Analysis of postoperative peritoneal metastasis and prognostic factors in advanced gastric signet-ring cell carcino-ma
Objective To investigate the peritoneal metastasis,prognosis and related factors of locally advanced signet ring cell carcinoma(SRCC)after surgery.Methods The clinical data of 357 patients with locally advanced gastric cancer with recurrence and metastasis after radical surgery in the First Affiliated Hospital of Zhengzhou University from January 2012 to December 2018 were retro-spectively analyzed,and the status of peritoneal metastasis and the influencing factors of prognosis were analyzed.Results Of357 pa-tients,94 cases were SRCC(SRCC group),65 cases(69.1%)had peritoneal metastasis.263 cases were non-SRCC(NSRCC group)and 126(47.9%)had peritoneal metastasis.The difference between the two groups was statistically significant(P =0.001).Of the 65 patients with peritoneal metastasis in the SRCC group,55(84.6%)occurred within 2 years after surgery,including 46(83.6%)in stage III and 9(16.4%)in stage II and stage I.The difference was statistically significant(P＜0.05).Of the 126 pa-tients with peritoneal metastasis in the NSRCC group,105(83.3%)occurred within 2 years after surgery,including 102(97.1%)in stage III and 3(2.9%)in stage Ⅱ and stage Ⅰ,with statistical significance(P =0.001).The median overall survival(OS)in the SRCC group was 23 months,and the 3-year survival rate was 25.5%.The patients in NSRCC group were 26 months and 38.1%,re-spectively,and the difference was statistically significant(P＜0.05).The median OS in SRCC group was 19 months and the 3-year survival rate was 20%,while the OS in NSRCC group was 23 months and 34.9%,respectively,with statistical significance(P＜0.05).There was no significant difference in overall survival and 3-year survival rate between the two groups(P =0.15).The results of single factor analysis showed that SRCC,peritoneal metastasis,tumor diameter,tumor stage and vascular invasion were the prognostic factors of patients.The results of multi-factor analysis showed that peritoneal metastasis,tumor diameter and stage were inde-pendent risk factors affecting prognosis.Conclusion The recurrence and metastasis rate of locally advanced gastric cancer after radical surgery is higher,and the rate of peritoneal metastasis is higher in patients with SRCC,most of which occur within 2 years after surgery,and stage III is more common.The prognosis of SRCC patients is worse than that of NSRCC patients,which may be related to the higher postoperative peritoneal metastasis rate.
万方数据
维普
