3.1. Patient characteristic
The baseline characteristics of the 429 patients are shown in Table 1. Group A and Group B have no significant differences in sex ratio, age, tumor size, the depth of invasion, histological classification, the macroscopic classification. The average age of patients was 56.01 ± 9.53 years. In total, the proportion of female patients (36.6%, 157/429) was lower than male patients (63.4%, 272/429) among patients with EGC. The size of the tumor was 24.5 ± 10.6mm. The most common location was the lower third of the stomach (53.8%, 231/429), followed by the middle (32.6%, 140/429) and upper (13.5%, 58/429) parts of the stomach. The most common gross appearance was the depressed type (53.4%, 229/429), followed by the flat type (31.7%, 136/429), elevated type (14.9%, 64/429), and the proportion of differentiated type (49.2%, 211/429) and undifferentiated type (50.8%, 218/429) is close. In total, 210 (49.0%) patients had submucosal invasion and 41 patients (16.6%) had lymph node metastasis.
Table 1
Baseline characteristics of patients with EGC
| Total | Group A | Group B | P-value |
---|
Patient number | 429 | 268 | 161 | |
Age (mean ± SD), y | 55.94 ± 9.50 | 55.90 ± 9.49 | 56.01 ± 9.53 | 0.908 |
≥60 | 157(36.6%) | 99(36.9%) | 58(36.0%) | 0.849 |
༜60 | 272(63.4%) | 169(63.1%) | 103(64.0%) | |
Gender | | | | 0.667 |
Male | 272(63.4%) | 172(64.2%) | 100(62.1%) | |
Female | 157(36.6%) | 96(35.8%) | 61(38.9%) | |
Tumor location | | | | 0.990 |
Upper | 58(13.6%) | 36 (13.4%) | 22(13.7%) | |
Middle | 140(32.6%) | 87 (32.5%) | 53(32.9%) | |
Lower | 231(53.8%) | 145(54.1%) | 86(53.4%) | |
Tumor size, mean ± SD, mm | 24.5 ± 10.6 | 23.9 ± 10.5 | 25.3 ± 10.7 | 0.176 |
≥20 | 267(62.2%) | 159(59.3%) | 108(67.1%) | 0.109 |
༜20 | 162(37.8%) | 109(40.7%) | 53(32.9%) | |
Depth of invasion | | | | 0.525 |
M | 219(51.0%) | 140(52.2%) | 79(49.1%) | |
SM | 210(49.0%) | 128(47.8%) | 82(50.9%) | |
Macroscopic type | | | | 0.510 |
Depressed | 229(53.4%) | 147(54.9%) | 82(50.9%) | |
Flat | 136(31.7%) | 85(31.7%) | 51(31.7%) | |
Elevate | 64(14.9%) | 36(13.4%) | 28(17.4%) | |
Node metastasis | | | | 0.924 |
Positive | 71(16.6%) | 44(16.4%) | 27(16.8%) | |
Negative | 388(83.4%) | 224(83.6%) | 134(83.2%) | |
Histology | | | | 0.404 |
Undifferentiated type | 218(50.8%) | 132(49.3%) | 86(53.4%) | |
Differentiated type | 211(49.2%) | 136(50.7%) | 75(46.6%) | |
3.2. Risk factors of recurrence among postoperative with early gastric cancer.
In univariate analysis, positive node metastasis (HR, 3.282; 95% CI, 2.008–5.363; P < 0.001), submucosal invasion (HR, 1.840; 95% CI, 1.151–2.940; P = 0.011), non-H. pylori eradication (HR, 1.638; 95% CI, 1.029–2.607; P = 0.037), undifferentiated type (HR, 2.898; 95% CI, 1.751–4.794; P < 0.001) were associated with recurrence among postoperative with early gastric cancer; In multivariate analysis, positive node metastasis (HR, 3.161; 95% CI, 1.860–5.371; P < 0.001), undifferentiated type (HR, 2.534; 95% CI, 1.503–4.272; P < 0.001), non-H. pylori eradication (HR, 1.728; 95% CI, 1.077–2.772; P = 0.023) were statistically significant independent risk factors of recurrence shown in Table 2.
Table 2
Predictive factors of recurrence of postoperative early gastric cancer
| Univariate | Multivariate |
---|
| HR | 95%CI | P value | HR | 95%CI | P value |
Age | 1.412 | 0.882–2.261 | 0.151 | 1.304 | 0.800-2.127 | 0.287 |
Gender | 0.894 | 0.554–1.444 | 0.648 | 1.196 | 0.727–1.968 | 0.481 |
Tumor location | 0.840 | 0.617–1.144 | 0.269 | 1.030 | 0.740–1.434 | 0.860 |
Tumor size | 0.971 | 0.610–1.544 | 0.900 | 0.953 | 0.589–1.541 | 0.845 |
Depth of invasion | 1.840 | 1.151–2.940 | 0.011 | 2.235 | 1.378–3.625 | 0.001 |
Macroscopic type | 0.874 | 0.628–1.217 | 0.426 | 0.816 | 0.581–1.148 | 0.243 |
Node metastasis | 3.282 | 2.008–5.363 | < 0.001 | 3.161 | 1.860–5.371 | < 0.001 |
Histology | 2.898 | 1.751–4.794 | < 0.001 | 2.534 | 1.503–4.272 | < 0.001 |
Hp eradication | 1.638 | 1.029–2.607 | 0.037 | 1.728 | 1.077–2.772 | 0.023 |
3.3. Risk factors of overall survival among postoperative with early gastric cancer.
In univariate analysis, age > 60 (HR, 3.397; 95% CI, 2.079–5.551; P < 0.001), positive node metastasis (HR, 3.712; 95% CI, 2.252–6.117; P < 0.001), submucosal invasion (HR, 1.861; 95% CI, 1.140–3.037; P = 0.013), non-H. pylori eradication (HR, 1.622; 95% CI, 1.001–2.628; P = 0.036), undifferentiated type (HR, 3.059; 95% CI, 1.791–5.225; P < 0.001) were associated with overall survival among postoperative with early gastric cancer. In multivariate analysis, age > 60 (HR, 3.250; 95% CI, 1.957–5.396; P < 0.001), positive node metastasis (HR, 3.669; 95% CI, 2.107–6.390; P < 0.001), undifferentiated type(HR, 2.074; 95% CI, 1.180–3.647; P = 0.011), non-H. pylori eradication (HR, 1.760; 95% CI, 1.067–2.902; P = 0.027) were statistically significant independent risk factors of overall survival shown in Table 3.
Table 3
Predictive factors of overall survival of postoperative early gastric cancer
| Univariate | Multivariate |
---|
| HR | 95%CI | P value | HR | 95%CI | P value |
Age | 3.397 | 2.079–5.551 | < 0.001 | 3.250 | 1.957–5.396 | < 0.001 |
Gender | 0.903 | 0.548–1.489 | 0.689 | 1.422 | 0.834–2.424 | 0.196 |
Tumor location | 0.769 | 0.560–1.057 | 0.106 | 0.839 | 0.609–1.156 | 0.283 |
Tumor size | 1.227 | 0.741–2.033 | 0.427 | 1.206 | 0.718–2.028 | 0.479 |
Depth of invasion | 1.861 | 1.140–3.037 | 0.013 | 2.255 | 1.368–3.717 | 0.001 |
Macroscopic type | 0.872 | 0.612–1.243 | 0.450 | 0.826 | 0.568–1.199 | 0.314 |
Node metastasis | 3.712 | 2.252–6.117 | < 0.001 | 3.669 | 2.107–6.390 | < 0.001 |
Histology | 3.059 | 1.791–5.225 | < 0.001 | 2.074 | 1.180–3.647 | 0.011 |
Hp eradication | 1.622 | 1.001–2.628 | 0.036 | 1.760 | 1.067–2.902 | 0.027 |
3.4. Prognosis and survival analysis.
67 patients (15.6%) died during a median follow-up of 69 months (range from 18 to 119 months). The 3-, 5-year survival rates were 98.5% and 93.6% in group A, and 96.9% and 86.6% in group B, respectively (Fig. 1A). It’s obvious that the survival curve of group A was higher than that of group B, and the difference was statistically significant (log-rank P = 0.034). There were 73 patients (17.0%) with recurrence during the follow-up, and the 3-, 5-year recurrence rates were 1.2% and 9.3% in group A, and 2.6% and 16.4% in group B, respectively (Fig. 1B). It is shown that the recurrence rate was lower in group A than in group B (log-rank P = 0.035).