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. 2023 Feb 7:13:976854.
doi: 10.3389/fonc.2023.976854. eCollection 2023.

Gastric cancer clinical characteristics and their altered trends in South China: An epidemiological study with 2,800 cases spanning 26 years

Hongfa Wei  1 , Xiao-Yong Zhan  2 , Xianying Liao  3 , Wenchao Li  1 , Hui Chen  2 , Cuncan Deng  1 , Xinghan Jin  1 , Zhangsen Huang  1 , Mo Yang  2 , Changhua Zhang  1 , Yulong He  1
Affiliations

Gastric cancer clinical characteristics and their altered trends in South China: An epidemiological study with 2,800 cases spanning 26 years

Hongfa Wei et al. Front Oncol. .

Abstract

Background: Gastric cancer (GC) is a serious threat to human health. The clinical GC characteristics in China may be impacted by changes in people's lifestyles and the promotion of early GC (EGC) screening. The present study aims to evaluate the recent trends of GC characteristics in South China and search for hazardous factors limiting the survival time of GC patients.

Methods: Data on GC patients that were hospitalized in the Department of Digestive Center, the First Affiliated Hospital, Sun Yat-sen University, from 1994 to 2019 were collected and divided into two categories according to the time when the EGC screening began in China: the PRE group (previous 13 years, 1994-2006) and the PAS group (past 13 years, 2007-2019).

Results: We found that, although the 5-year survival rate increased in the PAS group compared with the PRE group (P < 0.0001), patients with age ≥60 years or Borrmann type IV still had a worse prognosis. In the PAS group, the larger percentages of elderly patients and patients with Borrmann type IV in the lymphatic metastases (N1) group (41.0% vs. 51.1%, P = 0.0014) and stage IV subgroup (20.7% vs. 32.2%, P = 0.016), respectively, when compared with the PRE group, may have contributed to the poor outcome of GC. By comparing the odds ratio (OR) of 5-year overall survival (OS) in the two 13-year periods, female sex and T2 turned into risk factors because of a greater proportion of Borrmann type IV or elderly patients in the PAS group (OR = 0.983, 95% CI = 0.723-1.336 vs. OR = 1.277, 95% CI = 1.028-1.586 and OR = 1.545, 95% CI = 0.499-4.775 vs. OR = 2.227, 95% CI = 1.124-4.271, respectively).

Conclusions: Despite the GC epidemiology changes, the overall prognosis of GC patients has improved in South China. However, old age and Borrmann type IV are still the major restrictions affecting the survival of GC patients, a situation which calls for additional attention.

Keywords: South China; clinical characteristics; epidemiology; gastric cancer; trend.

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Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of the selection of gastric cancer patients in the database.
Figure 2
Figure 2
Kaplan–Meier survival curves of gastric cancer patients for different prognostic factors. The curves according to (A) two 13-year periods, (B) age, (C) Borrmann type, (D) gender, (E) tumor location, (F) T stage, (G) histological type, (H) N stage, (I) peritoneal metastasis, (J) hepatic metastasis, (K) pTNM, and (L) hospitalization. Log-rank was used to compare the curves.
Figure 3
Figure 3
Correlation networks among the clinicopathologic characteristics of gastric cancer (GC) from 1994 to 2019 and relative risk (RR) of GC clinicopathologic characteristics between the PRE and PAS groups. (A) The correlation networks show different profiles of correlations among the clinicopathologic characteristics of GC from 1994 to 2019. Kendall’s tau-b was used for the correlation analysis. (B) The RR of clinicopathologic characteristics for GC. Symbols and error bars: black, P >0.05; blue, P <0.05 and RR <1; red, P <0.05 and RR >1.
Figure 4
Figure 4
Heat maps showing the correlations of the gastric cancer patients’ clinicopathologic indices of the PRE group (A) and the PAS group (B). Kendall’s tau-b was used for the correlation analysis.
Figure 5
Figure 5
The relative risk of death and clinicopathologic features in the PRE group (A) and the PAS group (B). Symbols and error bars: black, P >0.05; red, P <0.05 and RR >1.
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