Tumor vessel invasion independent risk factor affecting prognosis of Gastric cancer: Study

A new study published in the World Journal of Surgical Oncology found that vessel invasion (VI) is a risk factor that affects the outcome of gastric cancer (GC) and is linked to several pathological variables. The fifth most frequent malignant tumor in the world is gastric cancer that causes around 700,000 deaths and 1,000,000 new cases annually.

Tumors within the blood vessels or lymphatic system are referred to as vessel invasion (VI). As cancer progresses, tumor cells infiltrate the blood vessel and lymphatic vessel around the tumor, which is a critical route for tumor growth and dissemination. Tumor metastasis and recurrence are significantly influenced by VI formation. This study by Qiannan Wang and team investigated the possible role of VI and determined whether it may be used in conjunction with more conventional clinicopathological criteria to evaluate the prognosis of GC.

The retrospective analysis and filtering based on certain inclusion and exclusion criteria were done on 3600 instances of GC patients who had radical gastrectomy at the gastrointestinal surgery department of the First Affiliated Hospital of Naval Medical University between June 2014 and June 2019. The patients were divided into 2 groups based on whether or not VI was present, and a one-to-one propensity score matching (PSM) was used to create 724 patients in each group to reduce the possibility of selection bias related to VI.

Data from 3,205 GC patients were evaluated to look for variations in VI positivity across different clinicopathological factors. To examine the relationship between clinicopathological variables and prognosis, both univariate and multivariate Cox regression models were used. Plotting Kaplan-Meier survival curves helped to better illustrate the results.

This study comprised a total of 3205 individuals, of whom 2216 (69.1%) were VI-negative and 989 (30.9%) were VI-positive. Age, body mass index (BMI), tumor location, pTNM stage, perineural invasion (PI), Lauren classification, and tumor deposit (TD) were shown to be substantially correlated with the VI-positive group, but not with gender or basic illness.

Prior to and during PSM matching, VI-positive patients had a more severe survival rate than VI-negative patients. The patients with VI had a 5-year survival rate of 58.03%, whereas the individuals without VI had a higher rate of 66.25% after PSM.

Furthermore, VI was shown to be a separate risk factor for prognosis by multivariate analysis following matching. Overall, the presence of VI in GC patients is impacted by a variety of parameters, including age, depth of infiltration, BMI, number of lymph node metastases, PI, gastrectomy site, Lauren classification, and TD.

Source:

Wang, Q., Liu, Z., Han, J., Gao, Y., Shao, Y., Cai, H., & Yin, K. (2024). Vessel invasion is a risk factor for gastric cancer: a retrospective analysis study. In World Journal of Surgical Oncology (Vol. 22, Issue 1). Springer Science and Business Media LLC. https://doi.org/10.1186/s12957-024-03604-1