Recurrent metastatic patterns and prognosis after radical surgery in patients with alpha-fetoprotein-producing gastric cancer: a retrospective cohort study
Alpha-fetoprotein-producing gastric cancer (AFPGC) is a rare and aggressive subtype of gastric cancer associated with poor prognosis. This study aimed to investigate the recurrent metastatic patterns and prognostic factors in AFPGC patients undergoing radical surgical resection. Data from 241 AFPGC patients diagnosed between January 2017 and January 2020 who underwent surgical resection were analyzed across multiple centers. Recurrence patterns, metastatic sites, and survival outcomes were evaluated. Univariate and multivariate analyses were performed to identify risk factors for recurrent metastasis, overall survival (OS), and disease-free survival (DFS). There is an annual increase in the proportion of AFPGC cases, rising from 3.45% in 2017 to 7.88% in 2023. Higher serum AFP level was associated with increased likelihood of lymph node metastasis (P=0.006), deeper invasion depth (P=0.000) and greater tumor diameter (P=0.036). Independent predictors of recurrent metastasis included T4 infiltration, lymph node metastasis, tumor diameter >5 cm, poorly differentiated-undifferentiated pathology, preoperative AFP>1000 ng/mL, and postoperative increasing trend in AFP levels. The 5-year OS and DFS rates were 36.5% and 34.2%, respectively, with poorer survival linked to higher preoperative AFP levels and postoperative increasing trend in AFP level. Independent risk factors for poor OS and DFS included T4 infiltration, lymph node metastasis, poorly differentiated-undifferentiated pathology, preoperative AFP>1000 ng/mL, and postoperative increasing trend in AFP. Serum AFP level can serve as a potential predictive and prognostic biomarker. Identifying independent risk factors informs risk stratification and personalized treatment for AFPGC patients.
基金:
This work was supported by the Cultivating
Outstanding Talents Project of Hebei Provincial Government Fund (2019012, ZF2023047);
and Hebei public health committee county-level public hospitals suitable health technology
promotion and storage project (No. 2019024).
第一作者机构:[1]Hebei Med Univ, Dept Gastroenterol, Hosp 4, Shijiazhuang 050011, Hebei, Peoples R China[2]Hebei Key Lab Precis Diag & Comprehens Treatment G, Shijiazhuang 050011, Hebei, Peoples R China[3]Hebei Prov Engn Res Ctr, Big Data Anal & Min Applicat Precise Diag & Treatm, Shijiazhuang 050011, Hebei, Peoples R China
共同第一作者:
通讯作者:
通讯机构:[1]Hebei Med Univ, Dept Gastroenterol, Hosp 4, Shijiazhuang 050011, Hebei, Peoples R China[2]Hebei Key Lab Precis Diag & Comprehens Treatment G, Shijiazhuang 050011, Hebei, Peoples R China[3]Hebei Prov Engn Res Ctr, Big Data Anal & Min Applicat Precise Diag & Treatm, Shijiazhuang 050011, Hebei, Peoples R China[4]Hebei Med Univ, Dept Surg 3, Hosp 4, Shijiazhuang 050011, Hebei, Peoples R China[*1]Department of Gastroenterology, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei, China[*2]Third Department of Surgery, The Fourth Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei, China
推荐引用方式(GB/T 7714):
Zhang Fengbin,Zhang Xinran,Zhang Xin,et al.Recurrent metastatic patterns and prognosis after radical surgery in patients with alpha-fetoprotein-producing gastric cancer: a retrospective cohort study[J].AMERICAN JOURNAL OF CANCER RESEARCH.2024,14(5):2124-2140.doi:10.62347/IIIO8739.
APA:
Zhang, Fengbin,Zhang, Xinran,Zhang, Xin,Wang, Yingnan,Li, Tongkun...&Zhang, Ruixing.(2024).Recurrent metastatic patterns and prognosis after radical surgery in patients with alpha-fetoprotein-producing gastric cancer: a retrospective cohort study.AMERICAN JOURNAL OF CANCER RESEARCH,14,(5)
MLA:
Zhang, Fengbin,et al."Recurrent metastatic patterns and prognosis after radical surgery in patients with alpha-fetoprotein-producing gastric cancer: a retrospective cohort study".AMERICAN JOURNAL OF CANCER RESEARCH 14..5(2024):2124-2140