Retrospective Study
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©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Oct 15, 2020; 12(10): 1146-1166
Published online Oct 15, 2020. doi: 10.4251/wjgo.v12.i10.1146
Table 1 General characteristics and overall survival among 1038 gastric cancer patients
Characteristic Patients n (%) Overall survival months (95%CI) P value Sex 0.864 Male 728 (70.2%) 59.6 (56.9-62.2) Female 309 (29.8%) 59.7 (55.7-63.8) Age (yr) < 0.001 < 70 716 (69%) 64.7 (62.2-67.3) ≥ 70 321 (31%) 48.1 (44.1-52.2) Hospitalization (d) < 0.001 < 18 494 (47.6%) 68.7 (65.7-71.6) ≥ 18 543 (52.4%) 51.5 (48.4-54.6) TNM stage < 0.001 I 251 (24.2%) 87.1 (84.9-89.2) II 197 (19.0%) 75.5 (71.4-79.5) III 509 (49.1%) 46.2 (43.1-49.2) IV 80 (7.7%) 19.1 (14.5-23.8) Tumor size (cm) < 0.001 < 4 405 (39.1%) 75.2 (72.3-78.1) ≥ 4 632 (60.9%) 49.7 (46.8-52.6) Lymph node metastasis (N) < 0.001 0 393 (37.9%) 80.6 (78.1-83.2) 1-3 644 (62.1%) 46.8 (44.0-49.6) Distant metastasis (M) < 0.001 0 957 (92.3%) 62.9 (60.7-65.2) 1 80 (7.7%) 19.1 (14.5-23.8) Tumor location < 0.001 Cardia 200 (19.3%) 50.9 (45.9-56.0) Non-cardia 837 (80.7%) 61.7 (59.2-64.1) Hematological type < 0.001 Intestinal type 555 (53.5%) 64.5 (61.6-67.4) Diffuse type 482 (46.5%) 53.9 (50.6-57.2) Depth of invasion < 0.001 1-2 313 (30.2%) 84.4 (82.0-86.8) 3-4 724 (69.8%) 48.9 (46.3-51.6) Neural invasion < 0.001 No 822 (74.3%) 63.1 (60.7-65.6) Yes 215 (25.7%) 45.9 (41.1-50.7) Vessel invasion < 0.001 No 771 (74.3%) 65.7 (63.2-68.1) Yes 266 (25.7%) 42.0 (37.7-46.3) Esophageal invasion < 0.001 No 949 (91.5%) 61.6 (59.3-63.9) Yes 88 (8.5%) 38.7 (31.5-45.8) NLR < 0.001 < 2.6 634 (61.1%) 64.5 (61.8-67.3) ≥ 2.6 382 (38.9%) 51.8 (48.2-55.5) HB (g/L) < 0.001 < 120 407 (39.2%) 53.2 (49.6-56.8) ≥ 120 630 (60.8%) 63.8 (61.1-66.6) PLR < 0.001 < 133 486 (46.9%) 64.9 (61.8-68.0) ≥ 133 551 (53.1%) 54.9 (51.8-58.0) Albumin < 0.001 < 35 165 (15.9%) 46.4 (40.8-52.0) ≥ 35 872 (84.1%) 62.1 (59.8-64.5) Pre-albumin < 0.001 < 212 354 (34.1%) 45.7 (41.8-49.5) ≥ 212 683 (65.9%) 66.9 (64.3-69.4) PNI < 0.001 < 47 387 (37.3%) 48.3 (44.7-52.0) ≥ 47 65 (62.7%) 66.4 (63.7-69.0)
Table 2 Comparison of clinical characteristics between 716 younger patients (age < 70 yr) and 321 older patients (age > 70 yr) with gastric cancer
Characteristic Younger group n (%) Older group n (%) P value Sex 0.407 Male 497 (69.4%) 231 (72.0%) Female 219 (30.6%) 90 (28.0%) Hospitalization (d) < 0.001 < 18 369 (51.5%) 125 (38.9%) ≥ 18 347 (48.5%) 196 (61.6%) TNM stage 0.003 I-II 331 (46.2%) 117 (36.4%) III-IV 385 (53.8%) 204 (63.6%) T stage < 0.001 1-2 240 (33.5%) 73 (22.7%) 3-4 476 (66.5%) 248 (77.3%) N stage 0.021 0 288 (40.2%) 105 (32.7%) 1-3 428 (59.8%) 216 (67.3%) M stage 0.343 0 657 (91.8%) 300 (93.5%) 1 59 (8.2%) 21 (6.5%) Tumor size (cm) < 0.001 < 4 318 (44.4%) 87 (27.1%) ≥ 4 398 (55.6%) 234 (72.9%) Tumor location 0.059 Cardia 127 (17.7%) 73 (22.7%) Non-cardia 589 (82.3%) 248 (77.3%) Histological type 0.001 Intestinal type 359 (50.1%) 196 (61.1%) Diffuse type 357 (49.9%) 125 (38.9%) Neural invasion 0.358 No 562 (78.5%) 260 (81%) Yes 154 (21.5%) 61 (19%) Vessel invasion 0.719 No 530 (74%) 241 (75.1%) Yes 186 (26%) 80 (24.9%) Esophageal invasion 0.855 No 656 (91.6%) 293 (91.3%) Yes 60 (8.4%) 28 (8.7%) NLR 0.003 < 2.6 459 (64.1%) 175 (54.5%) ≥ 2.6 257 (35.9%) 146 (45.5%) Anemia < 0.001 No 499 (69.7%) 131 (40.8%) Yes 217 (30.3%) 190 (59.2%) PLR 0.003 < 133 358 (50%) 128 (39.9%) ≥ 133 358 (50%) 193 (60.1%) Low albumin < 0.001 No 650 (90.8%) 222 (69.2%) Yes 66 (9.2%) 99 (30.8%) Low pre-albumin < 0.001 No 534 (74.6%) 149 (46.4%) Yes 182 (25.4%) 172 (53.6%) PNI < 0.001 < 47 191 (26.7%) 196 (61.1%) ≥ 47 525 (73.3%) 125 (38.9%)
Table 3 Univariate and multivariate analyses of overall survival of 716 gastric cancer patients in younger group (age < 70 yr)
Characteristic Univariate Analysis Multivariate Analysis HR (95%CI) P value HR (95%CI) P value Sex (Male/Female) 0.983 (0.765-1.263) 0.893 Hospitalization (≥ 18/< 18 mo) 2.439 (1.909-3.115) < 0.001 1.801 (1.394-2.327) < 0.001 T stage (3 + 4/1 + 2) 9.948 (6.242-15.855) < 0.001 N stage (1-3/0) 6.841 (4.797-9.756) < 0.001 M stage (1/0) 5.799 (4.278-7.860) < 0.001 TNM (III-IV/I-II) 7.791 (5.586-10.867) < 0.001 5.418 (3.731-7.869) < 0.001 Location (Cardia/non-cardia) 1.567 (1.190-2.064) < 0.001 1.042 (0.753-1.441) 0.804 Tumor size (≥ 4/< 4 cm) 2.962 (2.267-3.871) < 0.001 1.123 (0.831-1.517) 0.452 Histological type (Diffuse/Intestinal) 1.661 (1.311-2.105) < 0.001 1.249 (0.973-1.604) 0.081 Neural invasion (Y/N) 2.024 (1.573-2.604) < 0.001 0.987 (0.758-1.286) 0.925 Vessel invasion (Y/N) 2.865 (2.260-3.632) < 0.001 1.501 (1.163-1.936) 0.002 Esophageal invasion(Y/N) 2.197 (1.566-3.082) < 0.001 1.214 (0.814-1.810) 0.341 NLR (≥ 2.6/< 2.6) 1.602 (1.267-2.024) < 0.001 1.151 (0.881-1.505) 0.303 Anemia (Y/N) 1.282 (1.004-1.637) 0.046 0.746 (0.559-0.995) 0.046 PLR (≥ 133/< 133) 1.540 (1.217-1.948) < 0.001 1.102 (0.835-1.453) 0.493 Low albumin (Y/N) 1.585 (1.117-2.249) 0.010 0.781 (0.515-1.183) 0.243 Low prealbumin (Y/N) 2.149 (1.688-2.735) < 0.001 1.637 (1.254-2.138) < 0.001 PNI (< 47/≥ 47) 1.839 (1.444-2.343) < 0.001 1.226 (0.896-1.679) 0.203
Table 4 Univariate and multivariate analyses of overall survival of 321 gastric cancer patients in older group (age > 70 yr)
Characteristic Univariate Analysis Multivariate Analysis HR (95%CI) P value HR (95%CI) P value Sex (Male/Female) 1.016 (0.742-1.392) 0.920 Hospitalization (≥ 18/< 18 mo) 1.328 (0.991-1.780) 0.058 T stage (3 + 4/1 + 2) 4.356 (2.709-7.003) < 0.001 N stage (1-3/0) 3.690 (2.544-5.352) < 0.001 M stage (1/0) 5.142 (3.210-8.237) < 0.001 TNM (III-IV/I-II) 5.462 (3.723-8.001) < 0.001 3.873 (2.571-5.836) < 0.001 Location (Cardia/non-cardia) 1.314 (0.955-1.807) 0.094 Tumor size (≥ 4/< 4 cm) 2.711 (1.854-3.963) < 0.001 1.468 (0.965-2.232) 0.073 Histological type (Diffuse/Intestinal) 1.675 (1.264-2.220) < 0.001 1.441 (1.078-1.928) 0.014 Neural invasion (Y/N) 1.928 (1.392-2.671) < 0.001 1.191 (0.828-1.713) 0.347 Vessel invasion (Y/N) 1.983 (1.464-2.684) < 0.001 1.299 (0.927-1.822) 0.129 Esophageal invasion (Y/N) 2.602 (1.716-3.944) < 0.001 2.330 (1.505-3.607) <0.001 NLR (≥ 2.6/< 2.6) 1.554 (1.174-2.056) 0.002 1.396 (1.038-1.880) 0.028 Anemia (Y/N) 1.336 (0.999-1.785) 0.051 PLR (≥ 133/< 133) 1.221 (0.913-1.633) 0.179 Low albumin (Y/N) 1.420 (1.060-1.904) 0.019 1.121 (0.792-1.587) 0.519 Low prealbumin (Y/N) 1.781 (1.336-2.374) < 0.001 1.190 (0.857-1.653) 0.299 PNI (< 47/≥ 47) 1.589 (1.179-2.142) 0.002 0.962 (0.659-1.404) 0.840
Table 5 Univariate and multivariate analyses of overall survival of 65 gastric cancer patients in younger group (age < 45 yr)
Characteristic Univariate Analysis Multivariate Analysis HR (95%CI) P value HR (95%CI) P value Sex (Male/Female) 0.555 Hospitalization (≥ 18/< 18 mo) 2.698 (1.153-6.312) 0.022 0.072 T stage (3 + 4/1 + 2) 60.674 (2.194-1677.654) 0.015 N stage (1-3/0) 8.062 (2.361-27.534) 0.01 M stage (1/0) 6.437 (2.599-15.946) < 0.001 TNM (III-IV/I-II) 10.933 (3.217-37.162) < 0.001 9.253 (2.644-32.377) < 0.001 Location (Cardia/non-cardia) 3.684 (1.344-10.092) 0.011 0.301 Tumor size (≥ 4/< 4 cm) 4.293 (1.599-11.527) 0.004 0.271 Histological type (Diffuse/Intestinal) 0.161 Neural invasion (Y/N) 0.63 Vessel invasion (Y/N) 4.518 (1.988-10.266) < 0.001 2.898 (1.249-6.723) 0.013 Esophageal invasion (Y/N) 0.31 NLR (≥ 2.6/< 2.6) 2.878 (1.257-6.588) 0.012 0.445 Anemia (Y/N) 0.094 PLR (≥ 133/<133) 3.083 (1.148-8.276) 0.025 0.958 Low albumin (Y/N) 0.295 Low prealbumin (Y/N) 0.051 PNI (< 47/≥ 47) 2.760 (1.178-6.466) 0.019 0.244
Table 6 Univariate and multivariate analyses of overall survival of 651 gastric cancer patients in middle-age group (45 ≤ age < 70).
Characteristic Univariate Analysis Multivariate Analysis HR (95%CI) P value HR (95%CI) P value Sex (Male/Female) 0.953 Hospitalization (≥ 18/< 18 mo) 1.546 (1.210-1.976) 0.01 0.127 T stage (3 + 4/1 + 2) 8.995 (5.635-14.358) < 0.001 N stage (1-3/0) 6.752 (4.659-9.786) < 0.001 M stage (1/0) 5.792 (4.186-8.013) < 0.001 TNM (III-IV/I-II) 7.558 (5.348-10.682 < 0.001 5.994 (4.183-8.590) < 0.001 Histological type (Diffuse/Intestinal) 0.598 (0.468-0.764) < 0.001 0.104 Location (Cardia/non-cardia) 1.481 (1.111-1.973) 0.007 0.947 Tumor size (≥ 4/< 4 cm) 2.859 (2.165-3.776) < 0.001 0.302 Neural invasion (Y/N) 2.075 (1.596-2.696) < 0.001 0.723 Vessel invasion (Y/N) 2.749 (2.146-3.523) < 0.001 1.603 (1.242-2.069) < 0.001 Esophageal invasion (Y/N) 2.209 (1.559-3.130) < 0.001 1.431 (1.285-2.130) 0.046 NLR (≥ 2.6/< 2.6) 1.541 (1.206-1.970) 0.001 0.335 Anemia (Y/N) 0.157 PLR (≥ 133/< 133) 1.486 (1.163-1.898) 0.002 0.436 Low albumin (Y/N) 1.721 (1.216-2.438) 0.002 0.484 Low prealbumin (Y/N) 2.128 (1.656-2.735) < 0.001 1.654 (1.285-2.130) < 0.001 PNI (< 47/≥ 47) 1.806 (1.404-2.323) < 0.001 0.265
Table 7 Summary of meta-regression and the subgroup analysis
Subgroup 1 P value n HR 95%CI I 2 2 P value Design 0.715 Retrospective 15 1.54 1.39-1.70 14.8 0.287 Prospective 4 1.61 1.31-1.98 9.1 0.345 Sample size 0.879 < 400 12 1.56 1.38-1.76 2 0.424 ≥ 400 7 1.54 1.37-1.77 29.8 0.201 Cut-off value 0.223 < 3 10 1.46 1.29-1.66 33.2 0.142 ≥ 3 9 1.65 1.45-1.88 0 0.798 Male/all 0.225 < 0.7 14 1.50 1.36-2.66 0 0.469 ≥ 0.7 5 1.75 1.43-2.13 25.6 0.251 Treatment 0.162 Surgery 13 1.49 1.34-1.67 25.1 0.190 Chemotherapy 4 1.55 1.29-1.86 0 0.982 Multiple 2 1.95 1.46-2.60 0 0.375