19. Ratio of lymph node metastasis and lymphavascular invasion predict diseasespecific survival of proximal gastric adenocarcinoma in Chinese patients following curative resection

Background: The etiology and high share of proximal gastric cancer (PGC) in China indicates that it is a distinct entity from that in other countries. PGC has a poor outcome compared with distal gastric cancer (DGC), even after curative resection. Prognostic analysis may be of help in the design of clinical trials on adjuvant treatments for proximal gastric cancer. Patients and method: Patient data including clinical and pathological information derived from a database established in Beijing Cancer Hospital were analyzed. Comparison between PGC and DGC was performed. Univariate and multivariate prognostic analysis on PGC following curative resection were carried out.
Results: Ninety hundred and thirty-eight eligible patients were enrolled in this study. Disease-specific survival of 372 PGC was superior to that of DGC, even stratified by stage. PGC had more male, larger body mass index (BMI), more advanced lesion, and presented more aggressive. The median number of lymph nodes harvested in PGC was 11 [1-46], which was less than DGC 19 [1-71]. Multivariate analysis demonstrated that lymph node metastasis ratio (LMR), lymphavascular invasion (LVI), and Lauren’s classification were independent prognostic factors. Proximal gastric cancer with different LMR had significant different prognosis, even in those with total lymph.