Abstract
To investigate the correlation between clinicopathological features and prognosis in patients with synchronous multiple gastric carcinoma (SMGC). The clinicopathological data of 142 patients who underwent gastrectomy for SMGC from January 2000 to May 2014 at the Department of Abdominal Surgery, Cancer Institute & Hospital, Chinese Academy of Medical Sciences were retrospectively analyzed, mainly including epidemiological statistics (age, gender), surgery-related information (surgical mode, operation time, intraoperative blood loss), carcinoma-related data (quantity, location, degree of differentiation, T stage, maximum tumor diameter, vascular tumor thrombus, cutting edge, postoperative adjuvant chemotherapy), and lymph node status (number of lymph nodes dissected, lymph node metastasis). The survival analysis was performed using the Kaplan-Meier and log-rank test and multi-factor analysis with the Cox proportional hazard regression model. A total of 142 SMGC patients were included in the study, 118 men and 24 women, with an average age of 66.9 (range 32-90) years old at the time of diagnosis. There were a total of 294 lesions in 142 patients, including 136 with 2 primary gastric tumors and other 6 with 3 or more. Among these lesions, 104, 83, and 107 carcinomas were located in the proximal stomach, gastric body and distal stomach, respectively. The average diameter of the main tumors was 3.65 (0.8-15) cm, while that of the accessory ones was 3.31 (0.5-12) cm. The postoperative pathology showed that there were 97 T1, 51 T2, 62 T3, and 84 T4 lesions. Among the 142 patients, 90 (63.4%) had lymph node metastasis, and the average number of dissected lymph nodes was 25.5 (13-66). The postoperative 3-year and 5-year survival rates of the 142 patients were 73.5% and 52.2%, respectively. The univariate analysis revealed that both the main tumor T stage and TNM stage are related to the postoperative survival of SMGC patients (P<0.05 for both). The multivariate analysis showed that main tumor T stage and TNM stage are independent factors affecting prognosis of SMGC patients (average P<0.05 for both). SMGC is a special type of gastric cancer. The main treatment is radical gastrectomy. The Main tumor T stage and TNM stage are associated with the prognosis of SMGC patients.
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