Affiliation:
1. Shaoxing People’s Hospital
2. Korea University Medical Center, Anam Hospital
Abstract
Abstract
Background
There are few studies on the predictive factors and recurrence patterns of early and late postoperative recurrence of advanced gastric cancer (GC). Our study aims to explore the difference of clinicopathological features and recurrence patterns between early and late recurrence in patients with advanced GC after curative intent surgery, and further compare and analyze independent predictors influencing the prognosis respectively.
Materials and Method
Clinical data of patients with GC who received radical gastrectomy in Shaoxing People's Hospital between June 2016 and December 2019 was retrospectively collected. Survival analyses were conducted using the Kaplan-Meier method with log-rank tests. Cox regression analyses were used to identify independent risk factors of influencing post-recurrence survival (PRS).
Results
There was significantly statistical difference in median PRS between the early and late recurrence (4 months vs. 11 months, P = 0.038). Low body mass index (BMI) (HR = 0.86, P = 0.001), elevated monocytes (HR = 4.54, P = 0.003) and neutrophil–lymphocyte ratio (HR = 1.03, P = 0.037) at the time of recurrence were independent predictors of PRS after early recurrence. Low BMI (HR = 0.88, HR = 0.036) and hemoglobin (HR = 0.97, P = 0.008) at the time of recurrence were independent predictors of PRS after late recurrence. There were significant difference in prognosis between the three different BMI ranges for all recurrent patients (4 months vs. 9 months vs. 15 months, P = 0.02), especially for those with early recurrence (4 months vs. 7 months vs. 15 months, P = 0.015).
Conclusion
In view of the different predictive factors of early and late recurrence of GC, individualized treatment strategies can be considered to improve the survival rate in the future.
Publisher
Research Square Platform LLC