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A study on clinicopathological features and prognostic factors of patients with upper gastric cancer and middle and lower gastric cancer

Gang Wang, Jingrong Zhou, Feng Lu, Lei Qiu, Yongchang Miao

Objective: To compare the difference on clinicopathological features and prognostic factors in patients with upper gastric cancer and middle and lower gastric cancer.

Methods: 168 cases of gastric cancer patients treated in our hospital from January 2010 to March 2013 were enrolled as the research objects. All of these patients have complete data and were confirmed by pathology and classified into stages I-III period, with 90 cases of upper gastric cancer and 78 cases of middle and lower gastric cancer respectively. Of the 168 cases, 150 cases (89.3%) underwent R0 treatment (no residue under microscope after resection), 18 cases (10.7%) underwent R1 treatment (microscopic residual) and 152 cases (90.5%) underwent D2 (radical type II) perigastric lymph node dissection treatment.

Results: There were no significant differences on TNM stage, operation modes, the number of dissected lymph nodes and postoperative complications between the upper gastric cancer group and middle and lower gastric cancer group (P>0.05). There were significant differences on preoperative complications and postoperative adjuvant chemotherapy between the upper gastric cancer group and middle and lower gastric cancer group (P<0.05). 3 y Overall Survival (OS) and Progression-Free Survival (PFS) in the upper gastric cancer group were 35.6% (32/90 cases) and 47.8% (43/90) (P=0.026), and 43.6% (34/78 cases) and 51.3% (40/78) respectively in middle and lower gastric cancer group (P=0.035). Logistic regression analysis showed that risk factors affecting the prognosis of upper gastric cancer were preoperative complications and postoperative adjuvant chemotherapy, while the risk factors affecting the prognosis of middle and lower gastric cancer were TNM staging, preoperative complications and postoperative adjuvant chemotherapy. By the last follow-up on March 31, 2017, 51 of 90 (56.7%) patients with upper gastric cancer and 34 of 78 (43.6%) patients with middle and lower gastric cancer died respectively (P<0.05).

Conclusion: There were significant differences on the clinical pathological features and prognosis between patients with upper gastric cancer and middle and lower gastric cancer patients, it is of great guiding significance to know the pathological features of cancer in different parts, it can provide individualized treatment options for patients and improve the prognosis of patients.