Department of General Surgery & Institute of General Surgery, Chinese PLA General Hospital, Beijing, China.
Medical School of Chinese PLA, Beijing, China.
Cancer Med. 2020 May;9(10):3268-3277. doi: 10.1002/cam4.2963. Epub 2020 Mar 12.
Gastric cancer (GC) treatment is determined by accurate tumor staging. The value of tumor deposit (TD) in prognostic prediction staging system is not yet determined.
We retrospectively analyzed clinical information on GC patients who underwent gastrectomy at the Department of General Surgery of the Chinese PLA General Hospital from July 2014 to June 2016. Propensity score matching (PSM) was performed to reduce the possibility of selection bias according to the presence of TD.
Of the 1034 GC patients, 240 (23.21%) presented with TD, which was associated with younger age and larger tumor size (all P < .05). TD-positive patients had a worse survival than TD-negative patients before (P < .001) and after (P = .017) matching. Multivariable analysis showed that mortality risk of patients with TD increased by 58%, 62%, 37%, and 40% in the crude (HR = 1.58, 95% CI 1.32-1.89, P < .001), adjusted I (HR = 1.62, 95% CI 1.35-1.94, P < .001), adjusted II (HR = 1.37, 95% CI 1.13-1.66, P = .001), and adjusted III (HR = 1.40, 95% CI 1.16-1.68, P < .001) models before matching. Similarly, in the PSM cohort patients with TD had worse prognosis in the crude (HR = 1.32, 95% CI 1.07-1.63, P = .011), adjusted I (HR = 1.35, 95% CI 1.09-1.67, P = .005), adjusted II (HR = 1.26, 95% CI 1.00-1.58, P = .049), and adjusted III (HR = 1.33, 95% CI 1.07-1.65, P = .010) models. TD had a similar value range between N1 and N2 stages among different models.
Among GC patients, TD is associated with survival and may have a role in the staging of patients.
胃癌(GC)的治疗取决于准确的肿瘤分期。肿瘤沉积物(TD)在预后预测分期系统中的价值尚不确定。
我们回顾性分析了 2014 年 7 月至 2016 年 6 月在中国人民解放军总医院普通外科接受胃切除术的 GC 患者的临床信息。根据 TD 的存在,采用倾向评分匹配(PSM)降低选择偏倚的可能性。
在 1034 例 GC 患者中,240 例(23.21%)存在 TD,其与年龄较小和肿瘤较大有关(均 P<.05)。TD 阳性患者的生存状况比 TD 阴性患者差,匹配前(P<.001)和匹配后(P=.017)均如此。多变量分析显示,TD 患者的死亡率在未经调整(HR=1.58,95%CI 1.32-1.89,P<.001)、调整 I(HR=1.62,95%CI 1.35-1.94,P<.001)、调整 II(HR=1.37,95%CI 1.13-1.66,P=.001)和调整 III(HR=1.40,95%CI 1.16-1.68,P<.001)模型中分别增加了 58%、62%、37%和 40%。同样,在 PSM 队列中,TD 患者在未经调整(HR=1.32,95%CI 1.07-1.63,P=.011)、调整 I(HR=1.35,95%CI 1.09-1.67,P=.005)、调整 II(HR=1.26,95%CI 1.00-1.58,P=.049)和调整 III(HR=1.33,95%CI 1.07-1.65,P=.010)模型中的预后较差。TD 在不同模型中的 N1 和 N2 期之间具有相似的价值范围。
在 GC 患者中,TD 与生存相关,可能在患者分期中具有作用。