Effects of Traditional Chinese Medicine on the survival of patients with stage I gastric cancer and high-risk factors: a real-world retrospective study

doi:10.19852/j.cnki.jtcm.20230227.001

Abstract

Abstract:

OBJECTIVE: To investigate the benefits of Traditional Chinese Medicine (TCM) therapy for improving the survival of patients with stage I gastric cancer (GC) and high-risk factors in a real-world setting.

METHODS: The clinical data of patients who were diagnosed with stage I GC from March 1, 2012 to October 31, 2020 were collected. Prognostic analysis was performed to explore the high-risk factors that affected the survival of the patients. A Cox multivariate regression model was used to compare the hazard ratios for the mortality risk of patients, especially those with high-risk factors. Kaplan-Meier survival curve and log-rank test were utilized to assess the survival time.

RESULTS: Prognostic analysis demonstrated that female sex, tumor invasion into blood vessels, and Ib stage were independent risk factors. The 1-, 3-, and 5-year survival rates of the TCM group vs those of the non-TCM group were 100.0% vs 91.0%, 97.6% vs 64.5%, and 81.4% vs 55.5%, respectively. A significant difference in median overall survival (mOS) was found between the two groups (χ² = 7.670, P = 0.006). Subgroup analysis showed that the mOS of female patients and stage Ib patients in the TCM group were longer than those in the non-TCM group (P ≤ 0.001 and 0.001, respectively).

CONCLUSIONS: TCM treatment can improve the survival of patients with stage I GC and high-risk factors.

Key words: stomach neoplasms, overall mortality, integrative medicine, medicine, Chinese traditional, real-world

HOU Chao, ZHANG Yusen, YANG Die, LI Yifei, ZHANG Xiaochun, LIU Yanqing. Effects of Traditional Chinese Medicine on the survival of patients with stage I gastric cancer and high-risk factors: a real-world retrospective study[J]. Journal of Traditional Chinese Medicine, 2023, 43(3): 568-573.

Figures/Tables 4

References 21

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Subgroup		n (TCM/non-TCM)	OS (months, 95% CI)		Log-rank test
Subgroup		n (TCM/non-TCM)	TCM	non-TCM	χ² value	P value
Gender	Male	34/61	54.76 (50.08-59.45)	49.43 (42.58-56.28)	0.790	0.374
Gender	Female	14/18	57.91 (54.00-61.82)	28.47 (17.94-39.02)	14.15	0.000
Blood vessel invasion	No	18/31	56.00 (50.93-61.07)	50.36 (41.42-59.29)	1.246	0.264
Blood vessel invasion	Yes	7/10	46.86 (32.39-61.33)	31.63 (15.52-47.75)	1.621	0.203
T stage	T1	24/42	58.85 (56.65-61.05)	52.37 (46.11-58.63)	3.140	0.076
	T2	24/37	51.34 (44.18-58.50)	29.74 (20.19-39.28)	9.505	0.002
N stage	N0	42/65	56.03 (52.39-59.67)	43.82 (36.72-50.92)	6.667	0.010
	N1	6/14	52.33 (40.06-64.60)	43.98 (33.69-54.27)	0.825	0.364
TNM stage	Ia	18/28	-	-	2.869	0.090
TNM stage	Ib	30/51	51.34 (44.18-58.50)	29.85 (20.32-39.37)	10.547	0.001
Chemotherapy	No	9/8	59.67 (59.07-60.26)	19.33 (10.02-28.65)	7.499	0.006
	Yes	39/71	54.62 (50.25-59.00)	46.50 (40.16-52.85)	3.873	0.049

Subgroup		n (TCM/non-TCM)	OS (months, 95% CI)		Log-rank test
Subgroup		n (TCM/non-TCM)	TCM	non-TCM	χ² value	P value
Gender	Male	34/61	54.76 (50.08-59.45)	49.43 (42.58-56.28)	0.790	0.374
Gender	Female	14/18	57.91 (54.00-61.82)	28.47 (17.94-39.02)	14.15	0.000
Blood vessel invasion	No	18/31	56.00 (50.93-61.07)	50.36 (41.42-59.29)	1.246	0.264
Blood vessel invasion	Yes	7/10	46.86 (32.39-61.33)	31.63 (15.52-47.75)	1.621	0.203
T stage	T1	24/42	58.85 (56.65-61.05)	52.37 (46.11-58.63)	3.140	0.076
	T2	24/37	51.34 (44.18-58.50)	29.74 (20.19-39.28)	9.505	0.002
N stage	N0	42/65	56.03 (52.39-59.67)	43.82 (36.72-50.92)	6.667	0.010
	N1	6/14	52.33 (40.06-64.60)	43.98 (33.69-54.27)	0.825	0.364
TNM stage	Ia	18/28	-	-	2.869	0.090
TNM stage	Ib	30/51	51.34 (44.18-58.50)	29.85 (20.32-39.37)	10.547	0.001
Chemotherapy	No	9/8	59.67 (59.07-60.26)	19.33 (10.02-28.65)	7.499	0.006
	Yes	39/71	54.62 (50.25-59.00)	46.50 (40.16-52.85)	3.873	0.049

TCM prescription	Mortality		Hazard Ratio (95% CI )
TCM prescription	n	No. of events		Crude^a	Adjusted^b
Non-TCM user	79	15	1.00 (Reference)		1.00 (Reference)
TCM user
Chinese herb decoction	40	4	0.22 (0.07-0.67), P = 0.008		0.01 (0.00-0.19), P = 0.004
Shenqi Shiyi Wei granule	6	1	0.55 (0.07-4.20), P = 0.566		-
Shenyi capsule	5	3	1.80 (0.52-6.27), P = 0.356		-
Aidi injection	11	1	0.18 (0.02-1.36), P = 0.096		-
Yadanzi (Fructus Bruceae Javanicae) oil emulsion injection	14	0	-		-
Sodium cantharidinate vitamin B6	8	3	0.73 (0.21-2.52), P = 0.613		-
Shenmai injection	26	3	0.28 (0.08-0.95), P = 0.042		0.00 (0.00-0.13), P = 0.005
Shenqi Fuzheng injection	13	3	0.57 (0.16-1.96), P = 0.370		-
Xiaoaiping injection	7	3	1.04 (0.30-3.62), P = 0.947		-
Compound Kushen injection	11	2	0.39 (0.09-1.70), P = 0.209		0.01 (0.00-0.37), P = 0.014
Lentinan injection	16	2	0.25 (0.06-1.12), P = 0.070		0.00 (0.00-0.25), P = 0.011

TCM prescription	Mortality		Hazard Ratio (95% CI )
TCM prescription	n	No. of events		Crude^a	Adjusted^b
Non-TCM user	79	15	1.00 (Reference)		1.00 (Reference)
TCM user
Chinese herb decoction	40	4	0.22 (0.07-0.67), P = 0.008		0.01 (0.00-0.19), P = 0.004
Shenqi Shiyi Wei granule	6	1	0.55 (0.07-4.20), P = 0.566		-
Shenyi capsule	5	3	1.80 (0.52-6.27), P = 0.356		-
Aidi injection	11	1	0.18 (0.02-1.36), P = 0.096		-
Yadanzi (Fructus Bruceae Javanicae) oil emulsion injection	14	0	-		-
Sodium cantharidinate vitamin B6	8	3	0.73 (0.21-2.52), P = 0.613		-
Shenmai injection	26	3	0.28 (0.08-0.95), P = 0.042		0.00 (0.00-0.13), P = 0.005
Shenqi Fuzheng injection	13	3	0.57 (0.16-1.96), P = 0.370		-
Xiaoaiping injection	7	3	1.04 (0.30-3.62), P = 0.947		-
Compound Kushen injection	11	2	0.39 (0.09-1.70), P = 0.209		0.01 (0.00-0.37), P = 0.014
Lentinan injection	16	2	0.25 (0.06-1.12), P = 0.070		0.00 (0.00-0.25), P = 0.011

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