Sex-based differences in histology, staging, and prognosis among 2983 gastric cancer surgery patients

doi:10.3748/wjg.v28.i9.933

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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 Cohort Study

World J Gastroenterol. Mar 7, 2022; 28(9): 933-947
Published online Mar 7, 2022. doi: 10.3748/wjg.v28.i9.933

Table 1 Clinicopathological features of patients with gastric cancer

Characteristics	Total (N = 2983)	Female (n = 978)	Male (n = 2005)	P value
Age (yr, mean ± SD)	60.91 ± 12.31	59.36 ± 13.47	61.66 ± 11.63	< 0.001^a
Drinking history, n (%)
No	1631 (54.7)	790 (80.8)	841 (41.9)	< 0.001^a
Yes	1352 (45.3)	188 (19.2)	1164 (58.1)
Smoking history, n (%)
No	1645 (55.1)	902 (92.2)	743 (37.1)	< 0.001^a
Yes	1338 (44.9)	76 (7.8)	1262 (62.9)
Family history, n (%)
No	2467 (82.7)	803 (82.1)	1664 (83.0)	0.548
Yes	516 (17.3)	175 (17.9)	341 (17.0)
Tumor location, n (%)
Upper	77 (2.6)	19 (2.0)	58 (2.9)	< 0.001^a
Middle	1332 (44.6)	497 (50.8)	835 (41.6)
Lower	1574 (52.8)	462 (47.2)	1112 (55.5)
Atrophic gastritis, n (%)
No	2162 (72.5)	751 (76.8)	1411 (70.4)	< 0.001^a
Yes	821 (27.5)	227 (23.2)	594 (29.6)
Intestinal metaplasia, n (%)
No	1680 (56.3)	560 (57.3)	1120 (55.9)	0.469
Yes	1303 (43.7)	418 (42.7)	885 (44.1)
T stage, n (%)
T1	2134 (71.5)	696 (71.2)	1438 (71.7)	0.669
T2	330 (11.1)	102 (10.4)	228 (11.4)
T3	420 (14.1)	144 (14.7)	276 (13.8)
T4	99 (3.3)	36 (3.7)	63 (3.1)
N stage, n (%)
N0	2215 (74.3)	696 (71.2)	1519 (75.7)	0.014^a
N1	423 (14.2)	163 (16.7)	260 (13.0)
N2	174 (5.8)	66 (6.7)	108 (5.4)
N3	171 (5.7)	53 (5.4)	118 (5.9)
Stage, n (%)
I	2312 (77.5)	743 (76.0)	1569 (78.3)	0.189
II	405 (13.6)	151 (15.4)	254 (12.7)
III	212 (7.1)	69 (7.1)	143 (7.1)
IV	54 (1.8)	15 (1.5)	39 (1.9)
Cancer type, n (%)
EGC	2133 (71.5)	696 (71.2)	1437 (71.7)	0.774
AGC	850 (28.5)	282 (28.8)	568 (28.3)
Histologic type, n (%) (Lauren classification)
Intestinal	1843 (61.8)	447 (45.7)	1396 (69.6)	< 0.001^a
Diffuse	1014 (34.0)	494 (50.5)	520 (25.9)
Mixed	126 (4.2)	37 (3.8)	89 (4.5)
H. pylori status, n (%)
Negative	1267 (42.5)	379 (38.8)	888 (44.3)	0.004^a
Positive	1716 (57.5)	599 (61.2)	1117 (55.7)
P53, n (%)
Negative	1917 (64.3)	706 (72.2)	1211 (60.4)	< 0.001^a
Positive	1066 (35.7)	272 (27.8)	794 (39.6)

^aP < 0.05 indicates statistical significance. SD: Standard deviation; EGC: Early gastric cancer; AGC: Advanced gastric cancer; H. pylori: Helicobacter pylori.

Table 2 Univariate and multivariate analyses for gastric cancer related morbidity

Variable	Univariate analysis	P value	Multivariate analysis	P value
Sex
Male	Ref	0.169	Ref	0.672
Female	1.22 (0.92-1.61)		1.06 (0.80-1.42)
Age
< 60	Ref	0.001^a	Ref	< 0.001^a
≥ 60	1.64 (1.23-2.18)		2.02 (1.50-2.73)
Drinking history
No	Ref	0.996
Yes	1.00 (0.76-1.32)
Smoking history
No	Ref	0.283
Yes	1.16 (0.88-1.53)
Family history
No	Ref	0.189	Ref	0.165
Yes	0.77 (0.51-1.14)		0.75 (0.51-1.12)
Tumor location
Upper	Ref	0.003^a	Ref	< 0.001^a
Middle	1.65 (0.41-6.71)		1.40 (0.34-5.71)
Lower	2.61 (0.65-10.54)		2.63 (0.65-10.64)
Atrophic gastritis
No	Ref	0.871
Yes	0.97 (0.71-1.34)
Intestinal metaplasia
No	Ref	0.412
Yes	0.89 (0.67-1.18)
Histologic type (Lauren classification)
Intestinal	Ref	< 0.001^a	Ref	< 0.001^a
Diffuse	2.16 (1.62-2.89)		3.07 (2.25-4.19)
Mixed	2.25 (1.29-3.92)		2.50 (1.43-4.35)
P53
Negative	Ref	0.651
Positive	1.07 (0.80-1.42)

^aP < 0.05 indicates statistical significance.

P < 0.2 were used for multivariable analyses.

Table 3 Clinicopathological features by sex and histologic type

Characteristics	Intestinal type			Diffuse type
Characteristics	Female (n = 447)	Male (n = 1396)	P value	Female (n = 494)	Male (n = 520)	P value
Age (yr, mean ± SD)	65.72 ± 10.71	64.06 ± 10.34	0.792	53.60 ± 13.06	55.82 ± 12.48	0.229
Drinking history, n (%)
No	385 (86.1)	619 (44.3)	< 0.001^a	374 (75.7)	183 (35.2)	< 0.001^a
Yes	62 (13.9)	777 (55.7)		120 (24.3)	337 (64.8)
Smoking history, n (%)
No	420 (94.0)	530 (38.0)	< 0.001^a	447 (90.5)	175 (33.7)	< 0.001^a
Yes	27 (6.0)	866 (62.0)		47 (9.5)	345 (66.3)
Family history, n (%)
No	348 (77.9)	1138 (81.5)	0.088	419 (84.8)	447 (86.0)	0.606
Yes	99 (22.1)	258 (18.5)		75 (15.2)	73 (14.0)
Tumor location, n (%)
Upper	12 (2.7)	44 (3.2)	0.053	7 (1.4)	10 (1.9)	< 0.001^a
Middle	139 (31.1)	517 (37.0)		334 (67.6)	284 (54.6)
Lower	296 (66.2)	835 (59.8)		153 (31.0)	226 (43.5)
Atrophic gastritis, n (%)
No	320 (71.6)	951 (68.1)	0.168	400 (81.0)	389 (74.8)	0.018^a
Yes	127 (28.4)	445 (31.9)		94 (19.0)	131 (25.2)
Intestinal metaplasia, n (%)
No	229 (51.2)	751 (53.8)	0.344	303 (61.3)	306 (58.8)	0.418
Yes	218 (48.8)	645 (46.2)		191 (38.7)	214 (41.2)
T stage, n (%)
T1	355 (79.4)	1087 (77.9)	0.529	314 (63.6)	305 (58.6)	0.445
T2	40 (9.0)	138 (9.9)		57 (11.5)	66 (12.7)
T3	40 (9.0)	145 (10.4)		99 (20.0)	118 (22.7)
T4	12 (2.6)	26 (1.8)		24 (4.9)	31 (6.0)
N stage, n (%)
N0	356 (79.6)	1140 (81.7)	0.745	319 (64.6)	335 (64.4)	0.055
N1	56 (12.5)	149 (10.7)		97 (19.6)	85 (16.4)
N2	20 (4.5)	62 (4.4)		42 (8.5)	38 (7.3)
N3	15 (3.4)	45 (3.2)		36 (7.3)	62 (11.9)
Stage, n (%)
I	375 (83.9)	1171 (83.9)	0.49	342 (69.2)	347 (66.7)	0.152
II	47 (10.5)	142 (10.2)		96 (19.5)	89 (17.1)
III	23 (5.1)	65 (4.6)		43 (8.7)	66 (12.7)
IV	2 (0.5)	18 (1.3)		13 (2.6)	18 (3.5)
Cancer type, n (%)
EGC	355 (79.4)	1086 (77.8)	0.469	314 (63.6)	305 (58.7)	0.109
AGC	92 (20.6)	310 (22.2)		180 (36.4)	215 (41.3)
P53, n (%)
Negative	293 (65.5)	770 (55.2)	< 0.001^a	385 (77.9)	393 (75.6)	0.374
Positive	154 (34.5)	626 (44.8)		109 (22.1)	127 (24.4)

^aP < 0.05 indicates statistical significance. SD: Standard deviation; EGC: Early gastric cancer; AGC: Advanced gastric cancer.

Citation: Choi Y, Kim N, Kim KW, Jo HH, Park J, Yoon H, Shin CM, Park YS, Lee DH, Oh HJ, Lee HS, Park YS, Ahn SH, Suh YS, Park DJ, Kim HH, Kim JW, Kim JW, Lee KW, Chang W, Park JH, Lee YJ, Lee KH, Kim YH. Sex-based differences in histology, staging, and prognosis among 2983 gastric cancer surgery patients. World J Gastroenterol 2022; 28(9): 933-947
URL: https://www.wjgnet.com/1007-9327/full/v28/i9/933.htm
DOI: https://dx.doi.org/10.3748/wjg.v28.i9.933