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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
ARTICLE HIGHLIGHTS
Research background
The clinicopathological characteristics of gastric stump cancer (GSC) and proximal gastric cancer (PGC) have not yet been confirmed. There has always been controversy regarding the differences in treatment and prognosis prediction.
Research motivation
Evaluation of the differences between GSC and primary PGC using a larger sample size.
Research objectives
The object of this study was to evaluate the clinicopathological features, and prognostic factors of GSC and primary PGC.
Research methods
After detailed data statistics and data collection, 178 GSC patients and 957 PGC patients underwent surgical treatment at multiple centers. A 1:1 propensity score matching analysis was conducted on the two groups of patients, with 152 patients in each group entering the final analysis. Single factor and multivariate analysis were used to study the risk factors in gastric cancer patients. The survival curve was plotted to compare the differences in survival time between the two groups. The quality of life (QoL) of GSC-malignant (GSC-M) (post cancer GSC) and GSC-benign (GSC-B) (post benign gastric lesion GSC) patients was evaluated using the C30 and STO22 scales.
Research results
The number of lymph nodes and positive lymph nodes were different prognostic and clinicopathological factors between PGC and GSC. The 5-year overall survival and cancer-specific survival of patients with GSC were significantly lower than the PGC group, the scores for overall QoL in the GSC-M group were lower than the GSC-B group, and the differences were statistically significant.
Research conclusions
The differences in clinicopathological characteristics between GSC and PGC were significant, and compared to GSC patients, PGC patients had a better prognosis, and the overall health status of the GSC-M group was worse than that of the GSC-B group.
Research perspectives
More large-scale randomised controlled trial studies are needed to provide higher-level evidence regarding the comparison between PGC and GSC.
