Prognostic impact and reasons for variability by tumor location in gastric cancer

World J Gastroenterol. 2024 Nov 28;30(44):4709-4724. doi: 10.3748/wjg.v30.i44.4709.

Abstract

Background: Gastric cancer (GC) is a highly prevalent gastrointestinal tract tumor. Several trials have demonstrated that the location of GC can affect patient prognosis. However, the factors determining tumor location remain unclear.

Aim: To investigate the tumor location of patients, we went on to study the influencing factors that lead to changes in the location of GC.

Methods: A retrospective evaluation was carried out on 3287 patients who underwent gastrectomy for GC in Zhejiang Cancer Hospital. The patients were followed up post-diagnosis and post-gastrectomy. The clinicopathological variables and overall survival of the patients were recorded. By analyzing the location of GC, the tumor location was divided into four categories: "Upper", "middle", "lower", and "total". Statistical software was utilized to analyze the relationship of each variable with the location of GC.

Results: A total of 3287 patients were included in this study. The clinicopathological indices of gender, age, serum levels of carcinoembryonic antigen (CEA), carbohydrate antigen (CA19-9) and CA72-4 levels, were significantly associated with tumor location in patients with GC. In addition, there was a strong correlation between GC location and the prognosis of postoperative patients. Specifically, patients with "lower" and "middle" GC demonstrated a better prognosis than those with tumors in other categories.

Conclusion: The five clinicopathological indices of gender, age, CEA, CA19-9 and CA72-4 levels exhibit varying degrees of influence on the tumor location. The tumor location correlates with patient prognosis following surgery.

Keywords: Clinicopathologic characteristics; Gastric cancer; Overall survival; Tumor location; Tumor marker.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Antigens, Tumor-Associated, Carbohydrate* / analysis
  • Antigens, Tumor-Associated, Carbohydrate* / blood
  • Biomarkers, Tumor / analysis
  • Biomarkers, Tumor / blood
  • CA-19-9 Antigen / blood
  • Carcinoembryonic Antigen* / blood
  • China / epidemiology
  • Female
  • Gastrectomy*
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Retrospective Studies
  • Stomach Neoplasms* / blood
  • Stomach Neoplasms* / mortality
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / surgery
  • Treatment Outcome

Substances

  • Antigens, Tumor-Associated, Carbohydrate
  • Carcinoembryonic Antigen
  • CA-72-4 antigen
  • CA-19-9 Antigen
  • Biomarkers, Tumor