Analysis of the long-term efficacy of surgical treatment and endoscopic resection for early gastric carcinoma based on the SEER database
10.12025/j.issn.1008-6358.2025.20250168
- VernacularTitle:基于SEER数据库的手术和内镜切除治疗早期胃癌的长期疗效分析
- Author:
Jie HE
1
;
Xinyang LIU
2
;
Hua GAO
1
;
Peng LÜ
1
;
Qi JIANG
1
;
Weifeng CHEN
1
;
Jianwei HU
2
Author Information
1. Endoscopy Center, Zhongshan Hospital (Xiamen Branch), Fudan University, Xiamen 361015, Fujian, China.
2. Endoscopy Center, Zhongshan Hospital, Fudan University, Shanghai 200032, China.
- Publication Type:Monographicreport:Endoscopicdiagnosisandtreatmentofdigestivesystemdiseases
- Keywords:
early gastric carcinoma;
surgery;
endoscopic resection;
mortality ratio
- From:
Chinese Journal of Clinical Medicine
2025;32(5):761-767
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the long-term prognosis differences between surgical radical resection and endoscopic resection for early gastric cancer patients based on the SEER database. Methods A total of 1 437 patients with stage Tis to T1b gastric adenocarcinoma were selected from the SEER database from January 1, 2004 to December 31, 2013. They were divided into a surgery group (n=1 257) and an endoscope group (n=180) according to the treatment method. Kaplan-Meier survival curve and Cox regression model were used to analyze survival outcomes. Results The patients in the surgery group were younger than those in the endoscope group ([67.63±12.97] years old vs [71.29±10.82] years old), with higher rates of T1 stage (97.45% vs 87.78%) and lymph node metastasis (19.73% vs 5.00%, all P＜0.001). The median follow-up time for all patients was 37 (15, 66) months, and the mortality rate of gastric cancer in the endoscope group was lower than that in the surgery group (23.33% vs 27.13%, P＜0.001). Univariate Cox analysis showed that treatment modality, age, sex, T stage, lymph node metastasis were all associated with early gastric cancer mortality (all P＜0.05), and the risk of death in the endoscope group was 43% of that in the surgery group (HR=0.43, P=0.015). After adjusting for multiple factors, there was no statistically significant difference in mortality risk between the two groups (P=0.067), but after excluding lymph node positive patients, the mortality risk in the endoscope group was 46% of that in the surgery group (HR=0.46, P=0.048). Conclusions For early gastric cancer patients with negative lymph nodes, endoscopic resection may provide better survival benefits than surgical procedures, suggesting that it can be the preferred treatment strategy for patients with low risk of lymph node metastasis.
