Gastrointestinal Surgery Unit 1, The First Hospital of Putian City, Putian, 351100, Fujian, China.
Gastrointestinal Surgery Unit 2, The First Affiliated Hospital of Fujian Medical University, Fuzhou, 350004, Fujian, China.
Ann Surg Oncol. 2024 Sep;31(9):5984-5996. doi: 10.1245/s10434-024-15508-1. Epub 2024 May 30.
The mechanism underlying the formation of gastric tumor deposits (TDs) is unclear. We aimed to explore the risk factors for the formation and prognostic value of TDs.
This retrospective analysis included 781 locally advanced gastric cancer (LAGC) patients from four medical institutions in China, from June 2014 to June 2018. The risk factors for TD formation and prognostic value were determined through univariate and multivariate analyses.
Univariate analysis revealed that TD positivity was closely related to tumor diameter, Borrmann classification, differentiation degree, pT stage, pN stage, pTNM stage, and nerve and vascular invasion (p < 0.05). Multivariate logistic regression revealed that tumor diameter ≥ 5 cm (odds ratio [OR] 1.836, 95% confidence interval [CI] 1.165-2.894, p = 0.009) and vascular invasion (OR 2.152, 95% CI 1.349-3.433, p = 0.001) were independent risk factors for TD positivity. Multivariate Cox analysis revealed that TD positivity (OR 1.533, 95% CI 1.101-2.134, p = 0.011), tumor diameter ≥ 5 cm (OR 1.831, 95% CI 1.319-2.541, p < 0.001), pT4a stage (OR 1.652, 95% CI 1.144-2.386, p = 0.007), and vascular invasion (OR 1.458, 95% CI 1.059-2.008, p = 0.021) were independent risk factors for GC prognosis. The 5-year overall and disease-free survival of the TD-positive group showed significant effects among patients in the pT4a and pN3b stages (p < 0.05).
TDs are closely related to tumor diameter and vascular invasion in LAGC patients, and TD positivity is an independent prognostic factor for LAGC patients, especially those at pT4a and pN3b stages.
胃肿瘤沉积(TDs)形成的机制尚不清楚。我们旨在探讨 TD 形成的危险因素及其预后价值。
本回顾性分析纳入了来自中国四家医疗机构的 781 例局部进展期胃癌(LAGC)患者,时间为 2014 年 6 月至 2018 年 6 月。通过单因素和多因素分析确定 TD 形成的危险因素和预后价值。
单因素分析显示,TD 阳性与肿瘤直径、Borrmann 分类、分化程度、pT 分期、pN 分期、pTNM 分期以及神经和血管侵犯密切相关(p<0.05)。多因素 logistic 回归分析显示,肿瘤直径≥5cm(比值比 [OR] 1.836,95%置信区间 [CI] 1.165-2.894,p=0.009)和血管侵犯(OR 2.152,95%CI 1.349-3.433,p=0.001)是 TD 阳性的独立危险因素。多因素 Cox 分析显示,TD 阳性(OR 1.533,95%CI 1.101-2.134,p=0.011)、肿瘤直径≥5cm(OR 1.831,95%CI 1.319-2.541,p<0.001)、pT4a 期(OR 1.652,95%CI 1.144-2.386,p=0.007)和血管侵犯(OR 1.458,95%CI 1.059-2.008,p=0.021)是 GC 预后的独立危险因素。TD 阳性组在 pT4a 和 pN3b 期患者中的 5 年总生存率和无病生存率差异有统计学意义(p<0.05)。
TDs 与 LAGC 患者的肿瘤直径和血管侵犯密切相关,TD 阳性是 LAGC 患者的独立预后因素,尤其是 pT4a 和 pN3b 期患者。