Prognostic impact and reasons for variability by tumor location in gastric cancer

Table 1 Clinicopathological characteristics of gastric cancer patient samples, n = 3287, n (%)

Characteristics	Number of cases
Gender
Male	2541 (77.3)
Female	746 (22.7)
Age
< 60	1191 (36.2)
≥ 60	2096 (63.8)
BMI
≤ 18	296 (9.0)
18-24	2090 (63.6)
≥ 24	901 (27.4)
Family history
No	2102 (63.9)
Yes	1185 (36.1)
Smoking history
No	1767 (53.8)
Yes	1520 (46.2)
Drinking history
No	2261 (68.8)
Yes	1026 (31.2)
Surgery methods
Open	2274 (84.4)
Laparoscopy	513 (15.6)
Range of resection
Proximal	187 (5.7)
Distal	1719 (52.3)
Total	1381 (42.0)
Tumor location
Middle	1007 (30.6)
Lower	507 (15.4)
Upper	1721 (52.4)
Total	52 (1.6)
Differentiation
Well	22 (0.7)
Well-moderate	61 (1.9)
Moderate	771 (23.5)
Moderate-poor	1300 (39.5)
Poor	1133 (34.5)
Pathological type
Adenocarcinoma	2283 (87.7)
PMGC	206 (6.3)
MGC	198 (6.0)
Vascular tumor thrombus
No	1720 (52.3)
Yes	1567 (47.7)
Nerve invasion
No	1718 (52.3)
Yes	1569 (47.7)
Maximum tumor diameter (cm)
< 5	1982 (60.3)
≥ 5	1305 (39.7)
Tumor depth
T1	622 (18.9)
T2	447 (13.6)
T3	203 (6.2)
T4	2015 (61.3)
Lymph node metastasis
N0	1142 (34.7)
N1	622 (18.9)
N2	703 (21.4)
N3	820 (24.9)
pTNM
I	788 (24.0)
II	733 (22.3)
III	1766 (53.7)
CEA
< 5	2578 (78.4)
≥ 5	709 (21.6)
CA19-9
< 37	2573 (78.3)
≥ 37	714 (21.7)
CA125
< 35	3101 (94.3)
≥ 35	186 (5.7)
AFP
< 10	3110 (94.6)
≥ 10	177 (5.4)
CA242
< 15	2735 (83.2)
≥ 15	552 (16.8)
CA72-4
< 6.9	2661 (81.0)
≥ 6.9	626 (19.0)

AFP: Alpha-fetoprotein; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; BMI: Body mass index; pTNM: Pathological tumor-node-metastasis; PMGC: Peritoneal metastases of gastric cancer; MGC: Mucinous gastric carcinoma.

Table 2 Five-year overall survival of patients with different tumor locations, %

Tumor location	OS
	1-year	2-year	3-year	4-year	5-year
Upper	89.7	73.3	52.3	40.6	32.2
Middle	93.5	78.1	53.6	41.8	30.4
Lower	91.2	77.9	57.8	44.4	33.5
Total	78.8	53.8	36.5	26.9	25.0

OS: Overall survival.

Table 3 Correlations between tumor location and clinicopathologic characteristics of gastric cancer patients

Characteristics	Tumor location
	Middle	Lower	Upper	Total	P value
Gender
Male	390	1285	826	40	< 0.001
Female	117	436	181	12
Age
< 60	228	692	248	23	< 0.001
≥ 60	279	1029	759	29
BMI
≤ 18	40	161	89	6	0.354
18-24	306	1107	645	32
≥ 24	161	453	273	14
Family history
No	320	1125	629	28	0.177
Yes	187	596	378	24
Smoking history
No	290	935	515	27	0.140
Yes	217	786	492	25
Drinking history
No	364	1178	682	37	0.409
Yes	143	543	325	15
Range of resection
Proximal	9	1	177	0	< 0.001
Distal	197	1515	5	2
Total	301	205	825	50
Differentiation
Well	2	15	5	0	< 0.001
Well-moderate	4	37	19	1
Moderate	101	363	300	7
Moderate-poor	193	693	397	17
Poor	207	613	286	27
Pathological type
Adenocarcinoma	460	1509	871	43	0.131
PMGC	20	111	72	3
MGC	27	101	64	6
Vascular tumor thrombus
No	281	923	501	15	0.001
Yes	226	798	506	37
Nerve invasion
No	266	1023	421	8	< 0.001
Yes	241	698	586	44
Maximum tumor diameter
< 5 cm	344	1129	505	4	< 0.001
≥ 5 cm	163	592	502	48
Tumor depth
T1	103	433	86	0	< 0.001
T2	80	265	100	2
T3	40	96	64	3
T4	284	927	757	47
Lymph node metastasis
N0	196	624	318	4	< 0.001
N1	101	331	186	4
N2	95	350	244	14
N3	115	416	259	30
pTNM
I	135	501	150	2	< 0.001
II	136	377	218	2
III	236	843	639	48
CEA
< 5	424	1369	753	32	< 0.001
≥ 5	83	352	254	20
CA19-9
< 37	423	1365	752	33	< 0.001
≥ 37	84	356	255	19
CA125
< 35	474	1635	950	42	< 0.001
≥ 35	33	86	57	10
AFP
< 10	484	1626	954	46	0.197
≥ 10	23	95	53	6
CA242
< 15	439	1448	812	36	0.001
≥ 15	68	273	195	16
CA72-4
< 6.9	432	1391	802	36	0.008
≥ 6.9	75	330	205	16

AFP: Alpha-fetoprotein; CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; BMI: Body mass index; pTNM: Pathological tumor-node-metastasis; PMGC: Peritoneal metastases of gastric cancer; MGC: Mucinous gastric carcinoma.

Table 4 Spearman analysis of the correlation between tumor location and clinicopathological data

Characteristics	Tumor location
	Spearman correlation	P value
Gender	-0.056	0.001
Age	0.148	< 0.001
BMI	-0.022	0.197
Family history	0.019	0.279
Smoking history	0.040	0.020
Drinking history	0.022	0.202
Range of resection	0.256	< 0.001
Differentiation	-0.092	< 0.001
Pathological type	0.041	0.019
Vascular tumor thrombus	0.054	0.002
Nerve invasion	0.128	< 0.001
Maximum tumor diameter	0.169	< 0.001
Tumor depth	0.190	< 0.001
Lymph node metastasis	0.077	< 0.001
pTNM	0.159	< 0.001
CEA	0.083	< 0.001
CA19-9	0.080	< 0.001
CA125	0.013	0.452
AFP	0.014	0.410
CA242	0.064	< 0.001
CA72-4	0.048	0.006

CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; BMI: Body mass index; pTNM: Pathological tumor-node-metastasis.

Table 5 Tumor markers characteristics of gastric cancer patient samples (male and female, n = 3287), n (%)

Characteristics	Male	Female
Age
< 60	852 (33.5)	339 (45.4)
≥ 60	1689 (66.5)	407 (54.6)
CEA
< 5	1949 (76.7)	629 (84.3)
≥ 5	592 (23.3)	117 (15.7)
CA19-9
< 37	1988 (78.2)	585 (78.4)
≥ 37	553 (21.8)	161 (21.6)
CA242
< 15	2125 (83.6)	610 (81.8)
≥ 15	416 (16.4)	136 (18.2)
CA72-4
< 6.9	2051 (80.7)	610 (81.8)
≥ 6.9	490 (19.3)	136 (18.2)

CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen.

Table 6 Logistic regression analysis of multiple clinicopathological characteristic variables related to the location of gastric cancer (female)

		P value	OR
Middle	CA19-9	0.041	2.339
	CA72-4	< 0.001	7.052
Lower	Age	0.003	0.387
	CEA	0.034	0.312
	CA72-4	< 0.001	7.104
Upper	Age	< 0.001	0.150
	CEA	0.010	0.241
	CA72-4	< 0.001	8.152

CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; OR: Odd ratio.

Table 7 Logistic regression analysis of multiple clinicopathological characteristic variables related to the location of gastric cancer (male)

		P value	OR
Middle	CEA	< 0.001	3.545
	CA19-9	< 0.001	2.246
Lower	CEA	< 0.001	2.869
	CA19-9	< 0.001	1.932
Upper	Age	< 0.001	0.501
	CEA	< 0.001	2.473
	CA19-9	0.015	1.539

CEA: Carcinoembryonic antigen; CA: Carbohydrate antigen; OR: Odd ratio.