Retrospective Cohort Study
Copyright ©The Author(s) 2023. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Sep 15, 2023; 15(9): 1605-1615
Published online Sep 15, 2023. doi: 10.4251/wjgo.v15.i9.1605
Incorporation of perigastric tumor deposits into the TNM staging system for primary gastric cancer
Yang Li, Shuo Li, Lu Liu, Li-Yu Zhang, Di Wu, Tian-Yu Xie, Xin-Xin Wang
Yang Li, Shuo Li, Lu Liu, Li-Yu Zhang, Di Wu, Medical School of Chinese People's Liberation Army, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
Tian-Yu Xie, Xin-Xin Wang, Department of General Surgery, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing 100853, China
Author contributions: Li Y, Li S, and Liu L contributed equally to this work; Wang XX, Li Y, Li S, and Liu L designed the study; Li Y, Li S, and Liu L collected the sample data of the patients; Li S, Liu L, Zhang LY, Wu D, and Xie TY performed the statistical analysis; Li Y wrote the manuscript; all of the authors read and approved the final manuscript.
Institutional review board statement: This study was approved by the Medical Ethics Committee of the Chinese PLA General Hospital (No. S2023-065-01).
Informed consent statement: Due to the approval of the Medical Ethics Committee, the informed consent form has been waived.
Conflict-of-interest statement: All of the authors declare no interest in this study.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at [301wxx@sina.com]. Participants gave informed consent for data sharing.
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: Xin-Xin Wang, MD, PhD, Assistant Professor, Chief Doctor, Department of General Surgery, The First Medical Center, Chinese People's Liberation Army General Hospital, No. 28 Fuxing Road, Haidian District, Beijing 100853, China. 301wxx@sina.com
Received: June 14, 2023
Peer-review started: June 14, 2023
First decision: July 7, 2023
Revised: July 15, 2023
Accepted: August 2, 2023
Article in press: August 2, 2023
Published online: September 15, 2023
ARTICLE HIGHLIGHTS
Research background

The current prognostic significance of perigastric tumor deposits (TDs) in gastric cancer (GC) remains unclear.

Research motivation

The prognostic value of TDs in GC has not been extensively studied or confirmed. To date, no studies have investigated the prognostic significance of TDs in GC in detail. This study aimed to assess the prognostic value of perigastric TDs and put forward a new and appropriate TNM staging framework involving TDs for primary GC.

Research objectives

This study aimed to assess the prognostic value of perigastric TDs and put forward a new and appropriate TNM staging framework involving TDs for primary GC.

Research methods

We retrospectively analyzed the pathological data of 6672 patients with GC who underwent gastrectomy or surgery for GC with other diseases from January 1, 2012 to December 31, 2017 at the Chinese PLA General Hospital. The patients were divided into TD-positive and TD-negative groups by using the method of propensity score matching. The differences between TD-positive and TD-negative patients were analyzed using binary logistic regression modeling. The Kaplan-Meier method was used to plot survival curves. Multivariate Cox regression modeling and the log-rank test were used to analyze the data.

Research results

With the new GC staging scheme including TDs, the survival curves of patients in the lower grade TNM stage with TDs were closer to those of patients in the higher grade TNM stage without TDs.

Research conclusions

TDs are a poor prognostic factor in patients with primary GC, and a new TNM staging system combining TDs would be suitable for such patients.

Research perspectives

From a clinical point of view, we found deficiencies in the current TNM staging system for GC and conducted this study.