Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2020; 12(10): 1119-1132
Published online Oct 15, 2020. doi: 10.4251/wjgo.v12.i10.1119
Changing trends of clinicopathologic features and survival duration after surgery for gastric cancer in Northeast China
Zhao Zhai, Zi-Yu Zhu, Xi-Liang Cong, Bang-Ling Han, Jia-Liang Gao, Xin Yin, Yu Zhang, Sheng-Han Lou, Tian-Yi Fang, Yi-Min Wang, Chun-Feng Li, Xue-Feng Yu, Yan Ma, Ying-Wei Xue
Zhao Zhai, Zi-Yu Zhu, Xi-Liang Cong, Bang-Ling Han, Jia-Liang Gao, Xin Yin, Yu Zhang, Sheng-Han Lou, Tian-Yi Fang, Yi-Min Wang, Chun-Feng Li, Xue-Feng Yu, Yan Ma, Ying-Wei Xue, Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, Harbin 150081, Heilongjiang Province, China
Author contributions: Zhai Z and Zhu ZY designed the research and study concept; Cong XL and Han BL performed the research and data collection; Gao JL, Yin X, and Zhang Y performed the statistical analysis; Lou SH, Fang TY, Wang YM, Li CF, Yu XF, and Ma Y performed the data interpretation; Zhai Z wrote the manuscript draft; Xue YW revised the manuscript.
Supported by Nn10 Program of Harbin Medical University Cancer Hospital, China, No. Nn10 PY 2017-03.
Institutional review board statement: The study was approved by the Ethics Committee of the Harbin Medical University Cancer Hospital.
Informed consent statement: All study participants or their legal guardian provided informed written consent about personal and medical data collection prior to study enrolment.
Conflict-of-interest statement: All the authors have no conflict of interest related to the manuscript.
Data sharing statement: The original anonymous dataset is available on request from the corresponding author at xueyingwei@hrbmu.edu.cn.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Ying-Wei Xue, MD, Chief Doctor, Department of Gastroenterological Surgery, Harbin Medical University Cancer Hospital, No. 150 Haping Road, Nangang District, Harbin 150081, Heilongjiang Province, China. xueyingwei@hrbmu.edu.cn
Received: June 4, 2020
Peer-review started: June 4, 2020
First decision: July 21, 2020
Revised: July 28, 2020
Accepted: September 1, 2020
Article in press: September 1, 2020
Published online: October 15, 2020
Processing time: 132 Days and 10.6 Hours
Abstract
BACKGROUND

Through analyzing the data from a single institution in Northeast China, this study revealed the possible clinicopathologic characteristics that influence the prognosis of patients with gastric cancer (GC).

AIM

To evaluate the changing trends of clinicopathologic features and survival duration after surgery in patients with GC in Northeast China, which is a high-prevalence area of GC.

METHODS

The study analyzed the difference in clinicopathologic features and survival duration after surgery of 5887 patients who were histologically diagnosed with GC at the Harbin Medical University Cancer Hospital. The study mainly analyzed the data in three periods, 2000 to 2004 (Phase 1), 2005 to 2009 (Phase 2), and 2010 to 2014 (Phase 3).

RESULTS

Over time, the postoperative survival rate significantly increased from 2000 to 2014. In the past 15 years, compared with Phases 1 and 2, the tumor size was smaller in Phase 3 (P < 0.001), but the proportion of high-medium differentiated tumors increased (P < 0.001). The proportion of early GC gradually increased from 3.9% to 14.4% (P < 0.001). A surprising improvement was observed in the mean number of retrieved lymph nodes, ranging from 11.4 to 27.5 (P < 0.001). The overall 5-year survival rate increased from 24% in Phase 1 to 43.8% in Phase 3. Through multivariate analysis, it was found that age, tumor size, histologic type, tumor-node-metastasis stage, depth of invasion, lymph node metastasis, surgical approach, local infiltration, radical extent, number of retrieved lymph nodes, and age group were independent risk factors that influenced the prognosis of patients with GC.

CONCLUSION

The clinical features of GC in Northeast China changed during the observation period. The increasing detection of early GC and more standardized surgical treatment effectively prolonged lifetimes.

Keywords: Gastric cancer; Clinicopathologic features; Survival; Time trends; Epidemiology; Gastrectomy

Core Tip: In recent decades, due to the increasing heterogeneity of gastric cancer (GC), GC has attracted wide attention from epidemiologists, especially in terms of risk factors. More advanced technologies and concepts have been involved in the diagnosis and surgery of GC. The improvements include the dissection method, resection range, surgical techniques and instruments, as well as the emphasis on perioperative nursing and the strengthening of the concept of rapid recovery, which have effects that can help patients with GC directly or indirectly. Therefore, this study performed a comparative analysis of the clinicopathological characteristics and postoperative survival of patients with GC from the Harbin Medical University Cancer Hospital over 15 years starting in 2000. The factors affecting the prognosis of GC were clarified based on the time trend.