Retrospective Cohort Study
Copyright ©The Author(s) 2020.
World J Clin Cases. May 6, 2020; 8(9): 1608-1619
Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1608
Table 1 Clinicopathologic characteristics of all patients
Characteristic
Age (yr)
Range22-87
mean ± SD57.7 ± 12.3
Age grouping, n (%)
≤ 60 yr1069 (53.3)
> 60 yr936 (46.7)
Sex, n (%)
Male1384 (69)
Female621 (31)
Body mass index (kg/m2)
Range12.3–57.8
mean ± SD23.3 ± 3.2
Comorbidities, n (%)616 (30.7)
Hypertension441 (22)
Diabetes mellitus212 (10.6)
Others112 (5.6)
Tumour size (cm)
Range1-48
mean ± SD6.3 ± 3.5
Location, n (%)
Upper third345 (17.2)
Middle third463 (23.1)
Lower third1197 (59.7)
Depth of invasion, n (%)
Muscularis propria504 (25.1)
Subserosal865 (43.1)
Serosa exposed or invaded608 (30.4)
Histology, n (%)
Papillary adenocarcinoma7 (0.3)
Tubular adenocarcinoma (well differentiated)62 (3.1)
Tubular adenocarcinoma (moderately differentiated)624 (31.1)
Tubular adenocarcinoma (poorly differentiated)992 (49.5)
Signet ring cell carcinoma219 (10.9)
Others101 (5)
Gastrectomy, n (%)
Subtotal1127 (56.2)
Total878 (43.8)
Retrieved lymph nodes, n
Range12-106
mean ± SD28.4 ± 12
Lymph node metastasis, n (%)
Yes1079 (53.8)
No926 (46.2)
Lymphovascular invasion, n (%)
Yes1023 (51)
No982 (49)
Perineural invasion, n (%)
Yes925 (46.1)
No1080 (53.9)
Adjuvant chemotherapy, n (%)
Yes1340 (66.8)
No665 (33.2)
Recurrence, n (%)
Yes671 (33.5)
No1334 (66.5)
Mortality, n (%)
Yes874 (43.6)
No1131 (56.4)
Overall survival (mo)
Range0.5-129.7
mean ± SD55.3 ± 32.2
Recurrence-free survival (mo)
Range0.5-129.7
mean ± SD51.1 ± 33.6
Table 2 Multivariate analysis of factors influencing survival using a Cox proportional hazards model
CharacteristicOverall survival
Recurrence-free survival
P valueHR95%CIP valueHR95%CI
Sex
Male1.0001.000
Female0.4340.9430.813-1.0930.2920.9250.801-1.069
Age
≤ 60 yr1.0001.000
> 60 yr0.0011.7231.502-1.9780.0011.6581.451-1.895
Tumour size
≤ 5 cm1.0001.000
> 5 cm0.0011.4551.252-1.6900.0011.5051.302-1.740
Lymphovascular invasion
No1.0001.000
Yes0.0011.6781.450-1.9430.0011.6761.455-1.931
Lymph node metastasis
No1.0001.000
Yes0.0470.8660.752-0.9980.1110.8940.780-1.026
Depth of invasion
Muscularis propria0.1020.6540.394-1.0880.1600.6960.419-1.155
Sub-serosal0.1250.6760.410-1.1150.2000.7210.437-1.189
Serosal exposed0.0800.6360.383-1.0550.1420.6850.413-1.135
Serosal invasion0.2870.7050.370-1.3420.2720.6970.366-1.189
Histology
Tubular adenocarcinoma (well)1.0001.000
Tubular adenocarcinoma (moderate)0.0361.7831.038-3.0610.0691.5620.967-2.523
Tubular adenocarcinoma (poorly)0.0082.0701.211-3.5380.0261.7161.067-2.759
Signet ring cell carcinoma0.0012.6891.535-4.7070.0012.2901.387-3.781
Mucinous adenocarcinoma0.1561.6010.836-3.0660.2361.4310.791-2.588
Table 3 Multivariate analysis of factors influencing survival according to sex using a Cox proportional hazards model
CharacteristicMale
Female
P valueHR95%CIP valueHR95%CI
Age
≤ 60 yr1.0001.000
> 60 yr0.0011.8821.601-2.2130.1361.2040.943-1.536
Tumour size
≤ 5 cm1.0001.000
> 5 cm0.0011.4431.212-1.7180.0011.6101.239-2.090
Lymphovascular invasion
No1.0001.000
Yes0.0011.6971.428-2.0170.0011.5871.238-2.035
Lymph node metastasis
No1.0001.000
Yes0.1660.8900.754-1.0500.4370.9070.709-1.161
Depth of invasion
Muscularis propria0.0250.5210.295-0.9200.7361.2200.385-3.866
Sub-serosal0.0440.5650.324-0.9860.8241.1390.362-3.587
Serosal exposed0.0390.5510.314-0.9700.9860.9900.311-3.147
Serosal invasion0.2640.6690.330-1.3540.6530.6930.140-3.434
Histology
Tubular adenocarcinoma (well)1.0001.000
Tubular adenocarcinoma (moderate)0.0431.7541.017-3.0260.8860.9290.337-2.559
Tubular adenocarcinoma (poor)0.0102.0291.181-3.4860.7390.8440.312-2.282
Signet ring cell carcinoma0.0013.1531.769-5.6190.8120.8830.317-2.459
Mucinous adenocarcinoma0.3591.3900.688-2.8100.8961.0800.342-3.409
Table 4 Multivariate analysis of factors influencing survival according to age using a Cox proportional hazards model
Characteristic≤ 60 yr old
> 60 yr old
P valueHR95%CIP valueHR95%CI
Sex
Male1.0001.000
Female0.3001.1160.907-1.3730.0170.7800.636-0.957
Tumour size
≤ 5 cm1.0001.000
> 5 cm0.0011.9731.586-2.4540.0861.1870.976-1.444
Lymphovascular invasion
No1.0001.000
Yes0.0011.7831.441-2.2060.0011.5801.307-1.910
Lymph node metastasis
No1.0001.000
Yes0.4850.9290.756-1.1420.1470.8720.725-1.049
Depth of invasion
Muscularis propria0.1850.5700.249-1.3080.3710.7460.392-1.418
Sub-serosal0.2800.6380.283-1.4410.4720.7920.420-1.495
Serosal exposed0.2140.5940.262-1.3500.4650.7860.412-1.500
Serosal invasion0.5180.7240.272-1.9290.5490.7650.318-1.839
Histology
Tubular adenocarcinoma (well)1.0001.000
Tubular adenocarcinoma (moderate)0.7310.8910.463-1.7180.0102.5471.246-5.205
Tubular adenocarcinoma (poorly)0.9290.9720.514-1.8370.0042.8121.380-5.730
Signet ring cell carcinoma0.4271.3090.674-2.5430.0013.6521.700-7.843
Mucinous adenocarcinoma0.1340.5250.226-1.2200.0023.8471.648-8.979
Table 5 Analysis of lymph node metastasis using the chi-squared test and a logistic regression model
CharacteristicLymph node metastasis
Univariate
Multivariate
YesNoP valueOR95%CIP value
Sex
Male766 (71)618 (66.7)0.0401.000
Female313 (29)308 (33.3)0.8400.682-1.0340.099
Age
≤ 60 yr573 (53.1)496 (53.6)0.8371.000
> 60 yr506 (46.9)430 (46.4)1.0350.854-1.2550.726
Tumour size
≤ 5 cm580 (53.8)316 (34.1)0.0011.000
> 5 cm499 (46.2)610 (65.9)0.5520.453-0.6740.001
Lymphovascular invasion
Yes415 (38.5)608 (65.7)0.0010.3560.294-0.4310.001
No664 (61.5)318 (34.3)1.000
Depth of invasion
Muscularis propria252 (23.4)252 (27.2)0.6470.297-1.4090.273
Sub-serosal453 (42)412 (44.5)0.7110.329-1.5370.386
Serosal exposed327 (30.3)233 (25.2)0.9080.418-1.9750.808
Serosal invasion30 (2.8)18 (1.9)1.0780.414-2.8090.877
Histology
Tubular adenocarcinoma (well)46 (4.3)16 (1.8)0.0111.000
Tubular adenocarcinoma (moderate)342 (32.3)282 (31)0.5600.301-1.0430.068
Tubular adenocarcinoma (poorly)519 (49)473 (52)0.5830.315-1.0800.086
Signet ring cell carcinoma119 (11.2)100 (11)0.6760.347-1.3180.251
Mucinous adenocarcinoma33 (3.1)38 (4.2)0.4740.218-1.0290.059
Table 6 Analysis of lymph node metastasis according to sex using a logistic regression model
CharacteristicMale
Female
P valueOR95%CIP valueOR95%CI
Age
≤ 60 yr1.0001.000
> 60 yr0.9191.0120.804-1.2740.5121.1270.789-1.610
Tumour size
≤ 5 cm1.0001.000
> 5 cm0.0010.5320.418-0.6770.0060.6050.425-0.863
Lymphovascular invasion
No1.0001.000
Yes0.0010.3590.284-0.4530.0010.3570.254-0.501
Depth of invasion
Muscularis propria0.6840.8230.323-2.0980.1900.3870.094-1.601
Sub-serosal0.7350.8520.338-2.1490.2980.4740.116-1.035
Serosal exposed0.9341.0400.409-2.6450.5850.6730.163-2.779
Serosal invasion0.8171.1430.369-3.5401.0001.0000.160-6.255
Histology
Tubular adenocarcinoma (well)1.0001.000
Tubular adenocarcinoma (moderate)0.0440.4890.244-0.9800.8531.1570.247-5.405
Tubular adenocarcinoma (poor)0.0470.4970.249-0.9920.7261.3120.288-5.979
Signet ring cell carcinoma0.1220.5430.251-1.1770.5201.6730.349-8.015
Mucinous adenocarcinoma0.0480.4110.170-0.9920.9451.0650.178-6.387
Table 7 Analysis of lymph node metastasis according to age using a logistic regression model
Characteristic≤ 60 yr old
> 60 yr old
P valueOR95%CIP valueOR95%CI
Sex
Male1.0001.000
Female0.0660.7620.571-1.0180.5430.9100.670-1.235
Tumour size
≤ 5 cm1.0001.000
> 5 cm0.0010.4520.344-0.5940.0200.7070.528-0.947
Lymphovascular invasion
No1.0001.000
Yes0.0010.3120.239-0.4070.0010.4060.307-0.536
Depth of invasion
Muscularis propria0.0240.1690.036-0.7900.4521.4770.535-4.077
Sub-serosal0.0460.2110.046-0.9750.4441.4810.541-4.056
Serosal exposed0.1220.2980.064-1.3810.3321.6590.597-4.607
Serosal invasion0.3240.4220.076-2.3410.5031.5710.418-5.903
Histology
Tubular adenocarcinoma (well)1.0001.000
Tubular adenocarcinoma (moderate)0.3400.6440.261-1.5890.0880.4650.193-1.121
Tubular adenocarcinoma (poor)0.7880.8850.364-2.1510.0310.3810.158-0.918
Signet ring cell carcinoma0.9090.9470.370-2.4240.1660.4960.184-1.339
Mucinous adenocarcinoma0.4830.6770.228-2.0140.0680.3460.111-1.080