Cancer cells invasion to the gastric bare area adipose tissue: a poor prognostic predictor for gastric cancer
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(2020) 18:300
RESEARCH
Open Access
Cancer cells invasion to the gastric bare area adipose tissue: a poor prognostic predictor for gastric cancer Yongming Chen1,2† , Shuhang Xu3†, Chunyu Huang1,4, Yihong Ling1,5, Chengcai Liang1,2, Yuhua Miao1,2, Xiaowei Sun1,2, Yuanfang Li1,2* and Zhiwei Zhou1,2*
Abstract Background: The relationship between gastric bare area adipose tissues invasion (GBAI) confirmed pathologically and the prognosis of gastric cancer (GC) patients is undefined. Till present, there has not been literature investigating this phenomenon. Here, we aimed at analyzing the implication of GBAI in GC. Methods: The data of 1822 patients who underwent radical surgery between January 2000 and December 2013 at the Sun Yat-sen University Cancer Center were retrieved. Pathologically, tumor deposits (TDs) located > 5 mm from the leading edge of the primary tumor and the lymph nodes (LNs) station number 1, 2, 7, and 9 were considered GBAI. Kaplan-Meier method, log-rank test, and Cox’s proportional hazards model were employed to analyze. Results: Two hundred and five (11.3%) patients were pathologically diagnosed with GBAI, which was more commonly found in proximal or linitis lastica than distal GC (P < 0.001). There was significant difference in 5-year survival between patients with and without GBAI for stages IIB, IIIA, IIIB, and IIIC, respectively (P < 0.009 for IIB, IIIA, and IIIB; P = 0.021 for IIIC). Among the 205 GBAI patients, 61 had detailed radiological follow-up data in which 26 (34.7%) were found to have retroperitoneal infiltration, 27 (36.0%) had peritoneal metastasis, 10 (13.3%) had hematogenous metastasis, 16 (21.3%) had lymphatic metastasis, and 16 (21.3%) had others. Conclusions: GBAI was identified as a predictor of unfavorable prognosis for GC and was more commonly found in the proximal or linitis plastica of the stomach than in distal stomach. Retroperitoneal infiltration was one of the most commonly identified metastatic route for GC associated with GBAI after radical surgery. Keywords: Gastric cancer, GBA, GBAI, Retroperitoneal infiltration, TDs
Introduction The latest global cancer statistics showed that gastric cancer (GC) is now the sixth most common cancer affecting the global population but still rank third as the leading cause of cancer mortality [1]. In mainland China [2], GC remains third as the most prevalent cancer and * Correspondence: [email protected]; [email protected] † Yongming Chen and Shuhang Xu contributed equally to this work. 1 State Key Laboratory of Oncology in South China, Collaborative Innovation Center for Cancer Medicine, Guangzhou, China Full list of author information is available at the end of the article
leading cause of cancer-related death, illustrating a much higher incidence and mortality than in any other country, and most importantly, China also comprise nearly one half of the total global GC incidence [2–4]. Recurrences and metastases following radical surgery are major challenges to tackle for improving the survival outcomes of GC as these a
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