Clinical and Translational Research
Copyright ©The Author(s) 2024.
World J Gastrointest Oncol. Jun 15, 2024; 16(6): 2610-2630
Published online Jun 15, 2024. doi: 10.4251/wjgo.v16.i6.2610
Table 1 Baseline clinical characteristics of postoperative locally advanced gastric signet ring cell carcinoma patients
Characteristic
LAGSRC (n = 3793)
P value2
Untreated/unknown n = 12101
Chemotherapy, n = 25831
Age (yr)66 (14)57 (13)< 0.001
Sex0.039
Female621 (51)1233 (48)
Male589 (49)1350 (52)
Year of diagnosis< 0.001
2000-2003411 (34)582 (23)
2004-2007388 (32)742 (29)
2008-2011246 (20)656 (25)
2012-2015165 (14)603 (23)
Race0.34
White832 (69)1718 (67)
Black139 (11)304 (12)
Other239 (20)561 (22)
Tumor size (cm)0.92
< 259 (4.9)134 (5.2)
2-5440 (36)937 (36)
> 5495 (41)1035 (40)
Unknown216 (18)477 (18)
Grade0.19
G1/G242 (3.5)63 (2.4)
G3/G41101 (91)2378 (92)
Unknown67 (5.5)142 (5.5)
Primary site< 0.001
Body118 (9.8)257 (9.9)
Cardia116 (9.6)371 (14)
Fundus26 (2.1)66 (2.6)
Gastric antrum364 (30)690 (27)
Greater curvature46 (3.8)160 (6.2)
Lesser curvature171 (14)330 (13)
Pylorus68 (5.6)129 (5.0)
Overlapping lesion139 (11)317 (12)
Unknown162 (13)263 (10)
PT 8th< 0.001
T155 (4.5)103 (4.0)
T265 (5.4)171 (6.6)
T3392 (32)954 (37)
T4a387 (32)838 (32)
T4b311 (26)517 (20)
PN 8th0.067
N0220 (18)398 (15)
N1234 (19)466 (18)
N2243 (20)596 (23)
N3a324 (27)731 (28)
N3b189 (16)392 (15)
Pathologic stage0.5
IB33 (2.7)64 (2.5)
IIA152 (13)307 (12)
IIB159 (13)340 (13)
IIIA257 (21)622 (24)
IIIB334 (28)703 (27)
IIIC275 (23)547 (21)
Lymph node count17 (13)19 (13)< 0.001
Radiation status< 0.001
No/unknown1120 (93)983 (38)
Yes90 (7.4)1600 (62)
1Mean (SD); n (%).
2Welch Two Sample t test; Pearson's chi-squared test.
For race, ‘other’ includes American Indian, AK Native, Asian, and Pacific Islander.
LAGSRC: Locally advanced gastric signet ring cell carcinoma; PT: Pathological tumor stage; PN: Pathological node stage.
Table 2 Baseline clinical characteristics of postoperative locally advanced gastric signet ring cell carcinoma patients in the training and test sets
Characteristics
LAGSRC (n = 3793)
P value2
Train set (n = 2655)1
Internal test set (n = 1138)1
Age (yr)61.0 (13)59.5 (13)0.33
Sex0.96
Female1299 (48.9)555 (48.8)
Male1356 (51.1)583 (51.2)
Year of diagnosis0.87
2000-2003687 (25.9)306 (26.9)
2004-2007788 (29.7)342 (30.1)
2008-2011638 (24)264 (23.2)
2012-2015542 (20.4)226 (19.9)
Race0.57
White1771 (66.7)779 (68.5)
Black316 (11.9)127 (11.2)
Other568 (21.4)232 (20.4)
Tumor size (cm)0.81
< 2140 (5.3)53 (4.7)
2-5962 (36.2)415 (36.5)
> 51063 (40)467 (41)
Unknown490 (18.5)203 (17.8)
Grade0.26
G1/G281 (3.1)24 (2.1)
G3/G42426 (91.4)1053 (92.5)
Unknown148 (5.6)61 (5.4)
Primary site0.88
Body258 (9.7)117 (10.3)
Cardia335 (12.6)152 (13.4)
Fundus63 (2.4)29 (2.5)
Gastric antrum755 (28.4)299 (26.3)
Greater curvature147 (5.5)59 (5.2)
Lesser curvature353 (13.3)148 (13)
Pylorus131 (4.9)66 (5.9)
Overlapping lesion314 (11.8)142 (12.5)
Unknown299 (11.3)126 (11.1)
PT 8th0.67
T1118 (4.4)40 (3.5)
T2142 (5.3)94 (8.3)
T3976 (36.8)370 (32.5)
T4a851 (32.1)374 (32.9)
T4b568 (21.4)260 (22.8)
PN 8th0.84
N0423 (15.9)195 (17.1)
N1497 (18.7)203 (17.8)
N2585 (22)254 (22.3)
N3a737 (27.8)318 (27.9)
N3b413 (15.6)168 (14.8)
Pathologic stage0.11
IB78 (2.9)19 (1.7)
IIA322 (12.1)137 (12)
IIB337 (12.7)162 (14.2)
IIIA599 (22.6)280 (24.6)
IIIB742 (27.9)295 (25.9)
IIIC577 (21.7)245 (21.5)
Lymph node count16 (13)16 (14)0.52
Chemotherapy status0.18
No/unknown865 (32.6)345 (30.3)
Yes1790 (67.4)793 (69.7)
Radiation status0.45
No/unknown1461 (55)289 (37)
Yes1194 (45)486 (63)
1Mean (SD); n (%).
2Welch Two Sample t test; Pearson's chi-squared test.
For race, ‘other’ includes American Indian, AK Native, Asian, and Pacific Islander.
LAGSRC: Locally advanced gastric signet ring cell carcinoma; PT: Pathological tumor stage; PN: Pathological node stage.
Table 3 Cox regression with stepwise variable reduction
Dependent: Survival (time, status)
HR (univariable)
HR (multivariable)
AgeMean (SD)1.02 (1.01-1.02, P < 0.001)1.01 (1.01-1.02, P < 0.001)
SexFemale--
Male1.00 (0.93-1.07, P = 0.999)-
RaceWhite--
Black0.91 (0.82-1.02, P = 0.109)0.89 (0.75-1.05, P = 0.165)
Other0.77 (0.71-0.85, P < 0.001)0.84 (0.73-0.96, P = 0.009)
Tumor size< 2--
2-51.27 (1.07-1.52, P = 0.008)1.08 (0.83-1.40, P = 0.558)
> 51.98 (1.66-2.36, P < 0.001)1.41 (1.09-1.82, P = 0.009)
Unknown2.24 (1.86-2.70, P < 0.001)1.69 (1.29-2.22, P < 0.001)
GradeG1/G2--
G3/G41.11 (0.89-1.37, P = 0.348)-
Unknown1.16 (0.90-1.51, P = 0.245)-
Primary siteBody--
Cardia1.16 (1.00-1.35, P = 0.051)1.23 (0.98-1.53, P = 0.071)
Fundus1.07 (0.83-1.38, P = 0.608)1.14 (0.78-1.65, P = 0.503)
Gastric antrum1.11 (0.97-1.26, P = 0.135)1.06 (0.87-1.30, P = 0.551)
Greater curvature1.02 (0.84-1.23, P = 0.878)1.25 (0.96-1.64, P = 0.103)
Lesser curvature0.90 (0.78-1.05, P = 0.190)1.00 (0.79-1.27, P = 0.972)
Pylorus1.07 (0.88-1.30, P = 0.492)1.09 (0.82-1.46, P = 0.545)
Overlapping lesion1.53 (1.32-1.78, P < 0.001)1.38 (1.10-1.73, P = 0.005)
Unknown1.45 (1.24-1.69, P < 0.001)1.34 (1.06-1.69, P = 0.014)
Pathologic stageIB--
IIA1.37 (1.01-1.85, P = 0.045)1.59 (0.98-2.59, P = 0.062)
IIB1.94 (1.44-2.61, P < 0.001)2.37 (1.47-3.84, P < 0.001)
IIIA5.54 (4.14-7.40, P < 0.001)3.41 (2.13-5.44, P < 0.001)
IIIB2.73 (2.05-3.65, P < 0.001)4.86 (3.05-7.76, P < 0.001)
IIIC3.83 (2.87-5.10, P < 0.001)7.42 (4.62-11.92, P < 0.001)
Lymph node countMean (SD)0.99 (0.99-1.00, P < 0.001)0.98 (0.98-0.98, P < 0.001)
Chemotherapy statusNo/unknown-
Yes0.64 (0.59-0.69, P < 0.001)
Radiation statusNo/unknown--
Yes0.63 (0.59-0.68, P < 0.001)0.69 (0.62-0.77, P < 0.001)
For race, ‘other’ includes American Indian, AK Native, Asian, and Pacific Islander. HR: Hazard ratio.