Long-term outcomes after radical gastrectomy in gastric cancer patients with overt bleeding

doi:10.3748/wjg.v21.i47.13316

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World Journal of Gastroenterology

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1007-9327

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Baishideng Publishing Group Inc, 7041 Koll Center Parkway, Suite 160, Pleasanton, CA 94566, USA

Retrospective Study

World J Gastroenterol. Dec 21, 2015; 21(47): 13316-13324
Published online Dec 21, 2015. doi: 10.3748/wjg.v21.i47.13316

Table 1 Patient proportion according to tumor location n (%)

	OB	Non-OB	P value
All			0.541
Resectable	141 (20.3)	554 (79.7)
Unresectable	54 (22.1)	190 (77.9)
Upper			0.136
Resectable	41 (22.9)	138 (77.1)
Unresectable	14 (15.2)	78 (84.8)
Middle			0.887
Resectable	17 (24.3)	53 (75.7)
Unresectable	9 (23.1)	30 (76.9)
Lower			0.038^a
Resectable	83 (18.6)	363 (81.4)
Unresectable	31 (27.4)	82 (72.6)

^aP < 0.05, resectable vs unresectable. OB: Overt bleeding.

Table 2 Patient characteristics for the whole patient group and upper gastric cancer patients n (%)

	All			Upper gastric cancer
	Non-OB	OB	P value	Non-OB	OB	P value
Gender¹			0.718			0.996
Male	352 (67.6)	87 (65.9)		94 (71.8)	28 (71.8)
Female	169 (32.4)	45 (34.1)		37 (28.2)	11 (28.2)
Age²	63.2 ± 11.6	62.2 ± 13.4	0.497	64.8 ± 10.6	62 ± 12.8	0.276
AJCC stage¹			0.081			0.017^a
I-II	240 (46.1)	72 (54.5)		46 (35.1)	22 (56.4)
III-IV	281 (53.9)	60 (45.5)		85 (64.9)	17 (43.6)
T category¹			0.201			0.010^a
T1-T2	163 (31.3)	49 (37.1)		17 (13)	12 (30.8)
T3-T4	358 (68.7)	83 (62.9)		114 (87)	27 (69.2)
Involved lymph nodes²	5.4 ± 7.8	4.7 ± 6.5	0.523	4.9 ± 5.9	4.2 ± 6.0	0.248
N category¹			0.793			0.311
N0	187 (35.9)	49 (37.1)		36 (27.5)	14 (35.9)
N1-N3	334 (64.1)	83 (62.9)		95 (72.5)	25 (64.1)
Macroscopic (Borrmann) type¹			0.357			0.036^a
EGC	90 (17.5)	19 (14.4)		8 (6.1)	4 (10.3)
I	30 (5.8)	14 (10.6)		8 (6.1)	8 (20.5)
II	325 (62.4)	81 (61.4)		89 (67.9)	23 (59)
III	23 (4.4)	5 (3.8)		9 (6.9)	0 (0)
IV	52 (10)	13 (9.8)		17 (13)	4 (10.3)
Histological grade¹			0.448			0.770
G1-G2	176 (33.8)	40 (30.3)		47 (35.9)	13 (33.3)
G3-G4	345 (66.2)	92 (69.7)		84 (64.1)	26 (66.7)
Size (cm)²	4.7 ± 2.9	4.1 ± 2.1	0.083	5.4 ± 3.0	4.1 ± 2.0	0.018^a
R status¹			0.729			0.114
R0	508 (97.5)	130 (98.5)		123 (93.9)	39 (100)
R1	13 (2.5)	2 (1.5)		8 (6.1)	0 (0)
Lymphovascular invasion¹			0.785			0.484
Positive	437 (83.9)	112 (84.8)		108 (82.4)	34 (87.2)
Negative	84 (16.1)	20 (15.2)		23 (17.6)	5 (12.8)

¹Pearson’s χ² test;

²Mann-Whitney U-test.

^aP < 0.05, non-OB vs OB. EGC: Early gastric cancer; OB: Overt bleeding.

Table 3 Univariate and multivariate survival analyses for upper gastric cancer

Variable	Univariate analysis	Multivariate analysis
Variable	P value	HR	95%CI	P value
Age¹
Gender (vs male)²	0.056
OB vs non-OB²	< 0.001^b	0.346	0.148-0.808	0.014^a
AJCC stage³	< 0.001^b	1.638	1.366-1.966	< 0.001^b
AJCC T category³	< 0.001^b
AJCC N category³	< 0.001^b
Macroscopic (Borrmann) type² (vs type I)	0.003^b
II
III
IV
Histological type³	0.069
Size¹		1.090	1.012-1.174	0.023^a
R status² (vs R0)	0.008^b
R1	0.008^b
Lymphovascular invasion²	0.001^b
(vs negative)
Positive

¹Consecutive variables;

²Unordered categorical variables;

³Ordinal categorical variables.

^aP < 0.05;

^bP < 0.01.

Table 4 Patient characteristics for middle and lower gastric cancer patients n (%)

	Middle gastric cancer			Lower gastric cancer
	Non-OB	OB	P value	Non-OB	OB	P value
Gender¹			0.902			0.684
Male	29 (58)	9 (56.3)		229 (67.4)	50 (64.9)
Female	21 (42)	7 (43.8)		111 (32.6)	27 (35.1)
Age²	62.3 ± 11.2	61.3 ± 14.8	0.616	62.8 ± 11.9	62.6 ± 13.6	1.000
AJCC stage¹			0.319			0.659
I-II	18 (36.0)	8 (50.0)		176 (51.8)	42 (54.5)
III-IV	32 (64.0)	8 (50.0)		164 (48.2)	35 (45.5)
T category¹			0.291			0.891
T1-T2	12 (24)	6 (37.5)		134 (39.4)	31 (40.3)
T3-T4	38 (76)	10 (62.5)		206 (60.6)	46 (59.7)
Involved lymph nodes²	8.5 ± 10.6	7.1 ± 9.0	0.432	5.1 ± 7.9	4.5 ± 6.2	0.844
N category¹			0.104			0.396
N0	14 (28.0)	8 (50)		137 (40.3)	27 (35.1)
N1-N3	36 (72.0)	8 (50)		203 (59.7)	50 (64.9)
Macroscopic (Borrmann) type¹			0.577			0.742
EGC	7 (14.0)	3 (18.8)		76 (22.4)	12 (15.6)
I	4 (8.0)	2 (12.5)		18 (5.3)	4 (5.2)
II	29 (58.0)	7 (43.8)		207 (60.9)	51 (66.2)
III	2 (4.0)	2 (12.5)		12 (3.5)	3 (3.9)
IV	8 (16.0)	2 (12.5)		27 (7.9)	7 (9.1)
Histological grade¹			0.554			0.282
G1-G2	10 (20)	5 (31.3)		119 (35.0)	22 (28.6)
G3-G4	40 (80)	11 (68.8)		221 (65)	55 (71.4)
Size (cm)²	5.0 ± 3.0	4.0 ± 2.5	0.246	4.4 ± 2.8	4.1 ± 2.1	0.745
R status¹			1.000			0.559
R0	48 (96.0)	15 (93.8)		337 (99.1)	76 (98.7)
R1 + R2	2 (4.0)	1 (6.3)		3 (0.9)	1 (1.3)
Lymphovascular invasion¹			0.266			0.445
Positive	39 (78.0)	15 (93.8)		290 (85.3)	63 (81.8)
Negative	11 (22.0)	1 (6.3)		50 (14.3)	14 (18.2)

¹Pearson’s χ² test;

²Mann-Whitney U-test. EGC: Early gastric cancer; OB: Overt bleeding.

Table 5 Univariate and multivariate survival analyses for lower gastric cancer

Variable	Univariate analysis	Multivariate analysis
Variable	P value	HR	95%CI	P value
Age¹		1.023	1.008-1.037	0.002
Gender (vs male)²	0.930
OB vs non-OB²	0.553
AJCC stage³	< 0.001^b	1.690	1.508-1.894	< 0.001
AJCC T category³	< 0.001^b
AJCC N category³	< 0.001b^b
Macroscopic (Borrmann) type² (vs type I)	< 0.001^b
II
III
IV
Histological type³	0.001^b
Size¹
R status² (vs R0)	0.003^b
R1	0.003^b
Lymphovascular invasion² (vs negative)	< 0.001^b	1.687	1.160-2.455	0.006
Positive	< 0.001^b	1.687	1.160-2.455	0.006

¹Consecutive variables;

²Unordered categorical variables;

³Ordinal categorical variables;

^bP < 0.01.

Citation: Wang L, Wang XA, Hao JQ, Zhang LN, Li ML, Wu XS, Weng H, Lv WJ, Zhang WJ, Chen L, Xiang HG, Lu JH, Liu YB, Dong P. Long-term outcomes after radical gastrectomy in gastric cancer patients with overt bleeding. World J Gastroenterol 2015; 21(47): 13316-13324
URL: https://www.wjgnet.com/1007-9327/full/v21/i47/13316.htm
DOI: https://dx.doi.org/10.3748/wjg.v21.i47.13316