Long-term survival of patients with stage II and III gastric cancer who underwent gastrectomy with inadequate nodal assessment

Table 3 Cox regression analysis of overall survival and cancer-specific survival

	Overall survival				Cancer-specific survival
Variable	Univariable		Multivariable1		Univariable		Multivariable1
	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value	HR (95%CI)	P value
Sex
Male	Reference				Reference
Female	1.03 (0.99-1.08)	0.171			1.07 (1.02-1.13)	0.006
Age, yr
< 70	Reference		Reference		Reference		Reference
≥ 70	1.57 (1.50-1.64)	< 0.001	1.51 (1.43-1.59)	< 0.001	1.32 (1.26-1.39)	< 0.001	1.33 (1.26-1.41)	< 0.001
Race
White	Reference				Reference		Reference
Black	0.97 (0.91-1.03)	0.283	1.11 (1.05-1.18)	0.001	0.97 (0.90-1.03)	0.317	1.10 (1.03-1.18)	0.005
Asian/Pacific	0.80 (0.75-0.85)	< 0.001	0.82 (0.77-0.87)	< 0.001	0.82 (0.77-0.87)	< 0.001	0.83 (0.78-0.89)	< 0.001
Insurance status
NA	Reference				Reference
Insured	0.92 (0.88-0.97)	0.001			1.05 (0.91-1.21)	0.550
Uninsured	0.96 (0.84-1.09)	0.501			0.95 (0.83-1.09)	0.459
Site of tumor
Fundus-body	Reference				Reference
Antrum-pylorus	1.08 (1.01-1.15)	0.030			1.08 (0.99-1.16)	0.055
Overlapping lesion of the stomach	1.30 (1.19-1.42)	< 0.001			1.35 (1.23-1.49)	< 0.001
Stomach, NOS	1.05 (0.98-1.13)	0.167			1.04 (0.96-1.12)	0.373
Histology
ADC, NOS	Reference		Reference		Reference		Reference
Signet ring cell carcinoma	1.16 (1.09-1.23)	< 0.001	1.14 (1.07-1.21)	< 0.001	1.28 (1.20-1.37)	< 0.001	1.16 (1.09-1.25)	< 0.001
ADC, instestinal type	0.87 (0.81-0.93)	< 0.001	0.98 (0.91-1.05)	0.547	0.79 (0.73-0.86)	< 0.001	0.93 (0.86-1.01)	0.086
Carcinoma, diffuse type	1.15 (1.06-1.26)	0.001	1.12 (1.03-1.23)	0.011	1.22 (1.11-1.34)	< 0.001	1.11 (1.00-1.22)	0.045
ADC with mixed subtypes	1.06 (0.94-1.20)	0.349	1.09 (0.96-1.24)	0.169	1.12 (0.98-1.28)	0.103	1.08 (0.94-1.24)	0.281
Other	0.92 (0.85-1.00)	0.062	0.97 (0.89-1.06)	0.543	0.95 (0.86-1.04)	< 0.001	1.01 (0.92-1.11)	0.862
T stage, 8th ed.
T1	Reference		Reference		Reference		Reference
T2	1.13 (0.93-1.36)	0.217	1.08 (0.88-1.32)	0.455	1.12 (0.89-1.41)	0.322	1.01 (0.79-1.28)	0.963
T3	1.52 (1.28-1.80)	< 0.001	1.37 (1.09-1.73)	0.008	1.69 (1.37-2.07)	< 0.001	1.34 (1.02-1.76)	0.033
T4a	2.34 (1.98-2.78)	< 0.001	1.72 (1.33-2.22)	< 0.001	2.89 (2.35-3.55)	< 0.001	1.70 (1.27-2.28)	< 0.001
T4b	2.83 (2.37-3.38)	< 0.001	2.08 (1.48-2.93)	< 0.001	3.54 (2.86-4.39)	< 0.001	2.06 (1.40-3.01)	< 0.001
N stage, 8th ed.
N0	Reference		Reference		Reference		Reference
N1	1.22 (1.14-1.31)	< 0.001	1.30 (1.16-1.46)	< 0.001	1.31 (1.21-1.43)	< 0.001	1.26 (1.10-1.43)	0.001
N2	1.49 (1.39-1.59)	< 0.001	1.49 (1.28-1.73)	< 0.001	1.70 (1.57-1.84)	< 0.001	1.44 (1.22-1.70)	< 0.001
N3a	2.05 (1.92-2.19)	< 0.001	2.10 (1.61-2.74)	< 0.001	2.51 (2.32-2.71)	< 0.001	2.06 (1.55-2.76)	< 0.001
N3b	2.90 (2.66-3.15)	< 0.001	3.22 (2.17-4.80)	< 0.001	3.68 (3.36-4.03)	< 0.001	3.29 (2.14-5.05)	< 0.001
Stage, 8th ed.
IIA	Reference		Reference		Reference		Reference
IIB	1.34 (1.24-1.45)	< 0.001	1.17 (1.05-1.31)	0.005	1.62 (1.47-1.78)	< 0.001	1.38 (1.22-1.57)	< 0.001
IIIA	1.96 (1.83-2.10)	< 0.001	1.43 (1.21-1.70)	< 0.001	2.53 (2.33-2.75)	< 0.001	1.78 (1.48-2.15)	< 0.001
IIIB	2.47 (2.30-2.66)	< 0.001	1.44 (1.08-1.92)	0.012	3.38 (3.11-3.68)	< 0.001	1.87 (1.37-2.55)	< 0.001
IIIC	3.68 (3.39-3.99)	< 0.001	1.59 (1.04-2.44)	0.034	5.19 (4.73-5.70)	< 0.001	2.05 (1.29-3.26)	0.003
Grade
Well/moderately differentiated	Reference		Reference		Reference
Poorly/undifferentiated	1.35 (1.28-1.43)	< 0.001	1.19 (1.12-1.26)	< 0.001	1.59 (1.49-1.70)	< 0.001
Type of surgery
Partial gastrectomy	Reference		Reference		Reference		Reference
Total gastrectomy	1.25 (1.19-1.32)	< 0.001	1.23 (1.17-1.30)	< 0.001	1.32 (1.25-1.40)	< 0.001	1.22 (1.15-1.29)	< 0.001
Chemotherapy
No	Reference		Reference		Reference		Reference
Yes	0.62 (0.59-0.64)	< 0.001	0.68 (0.64-0.72)	< 0.001	0.71 (0.67-0.74)	< 0.001	0.73 (0.68-0.78)	< 0.001
Neoadjuvant chemotherapy
No	Reference				Reference
Yes	0.76 (0.71-0.83)	< 0.001			0.82 (0.75-0.89)	< 0.001
Radiotherapy
No	Reference		Reference		Reference		Reference
Yes	0.65 (0.62-0.68)	< 0.001	0.77 (0.73-0.82)	< 0.001	0.70 (0.66-0.73)	< 0.001	0.75 (0.71-0.80)	< 0.001
Number of retrieved lymph nodes
ILA	Reference		Reference		Reference		Reference
ALA	0.84 (0.79-0.88)	< 0.001	0.68 (0.64-0.71)	< 0.001	0.85 (0.81-0.90)	< 0.001	0.64 (0.60-0.68)	< 0.001
OLA	0.73 (0.68-0.79)	< 0.001	0.48 (0.44-0.52)	< 0.001	0.80 (0.74-0.86)	< 0.001	0.47 (0.43-0.51)	< 0.001

¹Forward selection model. ADC: Adenocarcinoma; ALA: Adequate lymph node assessment; CI: Confidence interval; HR: Hazard ratio; ILA: Inadequate lymph node assessment; OLA: Optimal lymph node assessment; NA: Not available, NOS: Not otherwise specified.