Relationship between different anatomical positions of tumor deposits and prognosis of gastric cancer patients

HOU Yuefeng; ZHANG Yong; LIU Huihui; REN Yinan; WANG Ji; GUO Hongrong

doi:10.3969/j.issn.1674-4136.2024.02.007

Abstract：Objective To analyze the incidence and clinical significance of tumor deposits in different anatomical regions of the perigastric omentum in gastric cancer patients undergoing gastrectomy combined with total omentum resection.Methods A retrospective analysis was conducted on the clinical data of 1,127 gastric cancer patients who underwent surgical treatment from January 2018 to November 2020 in Air Force Hospital of the Central Theater Command of the People's Liberation Army of China and Shanxi Cancer Hospital.According to the anatomical location of tumor deposits,the patients were divided into three subgroups:① tumor deposits were located in the omentum of the lesser curvature of the stomach;② tumor deposits were located in the proximal omentum of the greater curvature of the stomach;③tumor deposits were located in the distal omentum of the greater curvature of the stomach.The Cox risk proportional regression model was used to analyze independent risk factors and corresponding hazard ratios(HR)that affect 3-year OS in patients.Kaplan-Meier method was used to compare the three-year overall survival(OS)of patients with gastric cancer tumor deposits at different locations.Results Among all patients,a total of 125 cases(11.09%)was found to have tumor deposits by postoperative pathology.All locations of tumor deposits have a higher proportion of lymphatic vessel infiltration,worse pT staging,worse pTNM staging,and a higher proportion of 3-year mortality compared to corresponding non-tumor deposits(P＜0.05).In addition,compared to patients without corresponding tumor deposits,patients with tumor deposits in the proximal omentum of the greater curvature and in the omentum of lesser curvature of the stomach had a higher proportion over 60 years of age,the tumor size was larger than 5cm,the proportion of nerve invasion was higher,and the pT staging was worse(all P＜0.05).Multivariate COX regression analysis showed that age≥60 years,tumor size≥5 cm,pT stage,pN stage,and tumor deposits in the proximal omentum of the greater curvature of the stomach were independent prognostic factors affecting the 3-year OS of patients.The 3-year OS of patients with any location of tumor deposits was lower than that of patients without tumor deposits(P＜0.001).The median OS is the shortest in patients with proximal omental tumor deposits near the greater curvature of the stomach.Conclusions The proximal omental tumor deposits of the greater curvature of the stomach is a risk factor for death within 3 years in gastric cancer patients,with a shorter 3-year OS.