Cancer cells invasion to the gastric bare area adipose tissue: a poor prognostic predictor for gastric cancer

Abstract

Background The relationship between gastric bare area adipose tissues invasion (GBAI) confirmed pathologically and the prognosis of gastric cancer (GC) patients is undefined. Till present, there has not been literature investigating this phenomenon. Here, we aimed at analyzing the implication of GBAI in GC. Methods The data of 1822 patients who underwent radical surgery between January 2000 and December 2013 at the Sun Yat-sen University Cancer Center were retrieved. Pathologically, tumor deposits (TDs) located > 5 mm from the leading edge of the primary tumor and the lymph nodes (LNs) station number 1, 2, 7, and 9 were considered GBAI. Kaplan-Meier method, log-rank test, and Cox’s proportional hazards model were employed to analyze. Results Two hundred and five (11.3%) patients were pathologically diagnosed with GBAI, which was more commonly found in proximal or linitis lastica than distal GC (P < 0.001). There was significant difference in 5-year survival between patients with and without GBAI for stages IIB, IIIA, IIIB, and IIIC, respectively (P < 0.009 for IIB, IIIA, and IIIB; P = 0.021 for IIIC). Among the 205 GBAI patients, 61 had detailed radiological follow-up data in which 26 (34.7%) were found to have retroperitoneal infiltration, 27 (36.0%) had peritoneal metastasis, 10 (13.3%) had hematogenous metastasis, 16 (21.3%) had lymphatic metastasis, and 16 (21.3%) had others. Conclusions GBAI was identified as a predictor of unfavorable prognosis for GC and was more commonly found in the proximal or linitis plastica of the stomach than in distal stomach. Retroperitoneal infiltration was one of the most commonly identified metastatic route for GC associated with GBAI after radical surgery.

The Genomic Signatures of Linitis Plastica Signal the Entrance into a New Era: Novel Approaches for Diagnosis and Treatment

“…Adipocytes found around tumors, along their borders, or within the tumor itself, serve a function similar to CAFs. These are referred to as cancer-associated adipocytes (CAAs) and they promote angiogenesis, cancerous cell infiltration and serve as an initial step for peritoneal infiltration [44]. Saito et al elucidated the mechanisms underlying the interaction between cancerous cells and human peritoneal mesothelial cells (HPMCs) in the development of fibrosis and metastasis in GC caused by TGF-b1.…”

“…The latter is responsible for 36% of retroperitoneal infiltration and 21.3% of LN metastasis, observed in 11.3% of the patients. However, a prognosis is improved when signet ring cells make up more than 50% of the tumor composition [5,44,46].…”

A population-based predictive model to identify patients with signet ring cell carcinoma of the stomach who are most suitable for primary tumor resection

“…In other studies, a single small tumor and limited metastasis were associated with better results for SRCC patients undergoing primary tumor surgical resection, which might be due to the lower difficulty of the operation and the relatively good physical condition of the patients [ 12 ]. And we found that gastric bare area adipose tissues invasion (GBAI) was identified as a predictor of unfavorable prognosis for gastric cancer and was more commonly found in the proximal or linitis plastica of the stomach than in the distal stomach [ 13 ]. But we still do not know the relationship between GBAI and signet ring cell carcinoma.…”