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Differential prognostic implications of gastric adenocarcinoma based on Lauren’s classification: a Surveillance, Epidemiology, and End Results (SEER)-based cohort study

BACKGROUND: Our study aims to analyze the association between Lauren’s classification and gastric adenocarcinoma prognosis using comprehensive statistical analyses. METHODS: According to the selection criteria, patients were included from the Surveillance, Epidemiology, and End Results (SEER) databa...

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Autores principales: Tang, Dehua, Ni, Muhan, Zhu, Hao, Cao, Jun, Zhou, Lin, Shen, Shanshan, Peng, Chunyan, Lv, Ying, Xu, Guifang, Wang, Lei, Zou, Xiaoping
Formato: Online Artículo Texto
Lenguaje:English
Publicado: AME Publishing Company 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106066/
https://www.ncbi.nlm.nih.gov/pubmed/33987344
http://dx.doi.org/10.21037/atm-20-7953
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author Tang, Dehua
Ni, Muhan
Zhu, Hao
Cao, Jun
Zhou, Lin
Shen, Shanshan
Peng, Chunyan
Lv, Ying
Xu, Guifang
Wang, Lei
Zou, Xiaoping
author_facet Tang, Dehua
Ni, Muhan
Zhu, Hao
Cao, Jun
Zhou, Lin
Shen, Shanshan
Peng, Chunyan
Lv, Ying
Xu, Guifang
Wang, Lei
Zou, Xiaoping
author_sort Tang, Dehua
collection PubMed
description BACKGROUND: Our study aims to analyze the association between Lauren’s classification and gastric adenocarcinoma prognosis using comprehensive statistical analyses. METHODS: According to the selection criteria, patients were included from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression, propensity score matching, and a multivariate competing risk model were used to investigate the association between Lauren’s classification and prognosis. Subgroup analysis was used to investigate the role of confounding factors on the association between Lauren types and prognosis. RESULTS: After exclusion, a total of 20,218 patients from the SEER database were included, with 14,374 intestinal types and 5,844 diffuse types. The univariate Cox regression analysis revealed that the diffuse type had a poorer cancer-specific survival (CSS) rate [hazard ratio (HR), 1.44; 95% confidence interval (CI), 1.38–1.50]. After adjusting for confounding variables, the diffuse type also showed a higher risk of cancer-specific death (HR, 1.20; 95% CI, 1.15–1.20). Sensitivity analysis showed that after propensity score matching, the diffuse type had a poorer CSS rate (HR, 1.23; 95% CI, 1.10–1.36), and the competing risk model further validated these results [subdistribution HR (SHR), 1.32; 95% CI, 1.23–1.41]. Moreover, subgroup analysis demonstrated stable results in the subgroups, except for patients with T1 stage (HR, 1.06; 95% CI, 0.87–1.28) and a tumor size <2 cm (HR, 1.00; 95% CI, 0.83–1.21). CONCLUSIONS: Diffuse-type gastric adenocarcinoma had an overall poorer prognosis compared to the intestinal type. However, in patients with T1 stage and tumor size <2 cm, the diffuse type had a comparable survival rate with the intestinal type.
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spelling pubmed-81060662021-05-12 Differential prognostic implications of gastric adenocarcinoma based on Lauren’s classification: a Surveillance, Epidemiology, and End Results (SEER)-based cohort study Tang, Dehua Ni, Muhan Zhu, Hao Cao, Jun Zhou, Lin Shen, Shanshan Peng, Chunyan Lv, Ying Xu, Guifang Wang, Lei Zou, Xiaoping Ann Transl Med Original Article BACKGROUND: Our study aims to analyze the association between Lauren’s classification and gastric adenocarcinoma prognosis using comprehensive statistical analyses. METHODS: According to the selection criteria, patients were included from the Surveillance, Epidemiology, and End Results (SEER) database. Univariate and multivariate Cox regression, propensity score matching, and a multivariate competing risk model were used to investigate the association between Lauren’s classification and prognosis. Subgroup analysis was used to investigate the role of confounding factors on the association between Lauren types and prognosis. RESULTS: After exclusion, a total of 20,218 patients from the SEER database were included, with 14,374 intestinal types and 5,844 diffuse types. The univariate Cox regression analysis revealed that the diffuse type had a poorer cancer-specific survival (CSS) rate [hazard ratio (HR), 1.44; 95% confidence interval (CI), 1.38–1.50]. After adjusting for confounding variables, the diffuse type also showed a higher risk of cancer-specific death (HR, 1.20; 95% CI, 1.15–1.20). Sensitivity analysis showed that after propensity score matching, the diffuse type had a poorer CSS rate (HR, 1.23; 95% CI, 1.10–1.36), and the competing risk model further validated these results [subdistribution HR (SHR), 1.32; 95% CI, 1.23–1.41]. Moreover, subgroup analysis demonstrated stable results in the subgroups, except for patients with T1 stage (HR, 1.06; 95% CI, 0.87–1.28) and a tumor size <2 cm (HR, 1.00; 95% CI, 0.83–1.21). CONCLUSIONS: Diffuse-type gastric adenocarcinoma had an overall poorer prognosis compared to the intestinal type. However, in patients with T1 stage and tumor size <2 cm, the diffuse type had a comparable survival rate with the intestinal type. AME Publishing Company 2021-04 /pmc/articles/PMC8106066/ /pubmed/33987344 http://dx.doi.org/10.21037/atm-20-7953 Text en 2021 Annals of Translational Medicine. All rights reserved. https://creativecommons.org/licenses/by-nc-nd/4.0/Open Access Statement: This is an Open Access article distributed in accordance with the Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International License (CC BY-NC-ND 4.0), which permits the non-commercial replication and distribution of the article with the strict proviso that no changes or edits are made and the original work is properly cited (including links to both the formal publication through the relevant DOI and the license). See: https://creativecommons.org/licenses/by-nc-nd/4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) .
spellingShingle Original Article
Tang, Dehua
Ni, Muhan
Zhu, Hao
Cao, Jun
Zhou, Lin
Shen, Shanshan
Peng, Chunyan
Lv, Ying
Xu, Guifang
Wang, Lei
Zou, Xiaoping
Differential prognostic implications of gastric adenocarcinoma based on Lauren’s classification: a Surveillance, Epidemiology, and End Results (SEER)-based cohort study
title Differential prognostic implications of gastric adenocarcinoma based on Lauren’s classification: a Surveillance, Epidemiology, and End Results (SEER)-based cohort study
title_full Differential prognostic implications of gastric adenocarcinoma based on Lauren’s classification: a Surveillance, Epidemiology, and End Results (SEER)-based cohort study
title_fullStr Differential prognostic implications of gastric adenocarcinoma based on Lauren’s classification: a Surveillance, Epidemiology, and End Results (SEER)-based cohort study
title_full_unstemmed Differential prognostic implications of gastric adenocarcinoma based on Lauren’s classification: a Surveillance, Epidemiology, and End Results (SEER)-based cohort study
title_short Differential prognostic implications of gastric adenocarcinoma based on Lauren’s classification: a Surveillance, Epidemiology, and End Results (SEER)-based cohort study
title_sort differential prognostic implications of gastric adenocarcinoma based on lauren’s classification: a surveillance, epidemiology, and end results (seer)-based cohort study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8106066/
https://www.ncbi.nlm.nih.gov/pubmed/33987344
http://dx.doi.org/10.21037/atm-20-7953
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