Yun Dai,MD1, JingZhong Chen,MD1
1Endoscopy Center, The First Affiliated Hospital of Xiamen University, Xiamen City, Fujian Province, China.
Background/Aims: This study sought to explore the clinicopathological characteristics and prognostic factors of early gastric cancer patients with mucinous adenocarcinoma.
Methods: From January 1988 to December 2016, 7678 patients with early gastric cancer from SEER datebase were enrolled in this study. Comparing the survival differences between early mucinous adenocarcinoma and early signet ring cell carcinoma in patients with undifferentiated gastric cancer. Cox risk model was used to determine prognostic factors in patients with early mucinous adenocarcinoma.The Kaplan-Meier method and the log-rank test were used to analyze between-group differences in survival rate.
Results: Of the 7678 patients ,4639 were males (60.4%) with an average age of 68.6 years (21-100 years). Among them, there were 136 patients with mucinous adenocarcinoma and 1312 patients with signet ring cell carcinoma.The 5-year survival rate was 63.2% in patients with mucinous adenocarcinoma and 77.9% in patients with signet ring cell carcinoma. Univariate analysis showed that age HR=2.050,95%CI (1.121-3.748). TNM stage HR=2.750, 95%CI (1.318-5.373). N stage HR=2.776, 95%CI (1.330-5.796) and lymph node metastasis HR=2.039, 95%CI (1.260-3.300) (All P value <0.05) were associated with OS. A multivariate analysis showed that age (HR=1.872, 95%CI (1.365-3.024),p=0.002) and lymph node metastasis (HR=2.189, 95%CI (1.341-3.571),p=0.002) were independent risk factors for the prognosis of patients with early gastric mucinous adenocarcinoma.Risk grouping established in combination with age and lymph node metastasis status is well differentiated for long-term survival in patients with early gastric mucinous adenocarcinoma.
Conclusion: The overall survival rate of patients with early mucinous adenocarcinoma is significantly worse than that of patients with early signet ring cell gastric cancer. Age and lymph node metastasis are independent risk factors for prognosis in patients with early mucinous adenocarcinoma.
Keywords: Gastric cancer, Pathological type, Mucinous adenocarcinoma, Follow-up