Annual report of a multi-centered retrospective cohort study of treatment and prognosis of gastric cancer liver metastasis based on real-world data
GAO Yun-he
XI Hong-qing
SHANG Liang
TANG Zhao-qing
YU Jiang
WEI Bo
TANG Yun
QIAO Zhi
ZHOU Jing
WANG Xin-xin
WANG Xue-fei
LI Guo-xin
XUE Kan
ZANG Lu
LIANG Han
HUANG Chang-ming
LU Jun
HUANG Hua
TIAN Yan-tao
LI Zi-yu
SUN Yi-hong
LI Le-ping
CHEN Lin
Abstract：Objective To explore and describe the global clinicopathological features,treatment,clinical classification and prognosis of patients with gastric cancer liver metastasis across China under real-world condition.Methods A retrospectively-established database was built to collect real-world gastric cancer liver metastasis(GCLM)cases from 10 gastric cancer comprehensive treatment institutions including Chinese PLA General Hospital,Shandong Provincial Hospital Affiliated to Shandong First Medical University,etc.The inclusion criteria of this study were as follows:(1)aged from 18-and 80-year old;(2)patients diagnosed with gastric cancer by endoscopic biopsy or surgical pathology;hepatic metastases indicated by imaging or biopsy;(3)in-hospital patients between January 2010 and December 2019.The exclusion criteria were:(1)cases diagnosed with other neoplasms simultaneously or in the previous 5 years;(2)cases with poor performance score(ECOG＞3)or life expectance less than 1 month;(3)cases with insufficient data for analysis.Results Finally,1901 patients diagnosed with gastric cancer liver metastasis were included in this study with initially unresectable(type Ⅲ)patients accounting for more than half of the total population(type Ⅰ:368 patients,19.4％;typeⅡ:475 patients,25.0％;type Ⅲ:1058 patients,55.6％).Most patients were male(82.2％)and the median age was 62 years[interquartile range(IQR)54-68].Synchronic liver metastasis accounted for the vast majority population(1512 cases,80.1％).The most frequent primary location of tumor was the distal stomach(36.7％)compared with the proximal(29.3％)and middle stomach(24.1％).Moreover,the right hepatic lobe(20.5％)appeared to be a more vulnerable metastatic target compared with the left lobe(15.4％),while dispersed metastasis in all lobes(60.4％)was the main pattern.In general,the 1-and 3-year overall survival(OS)of gastric cancer patients with liver metastasis was 42.0％and 16.4％,respectively.And the 3-year OS of type Ⅰ,Ⅱ,and Ⅲ patients was 33.0％,24.5％,and 6.4％,respectively.Distinct survival differences were observed among the three groups(Log-rank test,P＜0.001).Multivariate Cox analysis demonstrated that the C-GCLM classification was an independent risk factor for prognosis(Type Ⅲ vs.Ⅰ,HR=2.35,95％CI 2.00-2.76,P＜0.001;type Ⅱ vs.Ⅰ,HR=1.29,95％CI 1.07-1.54,P=0.006).Conclusion At the time of the first diagnosis,the initially unresectable patients(C-GCLM Ⅲ)accounted for the majority of total patients with gastric cancer liver metastasis in China.Chemotherapy remains the cornerstone of systemic treatment model for patients with GCLM.The surgical interventions were more applied in initially resectable(type Ⅰ)and potentially resectable(type Ⅱ)C-GCLM patients.The Chinese consensus classification system of gastric cancer liver metastasis(C-GCLM)demonstrated excellent prognostic discrimination value,which may promote individualized therapy for such patients.
Keywords：gastric cancerliver metastasisC-GCLM classification systemclinicopathological featuresoverall survival
Publication Date：2024-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 89-97 )