BMI-adjusted prognosis of signet ring cell carcinoma in patients undergoing radical gastrectomy for gastric adenocarcinoma

Asian Journal of Surgery

Ping Li¹  Qi-Yue Chen¹  Man-Qiang Lin¹  Mi Lin²  Jian-Xian Lin²  Chang-Ming Huang²  Jian-Wei Xie³  Chao-Hui Zheng³  Long-Long Cao³  Jia-Bin Wang⁴  Jun Lu⁴  Ru-Hong Tu⁴ 

[1] Department of General Surgery, Fujian Medical University Union Hospital, Fuzhou, China;Fujian Key Laboratory of Tumor Microbiology, Fujian Medical University, Fuzhou, China;Key Laboratory of Ministry of Education of Gastrointestinal Cancer, Fujian Medical University, Fuzhou, China;Department of Gastric Surgery, Fujian Medical University Union Hospital, Fuzhou, China;

关键词: Gastric cancer;    Signet ring cell carcinoma;    Body mass index;    Prognosis;   

DOI  :  

来源: DOAJ

【 摘 要 】

Background: Compared with other histologic types, signet ring cell gastric carcinoma (SRC) has unique oncological characteristics, and its implication on the prognosis of gastric cancer patients remains unclear. The purpose of this study was to evaluate the prognostic impact of body mass index (BMI) on SRC patients. Methods: A retrospective analysis was performed using the clinical records of 3342 patients with SRC or tubular adenocarcinoma who underwent radical gastrectomy between 2000 and 2014. Patients were divided into three groups according to histologic subtype: SRC, well-to-moderately differentiated adenocarcinoma (WMD), and poorly differentiated adenocarcinoma (PD). We compared the survival of SRC patients with that of tubular adenocarcinoma patients according to BMI. Results: The 5-year survival of SRC was significantly worse than that of WMD (P < 0.001) but superior to that of PD (P < 0.001). BMI-stratified analysis showed that in the high-BMI group, the prognosis of SRC was similar to that of WMD (P > 0.05) and better than that of PD (P < 0.001). In normal-BMI patients, SRC had a worse prognosis than WMD (P < 0.001) but a more favorable prognosis than PD (P < 0.001). SRC among low-BMI patients displayed much poorer survival than did both WMD (P < 0.001) and PD (P = 0.005). Multivariate analysis indicated that the risk of death was the lowest in SRC patients with a high BMI and highest for SRC patients with a low BMI (low-BMI hazard ratio: SRC 1 vs. WMD 0.51 and PD 0.53). Conclusion: SRC has worse prognostic impact as BMI decreases. BMI leads to differing prognosis of SRC compared with tubular adenocarcinoma.

【 授权许可】

Unknown