The Research and Analysis of Bring Perigastric Tumor Deposits into The Staging of Primary Gastric Cancer [post]

xinxin wang, zhaoyang wang, tianyu xie, shuo li, di wu, xin guo, yong wang, lin chen
2020 unpublished
Background: The current significance of perigastric tumor deposits (TDs) in gastric cancer (GC) for indicating prognosis remains unclear. The aim of this study was to assess the prognostic value of perigastric TDs and a new TNM staging involving TDs for GC.Methods: The pathological data of 6672 patients with GC who underwent gastrectomy or operation of gastric cancer with other diseases between January 1, 2012 and December 31, 2017 at Chinese PLA General Hospital were analyzed retrospectively.
more » ... he patients were divided into tumor deposits positive (TD+) group and tumor deposits negative (TD-) group. The differences between TD+ and TD- were analyzed by binary Logistic regression model. To draw survival curves, we used Kaplan-Meier methods. Multivariate Cox regression model and Log-rank test was used to analyze the data.Results: Perigastric TDs were found to be positive in 339 (5.09%) of the 6672 patients with GC of which 237 were males (69.91%) and 102 females (30.09%) (2.32:1). The median age was 59 years (ranging from 27 to 78 years). No significant differences were detected between the two groups. Univariate and multivariate survival analysis both indicated that GC patients with positive TDs had poorer prognosis than those with negative TDs (p<0.05). The 1-, 3-and 5-year overall survival rates of GC patients with TDs were 68.3%, 19.6%, and 11.2%, respectively, and were significantly poorer than those of the staged matched control group. There was statistical significance between the location of TDs and patient survival in patients with gastric cancer (p<0.05). A new TNM staging was formulated according to the TDs location. When TDs appear on the gastric body, the original T1, T2, T3 stages change to T4a, and T4a, T4b change to T4b; when TDs appear in the lesser curvature, the previous N0, N1, N2, N3 stage change to N3; when the TDs located in the greater curvature or the distant tissue, the patient should be categorized as M1. After using the new stage, the survival curve of patients with TDs was closer to that of patients without TDs in each pTNM staging.Conclusion: 1. Tumor deposits is a bad prognostic factor in patients with primary gastric cancer. 2. The location of tumor deposits is associated with the prognosis of patients with primary gastric cancer. 3. The new stage is more suitable for patients with tumor deposits of gastric cancer.
doi:10.21203/ fatcat:io576kdhirb23laip6dh2qpwqa