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Clinicopathological Characteristics and Prognosis of Hepatoid Adenocarcinoma of the Stomach: Evaluation of a Pooled Case Series

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Summary

Hepatoid adenocarcinoma of the stomach (HAS) is an extremely rare and unique gastric malignancy. The present study aimed to examine the relevance of the clinicopathological characteristics of HAS with patient prognosis. We retrospectively reviewed clinical data of 34 HAS patients treated at our institution between January 2010 and December 2016, as well as 294 cases reported prior to 2017 in research databases. Among these patients, 45.6% (115/252) had lesions in the gastric antrum and 77.0% (235/305) were male. Elevated levels of serum alpha-fetoprotein (AFP) were detected in most patients (75/93, 80.6%). Vascular invasion (199/286, 69.6%), lymph node metastasis (222/283, 78.4%), and preoperative distant metastasis (121/328, 36.9%) were commonly observed. The 5-year disease-free survival (DFS) and disease-specific survival (DSS) were 20.7% and 29.2%, respectively. DFS and DSS of patients receiving neoadjuvant therapy were significantly higher than those of patients receiving postoperative adjuvant therapy [DFS: P<0.001, hazard ratio (HR)=–1.831, 95% confidence interval (CI): 0.060–0.429; DSS: P<0.001, HR=–2.185, 95% CI: 0.032–0.401]. In conclusion, HAS exhibits distinct clinicopathological characteristics and a strikingly worse prognosis when compared with common gastric cancer. Complete surgery, early pTNM stage, and adjuvant therapy may predict a more favorable prognosis. Neoadjuvant therapy is strongly recommended for patients with lymph node metastasis or/and preoperative distant metastasis.

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Author notes

  1. Both authors contributed equally to this work.

Authors and Affiliations

  1. Department of Gastrointestinal Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Xiang-yu Zeng, Yu-ping Yin, Peng Zhang, Wei-zhen Liu, Jin-bo Gao, Xiao-ming Shuai, Guo-bin Wang & Kai-xiong Tao

  2. Department of Gastroduodenal and Pancreatic Surgery, Hunan Cancer Hospital and The Affiliated Cancer Hospital of Xiangya School of Medicine, Central South University, Changsha, 410013, China

    Hua Xiao

  3. Department of Pathology, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, 430022, China

    Jun He & Xiu-li Wu

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  1. Xiang-yu Zeng
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  2. Yu-ping Yin
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  11. Kai-xiong Tao
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Corresponding authors

Correspondence to Xiu-li Wu or Kai-xiong Tao.

Additional information

This study was supported by the National Key Basic Research Program of China (No. 2015CB5540007), the National Natural Science Foundation of China (No. 81572413, No. 81702386), the Fundamental Research Funds for the Central Universities (No. 2017KFYXJJ256) and Scientific and Technological Application Foundation Project of Wuhan (No. 2015060101010044).

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Zeng, Xy., Yin, Yp., Xiao, H. et al. Clinicopathological Characteristics and Prognosis of Hepatoid Adenocarcinoma of the Stomach: Evaluation of a Pooled Case Series. CURR MED SCI 38, 1054–1061 (2018). https://doi.org/10.1007/s11596-018-1983-1

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  • DOI: https://doi.org/10.1007/s11596-018-1983-1

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