转移性胃癌的异质性：孤立性非区域淋巴结转移和孤立性肺转移的生存结果优于其他转移模式。

Heterogeneity of metastatic gastric cancer: solitary non-regional lymph node metastasis and solitary lung metastasis showed better survival outcomes than other metastatic patterns.

作者信息

Luan Xiaoyi, Han Xue, Wang Zerong, Zhao Lulu, Zhang Xiaojie, Wang Wanqing, Niu Penghui, Wang Danjun, Zhao Dongbing, Zhu Mingwei, Chen Yingtai

机构信息

National Clinical Research Center for Cancer/Cancer Hospital, National Cancer Center, Chinese Academy of Medical Sciences and Peking Union Medical College, 17 Panjiayuan Nanli, Beijing, 100021, People's Republic of China.

Department of General Surgery, Department of Hepatobiliopancreatic Surgery, Beijing Hospital, National Center of Gerontology, Institute of Geriatric Medicine, Chinese Academy of Medical Sciences, Beijing, People's Republic of China.

出版信息

BMC Cancer. 2025 Aug 8;25(1):1287. doi: 10.1186/s12885-025-14748-y.

DOI:10.1186/s12885-025-14748-y

PMID:40781666

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC12333190/

Abstract

BACKGROUND

Although metastatic gastric cancer has remarkably poor prognosis, a small group of patients achieved relatively favorable survival outcomes due to the disease's variable biological behavior. The study aimed to investigate the impact of metastatic patterns on survival outcomes of metastatic gastric cancer patients.

METHODS

Patients with distant metastatic (M1) gastric cancer in the China National Cancer Center between January 1999 to December 2019 were retrospectively reviewed. Univariate and multivariate cox regression analyses tested the relationship between metastatic patterns and survival.

RESULTS

A total of 2,042 patients with definitive information on metastatic organs were included in the study. Liver (772 [37.9%]), peritoneum (765 [37.6%]), and non-regional lymph node (692 [34.0%]) were the most three common metastasis organs for metastatic gastric cancer patients in our study. The median survival time of patients with metastatic gastric cancer was 15.4 months. For patients with solitary non-regional lymph node metastasis, the 2-year and 5-year overall survival (OS) rates were notably high at 48.12 and 24.55%, respectively. Patients with solitary lung metastasis demonstrated similarly favorable survival outcomes, with 2-year and 5-year OS rates reaching 46.45 and 16.02%. However, patients with multi-organ metastases faced the poorest prognosis among those with metastatic gastric cancer, with 26.98% of them surviving more than 2 years, and only 8.35% surviving more than 5 years. In multivariate cox regression analyses, solitary non-regional lymph node metastasis [multiple organs Ref; hazard ratio (HR) 0.636, 95% CI 0.507-0.798, P < 0.001] and solitary lung metastasis (multiple organs Ref; HR 0.535, 95% CI 0.336-0.852, P = 0.008) were independent beneficial prognostic factors in metastatic gastric cancer patients.

CONCLUSIONS

Gastric cancer patients with solitary non-regional lymph node metastasis and solitary lung metastasis showed better survival outcomes than other metastatic gastric cancer patients. Sub-classifying metastatic gastric cancer based on metastatic organs is recommended, which could assist in forecasting survival outcomes and facilitating individualized treatment.

摘要

背景

尽管转移性胃癌的预后极差，但一小部分患者由于该疾病可变的生物学行为而获得了相对较好的生存结果。本研究旨在探讨转移模式对转移性胃癌患者生存结果的影响。

方法

回顾性分析了1999年1月至2019年12月在中国国家癌症中心诊断为远处转移（M1）的胃癌患者。单因素和多因素cox回归分析检验了转移模式与生存之间的关系。

结果

本研究共纳入2042例有明确转移器官信息的患者。肝脏（772例[37.9%]）、腹膜（765例[37.6%]）和非区域淋巴结（692例[34.0%]）是本研究中转移性胃癌患者最常见的三个转移器官。转移性胃癌患者的中位生存时间为15.4个月。对于孤立性非区域淋巴结转移患者，2年和5年总生存率（OS）分别高达48.12%和24.55%。孤立性肺转移患者的生存结果同样良好，2年和5年OS率分别达到46.45%和16.02%。然而，多器官转移患者在转移性胃癌患者中预后最差，其中26.98%的患者存活超过2年，只有8.35%的患者存活超过5年。在多因素cox回归分析中，孤立性非区域淋巴结转移（多器官转移为参照；风险比[HR]0.636，95%可信区间0.507-0.798，P<0.001）和孤立性肺转移（多器官转移为参照；HR 0.535，95%可信区间0.336-0.852，P=0.008）是转移性胃癌患者独立的有利预后因素。