Abstract:

Objective

To explore the influencing factors of the short-term prognosis of patients with advanced gastric cancer (AGC) of different pathological types after laparoscopic-assisted radical resection(LAG).

Methods

A total of 100 patients with AGC from February 2018 to February 2022 were selected as the research subjects. According to different pathological types, they were divided into gastric adenocarcinoma(n=45 cases), gastric mucinous adenocarcinoma (n=30 cases), and gastric signet ring cell carcinoma (n=25 cases). A multivariate Cox regression model was used to analyze the influencing factors of their prognosis, and a Nomogram prediction model was constructed. The calibration curve and the receiver operating characteristic curve (ROC) were used to evaluate its diagnostic efficacy, and the Kaplan-Meier survival curve was used to calculate the survival rate.

Results

There were significant differences in tumor diameter, tumor location,invasion depth, lymphatic vessel cancer embolus, regional lymph node metastasis, and pTNM stage among AGC patients of different pathological types (P<0.05). The 1-year survival rate of patients with gastric adenocarcinoma showed significant differences in tumor diameter, regional lymph node metastasis, pTNM stage, tumor location, and invasion depth. For patients with gastric mucinous adenocarcinoma, there were significant differences in pTNM stage and regional lymph node metastasis. For patients with gastric signet ring cell carcinoma, there were significant differences in pTNM stage, regional lymph node metastasis, and invasion depth (all P<0.05). Multivariate Cox regression model analysis showed that the independent risk factors for the prognosis of patients with gastric adenocarcinoma after LAG were pTNM stage, tumor site, invasion depth,tumor diameter, and regional lymph node metastasis. For gastric signet ring cell carcinoma, they were regional lymph node metastasis and tumor invasion depth, and for gastric mucinous adenocarcinoma, it was regional lymph node metastasis (all P<0.05). A nomogram prediction model was constructed, with an AUC of the model of 0.881 (95% CI: 0.863-0.884), a sensitivity of 0.827, a specificity of 0.795, and a good discriminability.The calibration curve indicated that the model had a high accuracy.

Conclusion

There are differences in the clinicopathological characteristics and prognosis among AGC patients of different pathological types. Clinically,targeted treatment should be carried out according to specific conditions to improve the quality of life of patients.

Key words: Gastric Tumor, Advanced Stage, Radical Operation for Carcinoma of Stomach, Laparoscopes, Pathological Type