Analysis Of Clinicopathological Features And Prognosis Of 142 Cases With Synchronous Multiple Gastric Carcinoma

Objective To investigate the correlation between clinicopathological characters and prognosis in patients with synchronous multiple gastric carcinoma(SMGC).Methods 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 analyzed retrospectively.Potential clinicopathological prognostic factors were retrospectively analyzed,mainly including epidemiological statistics(age,gender),surgery-related information(surgical mode,operation time,and intraoperative blood loss),carcinoma-related data(quantity,location,degree of differentiation,T state,maximum tumor diameter,vascular tumor thrombus,cutting edge,and 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.Results 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 were located in the proximal stomach,gastric body and distal stomach,respectively.The average diameter of main tumor was 3.65(0.8-15)cm,while the accessory tumor was 3.31(0.5-12)cm.The postoperative pathology showed that there were 97 T1,51T2,62T3,and 84 T4 lesions.Among the 142 patients,90(63.4%)had metastatic lymph nodes,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 were 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(P<0.05)were independent factors affecting prognosis of SMGC patients(average P<0.05 for both).Conclusions SMGC is a special type of gastric cancer.The main treatment of SMGC is radical gastrectomy.The main tumor T stage and TNM stage are associated with the prognosis of SMGC patients.