Prognostic significance of tumor deposits in radically resected gastric cancer: a retrospective study of a cohort of 1915 Chinese individuals.
Prognostic significance of tumor deposits in radically resected gastric cancer: a retrospective study of a cohort of 1915 Chinese individuals.
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DOI：
10.1186/s12957-022-02773-1
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发表时间：
2022-09-23
影响因子：
3.2
通讯作者：
Xia, Fan
中科院分区：
文献类型：
--
作者：
Zhou, Menglong;Yang, Wang;Zou, Wei;Yang, Jianing;Zhou, Changming;Zhang, Zhiyuan;Wang, Yaqi;Zhang, Jing;Wang, Yan;Li, Guichao;Zhang, Zhen;Xia, Fan
肿瘤沉积物（tumor deposition，TDs）是影响胃癌预后的独立因素。然而，相关的临床病理因素，以及如何简单合理地将TD纳入TNM分期系统仍然没有确定。因此，本研究的目的是评估TD根治性切除胃癌患者的意义。我们回顾性分析了2007年至2012年间接受根治性切除术的1915例患者。根据TD状态将患者分为两组（无TD与存在TD），并比较临床病理特征、DFS和OS。TD的存在与其他临床病理因素的关联进行了Logistic回归分析。进行单变量和多变量考克斯回归分析，以确定主要队列中DFS和OS的预后因素。进行倾向评分匹配（PSM），以减少根据TD的存在而产生选择偏倚的可能性。外部验证以前提出的修改分期系统纳入TD进行。TD检出率为10.5%（201/1915）。TD的存在与不利的临床病理变量显著相关，包括晚期T和N分类。多因素考克斯回归分析显示TD是影响DFS和OS的独立预后因素（P均< 0.001）。在PSM后队列中，TD的存在也显著缩短了DFS和OS。在外部验证中，将TD纳入pTNM阶段的一个系统具有最佳性能。TD的存在与根治性切除的胃癌患者生存率低显著相关。将TD纳入TNM分期系统可进一步提高预测能力。需要一个大样本量的多中心队列来确定适当的纳入方法。在线版本包含补充材料，可通过10.1186/s12957-022-02773-1获得。
Tumor deposits (TDs) have been identified as an independent prognostic factor in gastric cancer (GC). However, the associated clinicopathological factors and how to simply and reasonably incorporate TD into the TNM staging system remain undetermined. The aim of the current study was therefore to assess the significance of TD among radically resected GC patients. We retrospectively reviewed 1915 patients undergoing radical resection between 2007 and 2012. The patients were classified into two groups according to TD status (absent vs. present), and the clinicopathologic characteristics, DFS, and OS were compared. Associations of TD presence with other clinicopathologic factors were evaluated by logistic regression analysis. Univariate and multivariate Cox regression analyses were performed to determine the prognostic factors for DFS and OS in the primary cohort. Propensity score matching (PSM) was performed to reduce the possibility of selection bias according to the presence of TD. External validation of previously proposed modified staging systems incorporating TD was conducted. The detection rate of TD was 10.5% (201/1915). The presence of TD was significantly related to unfavorable clinicopathologic variables, including advanced T and N categories. According to the multivariate Cox regression analysis, the presence of TD was identified as an independent prognostic factor for DFS and OS in the primary cohort (both P < 0.001). In the after-PSM cohort, TD presence also significantly shortened DFS and OS. In the external validation, one system that incorporated TD into the pTNM stage had the best performance. The presence of TD was significantly associated with poor survival in radically resected GC patients. The incorporation of TD into the TNM staging system can further improve the predictive capability. A multicenter cohort with a large sample size is needed to determine the appropriate method of incorporation. The online version contains supplementary material available at 10.1186/s12957-022-02773-1.
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影响因子：
9.6
作者：
Lee, I-S;Park, Y-S;Kim, B-S
通讯作者：
Kim, B-S
DOI：
10.1002/hed.23981
发表时间：
2016-04-01
影响因子：
2.9
作者：
Sarioglu, Sulen;Akbulut, Nilhan;Ikiz, Ahmet Omer
通讯作者：
Ikiz, Ahmet Omer
影响因子：
1.9
作者：
Anup, Shrestha;Lu, Jun;Huang, Chang-Ming
通讯作者：
Huang, Chang-Ming
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影响因子：
4
作者：
Liang Wenquan;Liu Yuhua;Chen Lin
通讯作者：
Chen Lin
影响因子：
--
作者：
Tan, Jianan;Yang, Bin;Han, Fanghai
通讯作者：
Han, Fanghai