Analysis Of Conditional Survival Of Gastric Cancer Patients With Curative Resection And Preliminary Evaluation Of The Current Follow-up Strategy

Background:With the increase of survival time of gastric cancer patients,there is a dynamic change in the risk of death.Compared with the traditional survival rate,the conditional survival rate takes this factor into account to evaluate the survival of patients and provide clinicians dynamically with more accurate prognostic information.Therefore,the aim of this study uses conditional survival to assess the prognosis of patients after gastric cancer surgery.In addition,there is no high-level evidence based evidence to evaluate the follow-up strategy,in order to provide some help and guidance for the formulation of future follow-up strategies.This study will use the dynamic index of conditional survival rate to evaluate the current follow-up strategy,Methods:The gastrointestinal tumor surgery of the first affiliated hospital of China medical university were used for analyses.Actuarial Disease-specific survival(DSS)was estimated using the Kaplan-Meier method.The disease-specific conditional survival rate(CDS)is calculated as follows: Three-year conditional disease-specific survival(CDS3)= DSS(x+3)/DSS(x),Which DSS(x)represents the patient's disease-specific survival rate at the "x" year.Cox proportional hazards regression analyses were used to identify the factors related with DSS.In the evaluation of the follow-up strategy,the conditional survival rates(CS)of 3 months,6 months and 12 months were calculated respectively in line with the current follow-up interval at different postoperative time intervals.Results:The 1-,3-and 5-year actuarial DSS was 80%,60% and 52.3% respectively.Using CDS estimates,the probabilities of patients remaining alive for additional 3 years given that they have already survived 1,3 and 5 years were 64.3%,83.6% and 91.8%respectively.Patients with unfavorable tumor characteristics diagnosed initially at surgery had greatest improvement in CDS3 and largest survival gap between actuarial DSS and CDS.In the follow-up evaluation,patients with different stages had different postoperative survival rates,and patients with earlier stages had less fluctuations in their survival,while patients with later stage had more fluctuations.In addition,the fluctuation range of CDS of patients with early stage is narrower than those with advanced stage.Conclusions:Our study demonstrated that CDS estimates of patients who received curative surgery were dynamic and increased with time elapsed.Patients with poorer clinical and pathological features had greatest improvement in CDS.Also from the conclusion,it should be more reasonable that postgastrectomy patients with different stage should be follow up by different surveillance schemes.This valuable information could provide more precise long-term prognosis evaluation and may serve as an important prognosis index in clinical practice.