Linitis Plastica: a Distinct Type of Gastric Cancer

被引:22
|
作者
Ikoma, Naruhiko [1 ]
Agnes, Annamaria [1 ]
Chen, Hsiang-Chun [2 ]
Wang, Xuemei [2 ]
Blum, Mariela M. [3 ]
Das, Prajnan [4 ]
Minsky, Bruce [4 ]
Estrella, Jeannelyn S. [5 ]
Mansfield, Paul [1 ]
Ajani, Jaffer A. [3 ]
Badgwell, Brian D. [1 ]
机构
[1] Univ Texas MD Anderson Canc Ctr, Dept Surg Oncol, 1400 Pressler St,FCT17-6010, Houston, TX 77030 USA
[2] Univ Texas MD Anderson Canc Ctr, Dept Biostat, Houston, TX 77030 USA
[3] Univ Texas MD Anderson Canc Ctr, Dept Gastrointestinal Med Oncol, Houston, TX 77030 USA
[4] Univ Texas MD Anderson Canc Ctr, Dept Radiat Oncol, Houston, TX 77030 USA
[5] Univ Texas MD Anderson Canc Ctr, Dept Pathol, Houston, TX 77030 USA
基金
美国国家卫生研究院;
关键词
Linitis plastica; Gastric cancer; Diffuse; Signet ring; Gastrectomy; Borrmann type IV; Scirrhous carcinoma; STAGING LAPAROSCOPY; PROGNOSTIC-FACTORS; PROPENSITY SCORE; SURVIVAL; ADENOCARCINOMA; RESECTION; RATES;
D O I
10.1007/s11605-019-04422-7
中图分类号
R57 [消化系及腹部疾病];
学科分类号
摘要
Background The prognosis of patients with linitis plastica (LP) gastric cancer is reported to be poor. The purpose of our retrospective study was to characterize the clinicopathologic features and survival outcomes of patients with LP, using a univocal definition. Methods We defined LP as gastric cancer that involves more than 1/3 of the gastric wall macroscopically. We reviewed a prospectively maintained institutional database of gastric cancer patients and summarized and compared clinicopathologic factors of patients with and without LP who had undergone gastrectomy. Patients were matched 1:1 using propensity score matching, and their overall survival (OS) rates and durations were compared. Multivariable Cox regression analyses were conducted, using gastrectomy as a time-varying covariate. Results We identified 740 patients with radiographically non-metastatic gastric cancer, 157 (21.2%) of whom had LP. Most patients with LP had advanced-stage disease (75.8% had stage IV disease, mainly due to peritoneal involvement). Patients with LP had significantly shorter OS durations than did those without LP in the entire cohort (median OS, 14.0 vs. 33.5 months; p value < 0.001) and in the surgical cohort (median OS after gastrectomy, 21.8 vs. 91.0 months; p < 0.001), as well as in the propensity-matched surgical cohort. In the LP cohort, chemotherapy (hazard ratio [HR] = 0.594; p = 0.076), chemoradiation therapy (HR = 0.346; p = 0.001), and gastrectomy (HR = 0.425; p = 0.003) were associated with a longer OS. Conclusions LP is a phenotype of gastric cancer that often presents at an advanced stage, with a high rate of peritoneal involvement. The survival durations of patients with LP were poor in our study, even in the surgical cohort. The use of preoperative chemotherapy, chemoradiation therapy, and gastrectomy appeared to be important in carefully selected patients with localized LP.
引用
收藏
页码:1018 / 1025
页数:8
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