BMC cancer · 2026
Incorporating tumor deposits into the TNM staging of gastric cancer: a retrospective cohort study for prognostic validation and staging optimization.
СтатьяНазвание и аннотация: Перевод пока не подготовлен
Обработка статьи · этапы, ошибки и управление
Загрузка состояния…
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Li Yang, Zhang Yisheng, Zhao Haiyuan, Wang Zhengguang, Chen Ke, Liu Yinhua, Zhao Jun, Xu Ran
Аннотация
BACKGROUND: Tumor deposits (TD) have been identified as adverse prognostic indicators in gastric cancer (GC); however, their incorporation into the TNM staging system remains controversial. This study aimed to determine the most effective approach for integrating TD into the TNM staging system to improve prognostic accuracy.
METHODS: A retrospective analysis was performed on clinicopathological and follow-up data from patients who underwent radical surgery for gastric cancer (GC) at Yijishan Hospital, affiliated with Wannan Medical College, between January 2012 and December 2021. Patients were classified into TD-negative and TD-positive groups according to the presence or absence of TD in postoperative pathological reports.
RESULTS: A total of 4,972 patients were analyzed, of whom 575 (11.56%) had TD. These patients were matched in a 1:1 ratio with 523 TD-negative patients. Several clinicopathological factors, including tumor size, T stage, N stage, neural invasion, and vascular invasion, were significantly associated with the presence of TD. Survival analysis revealed that patients with TD had significantly lower 5-year overall survival (OS) rates than those without TD across all TNM stage subgroups (I-II, IIIa, IIIb, and IIIc) (P < 0.05). The 5-year OS rates of patients with TD in stages I-II, IIIa, IIIb, and IIIc were comparable to those of TD-negative patients in stages IIIa, IIIc, IIIc, and IV, respectively (P > 0.05). The proposed staging system incorporating TD demonstrated the highest χ2 value (181.658), the highest C-index (0.634), and the lowest - 2 log-likelihood (8427.456), indicating improved prognostic stratification.
CONCLUSION: TD represent independent prognostic factors in GC, distinct from the T, N, and M categories, and should be incorporated into the TNM staging system.
METHODS: A retrospective analysis was performed on clinicopathological and follow-up data from patients who underwent radical surgery for gastric cancer (GC) at Yijishan Hospital, affiliated with Wannan Medical College, between January 2012 and December 2021. Patients were classified into TD-negative and TD-positive groups according to the presence or absence of TD in postoperative pathological reports.
RESULTS: A total of 4,972 patients were analyzed, of whom 575 (11.56%) had TD. These patients were matched in a 1:1 ratio with 523 TD-negative patients. Several clinicopathological factors, including tumor size, T stage, N stage, neural invasion, and vascular invasion, were significantly associated with the presence of TD. Survival analysis revealed that patients with TD had significantly lower 5-year overall survival (OS) rates than those without TD across all TNM stage subgroups (I-II, IIIa, IIIb, and IIIc) (P < 0.05). The 5-year OS rates of patients with TD in stages I-II, IIIa, IIIb, and IIIc were comparable to those of TD-negative patients in stages IIIa, IIIc, IIIc, and IV, respectively (P > 0.05). The proposed staging system incorporating TD demonstrated the highest χ2 value (181.658), the highest C-index (0.634), and the lowest - 2 log-likelihood (8427.456), indicating improved prognostic stratification.
CONCLUSION: TD represent independent prognostic factors in GC, distinct from the T, N, and M categories, and should be incorporated into the TNM staging system.