Vessel invasion is a risk factor for gastric cancer: a retrospective analysis study

World J Surg Oncol. 2024 Dec 27;22(1):348. doi: 10.1186/s12957-024-03604-1.

Abstract

Objective: To explore the relationship between vessel invasion (VI) and clinicopathological features and prognosis in patients with gastric cancer (GC).

Methods: A total of 3600 cases of patients with GC who underwent radical gastrectomy in gastrointestinal surgery department of the First Affiliated Hospital of Naval Medical University from June 2014 to June 2019 were retrospectively analyzed, and filtering them based on specific inclusion and exclusion criteria. To reduce the possibility of selection bias about the impact of VI, patients were divided into two groups according to the presence or absence of it, and performed a one-to-one propensity score matching (PSM), resulting in 724 patients in each group. In the analysis of data from 3,205 GC patients was employed to examine inter-group variations in VI positivity across diverse clinicopathological factors. Both univariate and multivariate Cox regression models were applied to investigate the correlation between clinicopathological factors and prognosis. The findings were further illustrated through the plotting of Kaplan-Meier survival curves.

Results: 3205 patients were included in this study, of which 989 (30.9%) were VI-positive and 2216 (69.1%) were VI-negative. VI-positive group was found to be significantly associated with age, body mass index (BMI), pTNM stage, tumor location, perineural invasion (PI), Lauren classfication and tumor deposit (TD) (P < .05), but not with gender or basic disease. VI-positive patients had a worse survival than VI-negative patients before (P < .001) and after (P = .007) PSM matching. The Kaplan-Meier survival curve after PSM illustrated that patients with VI had a 5-year survival rate of 58.03%, whereas patients without VI had a higher rate at 66.25%. Further, multivariate analysis after matching demonstrated that VI was an independent risk factor for prognosis (P = .030).

Conclusion: VI is associated with multiple pathological factors and serves as an independent risk factor affecting the prognosis of GC.

Keywords: Gastric cancer; Prognosis; Risk factors; Vessel invasion.

MeSH terms

  • Aged
  • Female
  • Follow-Up Studies
  • Gastrectomy*
  • Humans
  • Male
  • Middle Aged
  • Neoplasm Invasiveness*
  • Neoplasm Staging
  • Prognosis
  • Propensity Score
  • Retrospective Studies
  • Risk Factors
  • Stomach Neoplasms* / mortality
  • Stomach Neoplasms* / pathology
  • Stomach Neoplasms* / surgery
  • Survival Rate