Pathological tumor infiltrative pattern and sites of initial recurrence in stage II/III gastric cancer: Propensity score matching analysis of a multi‐institutional dataset

Abstract

BackgroundAdvanced gastric cancer frequently recurs even after radical resection followed by adjuvant chemotherapy. The aim of this study was to evaluate the relationship between pathological infiltrative pattern (INF) and initial recurrence patterns in patients with stage II/III gastric cancer using a large multicenter database.MethodsWe retrospectively analyzed 1098 eligible patients who underwent curative gastrectomy for stage II/III gastric cancer at nine institutions between 2010 and 2014. Patients were categorized into the INF‐a/b and INF‐c groups and adjusted using propensity score matching.ResultsAfter propensity score matching, 686 patients (343 for each) were classified in the INF‐a/b and INF‐c groups. There were no significant differences in overall and disease‐free survival between the two groups. In the INF‐a/b group, frequencies of recurrence at the peritoneum, lymph node, and liver were equivalent. In contrast, the peritoneum was the most frequent site and accounted for 60% of the total recurrences in the INF‐c group. The cumulative peritoneal recurrence rate was significantly higher in the INF‐c group than in the INF‐a/b group (hazard ratio 2.47). INF‐c was a significant risk factor for peritoneal recurrences in most subgroups including age, sex, macroscopic type, tumor differentiation, and disease stage, and whether the postoperative treatment was given. Multivariate analysis identified INF‐c as an independent risk factor for peritoneal recurrences. The cumulative liver recurrence rate was significantly higher in the INF‐a/b group than in the INF‐c group (hazard ratio 3.44).ConclusionsINF may represent an important predictor of recurrence patterns after curative resection of stage II/III gastric cancer.

Multi‐institutional analysis of the prognostic significance of postoperative complications after curative resection for gastric cancer

“…We analyzed an updated multi‐institutional retrospective database compiled by integrating clinical data from nine institutions and performed a retrospective review of the clinical data for 3575 patients who underwent gastrectomy for gastric cancer between January 2010 and December 2014 . The eligibility criteria of this study included histologically proven adenocarcinoma, no preoperative treatment, and no residual lesions after surgery (Figure A).…”

The protocol of a prospective, multicenter, randomized, controlled phase III study evaluating different cycles of oxaliplatin combined with S-1 (SOX) as neoadjuvant chemotherapy for patients with locally advanced gastric cancer: RESONANCE-II trial

“…At present radical gastrectomy is regarded as the only approach to curing gastric cancer. However, about 30% of patients with gastric cancer have recurrence after receiving radical gastrectomy [ 4 , 5 ]. Thus it is difficult to achieve a cure for gastric cancer through surgery alone.…”

Inhibition of circRNA circVPS33B reduces cell malignant behaviors and Warburg effect through regulation of the miR-873-5p/HNRNPK axis in infiltrative gastric cancer 

“…HNRNPK served as a target for miR-873-5p in XGC-1 cells. 5. The study provided a new mechanism to understand the progression of in ltrative GC.…”

“…Moreover, the prognosis of in ltrative GC is worse than that of expanding GC [3]. Studies have reported that the recurrence of the peritoneal or liver after radical resection of GC is closely related to the pathological in ltrative pattern (INF) [4,5]. Therefore, it is of great signi cance to explore the latent molecular mechanism of in ltrative GC progression.…”