Comparison of clinicopathologic profiles and prognosis of gastric cancer in the upper, middle and lower third of the stomach

Abstract

Gastric cancer (GC) is the fourth most common cancer in the world and the second most common cancer in China. The aim of this study was to investigate the clinicopathologic profiles and prognosis of GC in the upper third (UT), middle third (MT) and low third (LT) of the stomach. Five hundred and forty-two patients with GC resected between January 2010 and January 2014 were retrospectively studied and divided in 3 groups according to cancer location: upper third gastric cancer (UTGC) (n = 62); MTGC (n = 131) and LTGC (n = 349). Clinical and pathological parameters including gender, age, tumor size, macroscopic types, histological types, depth of invasion, lymph node metastasis, venous infiltration and lymph embolism were compared among groups. Overall survival (OS) was calculated based on the aforementioned parameters. Univariate and multivariate survival was analyzed and Cox regression was conducted for each location. The prognostic accuracy was determined using receiver operating characteristic curve analysis. Patients with UTGC was similar to those with MTGC and both were distinct from those with LTGC based on the tumor size, macroscopic types, depth of invasion and 5-year OS. Patients with MTGC were similar to those with LTGC and distinct from UTGC patients based on gender. 5-year OS were lower for patients with UTGC than those with LTGC ( P = .001) and were comparable between MTGC and LTGC. No significant differences in 5-year OS were observed between UTGC and MTGC. Cox regression revealed that macroscopic types, depth of invasion and lymph node metastasis were the independent prognostic factors for GC patients regardless of locations. Receiver operating characteristic curve analysis revealed that macroscopic types, depth of invasion and lymph node metastasis were the significantly effective prognosis for the 5-year OS in GC patients regardless of locations. Our results showed that UTGC is distinct from LTGC whereas MTGC shares some characteristics from both UTGC and LTGC.

Comparison of incidence and prognosis between young and old gastric cancer patient in North-Western China: A retrospective cohort study

“…In the previous study, we reported the clinicopathologic characteristics and prognosis of GC patients with different tumor locations in Qinghai Province located in the North-Western China, showing that upper third GC is distinct from the lower third GC whereas middle third GC shares some characteristics from both upper third GC and lower third GC. [ 10 ] In the present study, we compared the age-specific clinicopathologic characteristics and prognosis of GC and found that young GC patients was predominant in women, EGC of macroscopic types, T1 of T staging and low or non-differentiation degree compared with old GC patients.…”

“…[ 2 ] We previously analyzed the clinicopathologic characteristics and prognosis of GC patients with different tumor locations in Qinghai Province and found that GC in upper third of the stomach is distinct from the lower third GC whereas middle third GC shares some characteristics from both upper third GC and lower third GC. [ 10 ] However, few studies reported the incidence and prognosis of young GC in the province. The present study was designed to compare the clinicopathologic characteristics and prognosis of GC in patients ≤40 and >40 years of age.…”

Disease-Specific Survival of AJCC 8th Stage II Gastric Cancer Patients After D2 Gastrectomy

“…Like our results, several studies also showed that the tumor location of gastric cancer was an independent prognostic factor; additionally, the upper location was associated with worse prognoses. Recently, Ma et al (2020) reported that the 5-year OS for patients with gastric cancer (stages I-III, 542 cases) located in the upper, middle, and lower third of the stomach were 35.0, 43.2, and 51.4%, respectively (11). With the tumor stage similar to Ma's, some studies with similar results were (14).…”

“…Recently, Ma et al. (2020) reported that the 5-year OS for patients with gastric cancer (stages I–III, 542 cases) located in the upper, middle, and lower third of the stomach were 35.0, 43.2, and 51.4%, respectively ( 11 ). With the tumor stage similar to Ma’s, some studies with similar results were published earlier.…”

Parameters of Complete Blood Count Might Predict the Prognosis of Patients with Advanced Gastric Cancer

“…Although the TNM stage is frequently used to predict the prognosis of patients, it is observed that patients with the same TNM stage progress differently. In addition to the TNM stage, many variables such as pathophysiological classi cation, tumor differentiation, serosa involvement, and lymphovascular invasion have been shown to affect the prognosis of the disease [2,3]. Although these factors have been shown to affect gastric cancer prognosis, there is no single marker that can predict survival in patients with metastatic gastric cancer.…”