural Science Foundation of China [Grant number 81670123, 81670144].

Author information

Authors and Affiliations

  1. Department of Oncology I, Cancer Center, Renmin Hospital of Wuhan University, Wuhan, 430060, People’s Republic of China

    Y. Chu, B. Xu, Q. Song & Q. Hu

Authors
  1. Y. Chu
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. B. Xu
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Q. Song
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Q. Hu
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Q. Hu.

Ethics declarations

Conflict of interest

The authors have no conflict of interest to declare.

Ethical approval

All procedures performed were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Not applicable.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Chu, Y., Xu, B., Song, Q. et al. Radiotherapy benefited the survival of patients with intestinal-type gastric adenocarcinoma: a SEER population-based study. Clin Transl Oncol 23, 164–171 (2021). https://doi.org/10.1007/s12094-020-02408-5

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s12094-020-02408-5

Keywords

Search

Navigation