Background
Methods
Patients
Data collection
Statistical analysis
Declarations
Results
Clinicopathological characteristics
Factors | Number | (%) | |
---|---|---|---|
Age (years) | Median [range] | 67 | [21–92] |
Sex | Male Female | 394 190 | (67.5) (32.5) |
Body mass index | Median [range] | 23.0 | [14.0–36.7] |
Tumor location | Upper 1/3 stomach Middle 1/3 stomach Lower 1/3 stomach Whole stomach | 142 240 198 4 | (24.3) (41.1) (33.9) (0.7) |
Histological features | Differentiated Un-differentiated | 330 254 | (56.5) (43.5) |
Pathological T disease | T1 T2 T3 T4 | 83 184 160 157 | (14.2) (31.5) (27.4) (26.9) |
Pathological N disease | N0 N1 N2 N3 | 204 194 99 87 | (34.9) (33.2) (17.0) (14.9) |
Pathological stage | IB IIA IIB IIIA IIIB IIIC | 163 102 134 82 56 47 | (27.9) (17.5) (22.9) (14.0) (9.6) (8.0) |
Surgical approach | Laparoscopic Open method | 104 480 | (17.8) (82.2) |
Surgical method | Distal gastrectomy Total gastrectomy Proximal gastrectomy Segmental gastrectomy | 401 167 13 3 | (68.7) (28.6) (2.2) (0.5) |
Lymph node dissection | D1 + D2 D2 + | 182 371 31 | (31.2) (63.5) (5.3) |
Resection of adjacent organ | Spleen Pancreas Lower thoracic esophagus Transverse colon Liver Uterus, ovary | 27 9 12 1 1 4 | (4.6) (1.5) (2.1) (0.2) (0.2) (0.7) |
Operation time (min) | Median [range] | 165 | [65–678)] |
Bleeding (mL) | Median [range] | 70 | [2,690] |
Postoperative morbidity (Clavien-Dindo classification) | None Grade I Grade II Grade IIIa Grade IIIb Grade IVa Grade IVb | 493 8 28 46 5 2 2 | (84.4) (1.4) (4.8) (7.9) (0.9) (0.3) (0.3) |
Postoperative adjuvant chemotherapy | Present Absent | 362 222 | (62.0) (38.0) |
Perioperative ALC values
Factors | Number | Pre-ALC median [range] | p value | Post-ALC median [range] | p value | |
---|---|---|---|---|---|---|
Age (years) | < 70 ≥ 70 | 347 237 | 1747 [588–4229] 1732 [591–4001] | 0.07 | 1732 [592–4001] 1663 [357–3559] | 0.06 |
Sex | Male Female | 394 190 | 1669 [588–3531] 1730 [396–4229] | 0.46 | 1676 [637–3557] 1736 [357–4001] | 0.19 |
Body mass index | < 25.0 ≥ 25.0 | 414 170 | 1854 [655–3952] 1681 [396–4226] | < 0.01 | 1783 [616–4001] 1647 [357–3559] | < 0.01 |
Tumor size | < 8 cm ≥ 8 cm | 504 80 | 1713 [396–4229] 1656 [588–3192] | 0.24 | 1712 [357–4001] 1644 [363–3332] | 0.16 |
Depth of tumor | pT1–2 pT3–4 | 267 317 | 1710 [630–4229] 1707 [396–3729] | 0.34 | 1724 [357–4001] 1700 [363–3507] | 0.60 |
Nodal status | pN0–1 pN2–3 | 398 186 | 1734 [396–4229] 1682 [655–3492] | 0.13 | 1732 [357–4001] 1645 [363–3461] | 0.11 |
Vessel invasion | Ly0–2 and V0–2 Ly3 and/or V3 | 481 101 | 1742 [396–4229] 1587 [655–3952] | < 0.01 | 1729 [357–4001] 1627 [531–2790] | 0.14 |
Histological feature | Differentiated Un-differentiated | 330 254 | 1724 [588–4229] 1695 [396–3952] | 0.36 | 1721 [357–4001] 1689 [363–3557] | 0.51 |
Type of gastrectomy | Non-total Total | 417 167 | 1702 [588–4229] 1735 [396–3952] | 0.55 | 1724 [357–4001] 1652 [531–3557] | 0.29 |
Surgical approach | Open method Laparoscopic | 480 104 | 1690 [396–4229] 1755 [616–3729] | 0.35 | 1687 [357–4001] 1805 [630–3461] | 0.25 |
Operation time | ≤ 240 min > 240 min | 449 135 | 1686 [396–4229] 1792 [600–3952] | 0.43 | 1693 [357–4001] 1739 [624–3559] | 0.58 |
Blood loss | ≤ 200 mL > 200 mL | 477 107 | 1700 [396–4229] 1808 [588–3952] | 0.91 | 1700 [357–4001] 1705 [624–3493] | 0.92 |
Resection of other organs | ( −) ( +) | 537 47 | 1710 [396–4229] 1659 [588–3072] | 0.51 | 1701 [357–4001] 1652 [658–3494] | 0.88 |
Morbidity CD grade | < Grade II ≥ Grade II | 498 86 | 1695 [396–4229] 1817 [663–3952] | 0.17 | 1701 [357–3559] 1703 [363–4001] | 0.89 |
Survival analysis
Covariates | Number | Univariate analysis | Multivariate analysis | ||||
---|---|---|---|---|---|---|---|
3Y-RFS (%) | Log rank P value | HR | [95% CI] | p value | |||
Age (years) | < 70 ≥ 70 | 347 237 | 86.5 79.1 | < 0.01 | 1.906 | [1.339–2.715] | < 0.01 |
Sex | Male Female | 394 190 | 80.7 89.5 | < 0.01 | 2.047 | [1.327–3.158] | < 0.01 |
Body mass index | < 25.0 ≥ 25.0 | 414 170 | 81.0 89.7 | 0.04 | 1.768 | [1.165–2.681] | < 0.01 |
Tumor size | < 8 cm ≥ 8 cm | 504 80 | 86.0 67.3 | < 0.01 | 1.609 | [1.061–2.440] | 0.03 |
Depth of tumor | pT1-2 pT3-4 | 267 317 | 93.0 75.4 | < 0.01 | 1.711 | [1.234–2.742] | < 0.01 |
Nodal status | pN0-1 pN2-3 | 398 186 | 89.9 69.8 | < 0.01 | 1.903 | [1.324–2.734] | < 0.01 |
Vessel invasion | Ly0–2 and V0–2 Ly3 and/or V3 | 481 101 | 88.3 60.3 | < 0.01 | 2.257 | [1.535–3.317] | < 0.01 |
Histological feature | Differentiated Un-differentiated | 330 254 | 85.1 81.6 | 0.30 | – | – | – |
Type of gastrectomy | Non-total Total | 417 167 | 88.3 71.6 | < 0.01 | 1.598 | [1.116–2.290] | 0.01 |
Surgical approach | Open method Laparoscopic | 480 104 | 83.1 87.3 | 0.31 | – | – | – |
Operation time | ≤ 240 min > 240 min | 449 135 | 83.7 83.6 | 0.40 | – | – | – |
Blood loss | ≤ 200 mL > 200 mL | 477 107 | 84.7 78.1 | 0.03 | 1.029 | [0.679–1.561] | 0.89 |
Resection of other organs | ( −) ( +) | 537 47 | 84.2 75.9 | 0.10 | – | – | – |
Morbidity | < Grade II ≥ Grade II | 498 86 | 85.0 75.0 | < 0.01 | 1.589 | [1.060–2.382] | 0.03 |
Pre-ALC | ≥ 1000/μL < 1000/μL | 524 60 | 85.0 71.8 | < 0.01 | 0.951 | [0.533–1.694] | 0.86 |
Post-ALC | ≥ 1000/μL < 1000/μL | 521 63 | 85.9 63.7 | < 0.01 | 1.875 | [1.156–3.042] | 0.01 |
Covariates | Number | Univariate analysis | Multivariate analysis | ||||
---|---|---|---|---|---|---|---|
5Y-OS (%) | Log rank P value | HR | [95% CI] | p value | |||
Age (years) | < 70 ≥ 70 | 347 237 | 86.4 75.8 | < 0.01 | 2.277 | [1.558–3.328] | < 0.01 |
Sex | Male Female | 394 190 | 79.1 88.8 | < 0.01 | 1.816 | [1.143–2.883] | 0.01 |
Body mass index | < 25.0 ≥ 25.0 | 414 170 | 87.1 80.2 | 0.07 | – | – | – |
Tumor size | < 8 cm ≥ 8 cm | 504 80 | 84.2 68.3 | < 0.01 | 1.587 | [1.003–2.512] | 0.04 |
Depth of tumor | pT1-2 pT3-4 | 267 317 | 88.1 77.1 | < 0.01 | 1.530 | [1.003–2.335 | 0.04 |
Nodal status | pN0-1 pN2-3 | 398 186 | 86.7 72.5 | < 0.01 | 1.577 | [1.059–2.349] | 0.03 |
Vessel invasion | Ly0–2 and V0–2 Ly3 and/or V3 | 481 101 | 87.6 76.7 | < 0.01 | 2.444 | [1.610–3.709] | < 0.01 |
Histological feature | Differentiated Un-differentiated | 330 254 | 82.5 81.9 | 0.65 | – | – | – |
Type of gastrectomy | Non-total Total | 417 167 | 86.8 70.5 | < 0.01 | 1.518 | [1.027–2.244] | 0.04 |
Surgical approach | Open method Laparoscopic | 480 104 | 81.6 90.0 | 0.28 | – | – | – |
Operation time | ≤ 240 min > 240 min | 449 135 | 81.9 81.5 | 0.79 | – | – | – |
Blood loss | ≤ 200 mL > 200 mL | 477 107 | 83.9 75.8 | 0.09 | – | – | – |
Resection of other organs | ( −) ( +) | 537 47 | 83.2 71.5 | 0.40 | – | – | – |
Morbidity | < Grade II ≥ Grade II | 498 86 | 83.9 72.5 | < 0.01 | 1.666 | [1.088–2.552] | 0.02 |
Pre-ALC | ≥ 1000/μL < 1000/μL | 524 60 | 83.4 67.7 | 0.02 | 0.900 | [0.479–1.688] | 0.74 |
Post-ALC | ≥ 1000/μL < 1000/μL | 521 63 | 83.8 67.6 | < 0.01 | 2.275 | [1.373–3.769] | 0.01 |