Abstract:

Objective To investigate the factors influencing the prognosis of patients with postoperative peritoneal metastasis of gastric cancer. Methods The clinical data of 141 patients with postoperative peritoneal metastasis of gastric cancer admitted to the 909th Hospital （Dongnan Hospital of Xiamen University） from January 2022 to December 2023 were analyzed retrospectively. All patients were followed up for 1 year， and the clinical characteristics of patients with different outcomes were analyzed. The Cox proportional hazards regression model was used to analyze factors influencing patients' prognosis， Kaplan-Meier survival curves were plotted， and the log-rank test was employed to compare 1-year overall survival （OS） rates among patients with different influencing factors. Results Among 141 patients with peritoneal metastasis after gastric cancer surgery， 51 died. The 1-year OS rate of the patients was 70.20%， and the median OS was 13 months. There were statistically significant differences in terms of lymph node metastasis （χ²=9.17， P=0.002）， vascular invasion （χ²=11.78， P=0.001）， cancer nodules （χ²=10.04， P=0.002）， Borrmann type （χ²=6.81， P=0.009）， TNM stage （χ²=22.22， P<0.001）， systemic treatment （χ²=6.47， P=0.011）， and intraperitoneal perfusion chemotherapy （χ²=10.28， P=0.001） between deceased and surviving patients. Multivariate analysis showed that， lymph node metastasis （HR=2.15， 95%CI： 1.44-6.53， P=0.010）， vascular invasion （HR=1.98， 95%CI： 1.28-6.91， P=0.023）， cancer nodules （HR=1.98， 95%CI： 1.26-7.98， P=0.042）， TNM stage （HR=2.09， 95%CI： 1.37-8.03， P=0.025）， and intraperitoneal perfusion chemotherapy （HR=2.19， 95%CI： 1.53-6.30， P=0.008） were all factors influencing the prognosis of patients with postoperative peritoneal metastasis of gastric cancer. Survival curve analysis showed that， the 1-year OS rates of patients with and without lymph node metastasis were 50.0% and 74.7%， respectively， with a statistically significant difference （χ²=9.77， P=0.002）； the 1-year OS rates of patients with and without vascular invasion were 47.5% and 75.6%， respectively， with a statistically significant difference （χ²=12.51， P<0.001）； the 1-year OS rates of patients with and without cancer nodules were 34.8% and 69.5%， respectively， with a statistically significant difference （χ²=11.80， P=0.001）； the 1-year OS rates of patients with TNM stage Ⅰ and Ⅱ were 80.2% and 41.7%， respectively， with a statistically significant difference （χ²=20.64， P<0.001）； and the 1-year OS rates of patients without and with intraperitoneal perfusion chemotherapy were 52.5% and 78.7%， respectively， with a statistically significant difference （χ²=9.83， P=0.002）. Conclusions Lymph node metastasis， vascular invasion， cancer nodules， TNM stage Ⅱ， and no intraperitoneal perfusion chemotherapy are all risk factors for the prognosis of patients with postoperative peritoneal metastasis of gastric cancer.

Key words: Stomach neoplasms, Neoplasm metastasis, Peritoneum, Prognosis