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©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
Does gastric stump cancer really differ from primary proximal gastric cancer? A multicentre, propensity score matching-used, retrospective cohort study
Shuan-Hu Wang, Jing-Cheng Zhang, Liang Zhu, He Li, Kong-Wang Hu
Shuan-Hu Wang, Department of the General Surgery, The First Affiliated Hospital of Bengbu Medical College, Bengbu 233000, Anhui Province, China
Jing-Cheng Zhang, Department of Surgery, Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Munich 80-819, Germany
Liang Zhu, Department of the General Surgery, Anhui Provincial Hospital, Hefei 230001, Anhui Province, China
He Li, Department of the Emergency Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
Kong-Wang Hu, Department of the General Surgery, The First Affiliated Hospital of Anhui Medical University, Hefei 230001, Anhui Province, China
Kong-Wang Hu, Department of the General Surgery, The Fuyang Affiliated Hospital of Anhui Medical University, Fuyang 236000, Anhui Province, China
Co-corresponding authors: He Li and Kong-Wang Hu.
Author contributions: Wang SH and Zhang JC contributed to the data statistics and writing; Wang SH, Zhang JC, and Zhu L collected the data; Li H and Hu KW were involved in the design of ideas and quality control; Wang SH and Zhang JC contributed equally to this work. KW Hu and Li H contributed equally to this work as co-corresponding authors. There are several reasons for this decision. First of all, although the two authors have slight differences in their contributions to the research, they have maintained close communication and effective discussion throughout the whole process of the project, which has made the project move forward in the right direction and finally improved the quality of the paper. In terms of project design, our original plan was not the research idea presented now, but with deepening of the research, the two authors timely revised the direction of the article, and finally achieved successful publication of the manuscript. We believe that the designation of co-authors accurately reflects the degree of contribution to the research and reflects the collaborative spirit of the team.
Institutional review board statement: This research was approved by the First Affiliated Hospital of Anhui Medical University.
Informed consent statement: Informed consent was obtained from each enrolled patient before entering this study.
Conflict-of-interest statement: All authors report no relevant conflicts of interest for this article.
Data sharing statement: We will share the data on reasonable request.
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:
https://creativecommons.org/Licenses/by-nc/4.0/ Corresponding author: Kong-Wang Hu, MD, PhD, Chief Doctor, Professor, Department of the General Surgery, The First Affiliated Hospital of Anhui Medical University, No. 206 Jixi Road, Hefei 230001, Anhui Province, China.
hukw@sina.com
Received: August 1, 2023
Peer-review started: August 1, 2023
First decision: September 1, 2023
Revised: September 3, 2023
Accepted: September 26, 2023
Article in press: September 26, 2023
Published online: November 27, 2023
Processing time: 118 Days and 4.8 Hours
BACKGROUND
Although the location of proximal cancer of the remnant stomach is the same as that of primary proximal cancer of the stomach, its clinical characteristics and prognosis are still controversial.
AIM
To evaluate the clinicopathological features and prognosis factors of gastric stump cancer (GSC) and primary proximal gastric cancer (PGC).
METHODS
From January, 2005 to December, 2016, 178 patients with GSC and 957 cases with PGC who received surgical treatment were enrolled. Patients in both groups underwent 1:1 propensity score matching analysis, and both clinical and pathological data were systematically collected for statistical purposes. Quality of life was evaluated by the C30 and STO22 scale between GSC-malignant (GSC following gastric cancer) and GSC-benign (GSC following benign lesions of the stomach).
RESULTS
One hundred and fifty-two pairs were successfully matched after propensity score matching analysis. Of the 15 demographic and pathological variables collected, the analysis further revealed that the number of lymph nodes and positive lymph nodes were different prognostic and clinicopathological factors between PGC and GSC. Univariate and multivariate analyses showed that gender, differentiation degree and tumor-node-metastasis stage were independent risk factors for patients with GSC. Gender, vascular invasion, differentiation degree, depth of infiltration, positive lymph nodes, and tumor-node-metastasis stage were independent risk factors for patients with PGC. The 5-year overall survival and cancer-specific survival of patients with GSC were significantly lower than those in the PGC group, the scores for overall quality of life in the GSC-malignant group were lower than the GSC-benign, and the differences were statistically significant.
CONCLUSION
The differences in clinicopathological characteristics between GSC and PGC were clarified, and PGC had a better prognosis than GSC.
Core Tip: Although the location of gastric stump cancer (GSC) is the same as that of primary proximal gastric cancer (PGC) , its clinical characteristics and prognosis are still controversial. In our research, 152 pairs of patients were successfully matched after propensity score matching analysis. The differences in clinicopathological characteristics between GSC and PGC were clarified, and PGC had a better prognosis than GSC. The scores for overall quality of life in the GSC-malignant group were lower than the GSC-benign group, and the differences were statistically significant.
