Clinicopathological Characteristics and Prognosis of Upper Gastric Cancer Patients in China: A 32-Year Single-Center Retrospective Clinical Study
Clinicopathological Characteristics and Prognosis of Upper Gastric Cancer Patients in China: A 32-Year Single-Center Retrospective Clinical Study
复制标题
中国上层胃癌患者的临床病理特征和预后：32年单中心回顾性临床研究
DOI：
10.1155/2019/9248394
复制
发表时间：
2019-12-01
影响因子：
2
通讯作者：
Xu, Huimian
中科院分区：
文献类型：
--
作者：
Gong, Yingbo;Wang, Pengliang;Xu, Huimian
Purpose Upper or proximal gastric cancer occurs in the upper third of the stomach between the cardia and a line connecting the greater and lesser curvatures. As it differs from other gastric cancers in pathology and prognosis, we evaluated patient and disease characteristics that might guide improved treatment and survival of upper gastric cancer. Methods We conducted a retrospective analysis of 649 patients with upper gastric cancer and 1551 patients with lower gastric cancer and R0 radical surgery at our institution between January 1980 and December 2012. Results Survival after radical surgery for upper gastric cancer was 77.8% at 1 year, 49.6% at 3 years, and 41.1% at 5 years. The corresponding rates for lower gastric cancer were 85.9%, 60.0%, and 57.2% (p < 0.001). Upper gastric cancer had a poor prognosis. Sex (p = 0.036), tumor diameter (p = 0.001), macroscopic type (p < 0.001), pTM stage (p < 0.001), tissue differentiation type (p = 0.003), and serosal invasion (p = 0.034) were independently associated with lymph node metastasis. The macroscopic type (p = 0.045), lymphovascular tumor emboli (p = 0.021), and pTNM stage were independently associated with recurrence and metastasis. Survival of 333 patients with D2 total gastrectomy was 81.3% at 1 year, 54.4% at 3 years, and 45.2% at 5 years. The corresponding rates for 316 proximal gastrectomy patients were 75.4%, 44.9%, and 36.7%. Radical total gastrectomy had better survival than radical proximal resection. Conclusions Upper gastric cancers were more aggressive, had a worse prognosis, and were more prone to recurrence and metastasis compared with lower gastric cancers. Survival was better after total gastrectomy than after proximal resection.
