Tumor recurrence and survival prognosis in patients with advanced gastric cancer after radical resection with radiotherapy and chemotherapy

Table 1 Clinical data of 171 gastric cancer patients

Project	n (%)	Project	n (%)
Age (yr)		T staging
≤ 40	6 (3.5)	T1	8 (4.7)
41-65	126 (73.7)	T2	21 (12.3)
≥ 66	39 (22.8)	T3	86 (50.3)
Gender		T4a	31 (18.1)
Male	124 (72.5)	T4b	25 (14.6)
Female	47 (27.5)	N stages
Surgical hospital		N0	24 (14.0)
Court	102 (59.6)	N1	33 (19.3)
Outer courtyard	69 (40.4)	N2	41 (24.0)
Operation		N3a	58 (33.9)
Subtotal proximal gastrectomy	26 (15.2)	N3b	15 (8.8)
Subtotal distal gastrectomy	76 (44.4)	Clinical stages
Total gastrectomy	58 (33.9)	IB	4 (2.3)
Gastrectomy and other organ	11 (6.5)	IIA	30 (17.5)
Primary lesion site		IIB	23 (13.5)
1/3 upper stomach	37 (21.6)	IIIA	42 (24.6)
1/3 stomach	76 (44.4)	IIIB	45 (26.3)
1/3 subgastric	15 (8.8)	IIIC	27 (15.8)
Whole stomach	15 (8.8)	Lymphatic invasion
Pathological type		Negative	82 (48.0)
Medium to high differentiation	58 (33.9)	Positive	89 (52.0)
Poorly differentiated	91 (53.2)	Peripheral nerve invasion
Mucinous adenocarcinoma	9 (5.3)	Negative	91 (53.2)
Signet-ring cell carcinoma	12 (7.0)	Positive	80 (46.8)
Neuroendocrine degeneration	1 (0.6)	Synchronous chemotherapy
Lauren typing		Capecitabine	95 (55.6)
Intestinal	69 (40.4)	Tegafur	25 (14.6)
Diffuse	95 (55.5)	Other	51 (29.8)
Mixed unclassified	7 (4.1)	Adjuvant chemotherapy regimen
Number of lymph nodes cleaned		XELOX	81 (47.4)
< 15	57 (33.3)	SOX	29 (17.0)
≥ 15	114 (66.7)	FOLFOX	15 (8.8)
Positive lymph nodes		EOF	14 (8.2)
LNR ≤ 0.3	89 (52.0)	FLOT	5 (2.9)
0.3 < LNR ≤ 0.7	58 (33.9)	other	27 (15.7)
LNR > 0.7	24 (14.1)
Age [yr, median (range)]			60 (27-76)
Number of lymph nodes cleaned [n, median (Range)]			19 (5-56)
Number of positive lymph nodes [n, median (Range)]			5 (0-47)

LNR: Lymph node metastasis rate.

Table 2 Multivariate analysis of prognostic factors related to overall survival rate

Factors	Univariate analysis	Multivariate analysis
		Hazard ratio	95%CI	P value
Age	0.092	1.659	0.977-2.815	0.061
Pathological type	0.063	0.826	0.263-2.593	0.743
Lauren typing	0.037	0.488	0.054-4.449	0.525
LNR	< 0.001	2.174	1.115-3.862	0.015
T stage	0.005	1.636	1.108-2.415	0.013
N stage	< 0.001	1.135	0.774-1.665	0.516
PNI	0.008	1.719	1.006-2.937	0.047

PNI: Peripheral nerve invasion; LNR: Lymph node metastasis rate.

Table 3 Multivariate analysis of prognostic factors related to disease-free survival rate

Factors	Univariate analysis	Multivariate analysis
		Hazard ratio	95%CI	P value
Pathological type	0.096	0.850	0.276-2.618	0.778
Lauren typing	0.053	0.521	0.058-4.705	0.561
LNR	< 0.001	1.182	0.792-1.763	0.413
T stage	0.002	1.573	1.102-2.245	0.013
N stage	< 0.001	1.310	0.918-1.869	0.136
PNI	0.054	1.395	0.853-2.282	0.185

PNI: Peripheral nerve invasion; LNR: Lymph node metastasis rate.

Table 4 The proportion of different recurrence patterns in 47 recurrent gastric cancer patients out of 171 cases

Recurrence pattern	Cases	Proportion (%)	Recurrence pattern	Cases	Proportion (%)
Single mode	34	72.3	Dual mode	13	27.7
Local recurrence	1	2.1	Local recurrence + abdominal metastasis	2	4.3
Regional recurrence	5	10.6	Local recurrence + regional recurrence	2	4.3
Abdominal metastasis	5	10.6	Regional recurrence + abdominal metastasis	3	6.4
Distant metastasis	23	48.9	Regional recurrence + distant metastasis	4	8.5
Multi mode	0	0	Abdominal metastasis + distant metastasis	2	4.3

Table 5 Recurrence patterns in 47 out of 171 gastric cancer patients with relapses of proportion a

Recurrence pattern	Cases	Proportion a (%)	Recurrence pattern	Cases	Proportion a (%)
Local recurrence	5	10.6	Distant metastasis	29	61.7
Gastric stump	1	2.1	Liver	14	29.8
Anastomotic opening	4	8.5	Bone	11	23.4
Regional recurrence	14	29.8	Lungs	10	21.3
Abdominal metastasis	12	25.5	Brain	4	8.5
Peritoneum	9	19.1	Spleen	1	2.1
Ovary	2	4.3	Adrenal gland	1	2.1
Colorectal	1	2.1	Non regional Lymph nodes	1	2.1

Table 6 Recurrence patterns in 47 out of 171 gastric cancer patients with relapses of proportion b

Recurrence pattern	Cases	Proportion b (%)	Recurrence pattern	Cases	Proportion b (%)
Local recurrence	5	2.9	Abdominal metastasis	12	7.0
Regional recurrence	14	8.2	Distant metastasis	29	17.0

Table 7 Analysis of prognostic factors related to local recurrence

Factors	Univariate analysis	Multivariate analysis
		Hazard ratio	95%CI	P value
Gender	0.210	0.961	0.561-1.648	0.886
Pathological type	0.109	0.547	0.216-1.387	0.204
LNR	0.079	1.253	0.850-1.846	0.255
T stage	0.040	1.643	1.155-2.337	0.006
N stage	0.020	1.271	0.902-1.790	0.171
LVI	0.060	1.211	0.742-1.975	0.443

LVI: Lymphatic vessel invasion; LNR: Lymph node metastasis rate.

Table 8 Analysis of prognostic factors related to abdominal metastasis

Factors	Univariate analysis	Multivariate analysis
		Hazard ratio	95%CI	P value
Pathological type	0.149	0.462	0.189-1.132	0.091
Cleaning lymph nodes	0.161	0.923	0.550-1.551	0.763
T stage	0.195	1.700	1.199-2.410	0.003
LVI	0.012	1.221	0.745-2.002	0.428

LVI: Lymphatic vessel invasion.