Clinicopathological Characteristics And Prognosis Of Upper Gastric Cancer Patients In China

Background : Upper gastric cancer is also known as proximal gastric cancer,and it usually occurs in the position of one third of the connecting line from the stomach from the cardia to the greater curvature of the stomach and the lesser curvature of the stomach.It is gradually increasing in the incidence of gastric cancer.Not only that,the upper gastric cancer also has unique epidemiological and biological characteristics,which are significantly different from the lower stomach in terms of clinical pathological features,surgical treatment and prognosis.Therefore,how to implement depending on the clinical and pathological features of personalized medicine and to develop a reasonable standard of surgical options,thereby improving the therapeutic effect of upper gastric cancer and improve survival rates,become the focus of current research and debate.Methods:From January 1980 to December 2012,the Department of Gastrointestinal Surgery,the First Hospital of China Medical University,underwent radical surgery for gastric cancer.Finally,there are 649 cases of upper gastric cancer and 1551 cases of lower gastric cancer and a total of 2200 cases were analyzed for clinicopathological features and prognosis.Results:Upper and lower gastric cancer patients differed in sex,age,tumor diameter,tissue type,growth pattern,macroscopic type,infiltration depth,degree of lymph node metastasis,lymphovascular tumor emboli,and postoperative tumor recurrence and metastasis.Survival after radical surgery for upper gastric cancer was 77.8%,at 1,49.6%at 3,and 41.1% at and 5 years.The corresponding rates for lower gastric cancer were85.9%,60.0%,and 57.2%.Upper gastric cancer had a poor prognosis.tumor diameter,macroscopic type,pTM stage,tissue differentiation type,and serosal invasion were independently associated with lymph node metastasis.Macroscopic type,lymphovascular tumor emboli,and pTNM stage were independently associated with recurrence and metastasis.Survival of 333 patients with D2 total gastrectomy was 81.3%at 1,54.4% at 3,and 45.2% at 5 years.The corresponding rates for 316 proximal gastrectomy patients were 75.4%,44.9%,and 36.7%.Radical total gastrectomy hadbetter survival than radical proximal resection.Conclusion : The clinicopathological characteristics and prognosis of upper gastric cancer and lower gastric cancer are significantly different.The upper gastric cancer has poor biological behavior,poor prognosis,and is more prone to recurrence and metastasis after radical gastrectomy.Surgical treatment of upper gastric cancer with radicalized total gastrectomy has a higher survival rate than radical proximal resection.