Distinct metastatic patterns and survival outcomes in intestinal- versus diffuse-type gastric cancer: a SEER-based propensity score-matched analysis.

IF 2.1 4区医学 Q3 GASTROENTEROLOGY & HEPATOLOGY

Journal of gastrointestinal oncology Pub Date : 2026-08-31 Epub Date: 2026-06-26 DOI:10.21037/jgo-2026-0323

Yan Ming, Aiping Shang, Yin Zhou, Xiangmei Zhao

{"title":"Distinct metastatic patterns and survival outcomes in intestinal- versus diffuse-type gastric cancer: a SEER-based propensity score-matched analysis.","authors":"Yan Ming, Aiping Shang, Yin Zhou, Xiangmei Zhao","doi":"10.21037/jgo-2026-0323","DOIUrl":null,"url":null,"abstract":"Background: To investigate the prognostic significance of Lauren classification in metastatic gastric cancer (GC), its association with metastatic patterns, and the prognostic impact of metastatic sites.Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was applied to reduce baseline imbalances. Survival outcomes, including overall survival (OS) and gastric cancer-specific survival (GCSS), were analyzed using Kaplan-Meier methods and multivariate Cox regression.Results: A total of 4,696 patients with metastatic GC were included, comprising 3,758 intestinal-type and 938 diffuse-type cases. After PSM, 934 matched pairs were analyzed. Intestinal-type GC was associated with a higher incidence of liver metastasis and a lower incidence of bone metastasis compared with diffuse-type GC. Multivariate Cox regression analysis indicated that diffuse-type GC was an independent adverse prognostic factor for OS and GCSS both before and after PSM adjustment. Kaplan-Meier analyses demonstrated differences in survival outcomes according to metastatic site, with patients presenting with liver metastasis showing relatively longer survival than those with bone, brain, or multiple-site metastases.Conclusions: Lauren classification is significantly associated with distinct metastatic patterns and survival outcomes in metastatic GC. These findings may help refine prognostic stratification and support more individualized risk assessment based on histological subtype and metastatic distribution.","PeriodicalId":15841,"journal":{"name":"Journal of gastrointestinal oncology","volume":"17 4","pages":"222"},"PeriodicalIF":2.1000,"publicationDate":"2026-08-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC13546523/pdf/","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of gastrointestinal oncology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.21037/jgo-2026-0323","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2026/6/26 0:00:00","PubModel":"Epub","JCR":"Q3","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}

引用次数: 0

Abstract

Background: To investigate the prognostic significance of Lauren classification in metastatic gastric cancer (GC), its association with metastatic patterns, and the prognostic impact of metastatic sites.

Methods: A retrospective cohort study was conducted using the Surveillance, Epidemiology, and End Results (SEER) database. Propensity score matching (PSM) was applied to reduce baseline imbalances. Survival outcomes, including overall survival (OS) and gastric cancer-specific survival (GCSS), were analyzed using Kaplan-Meier methods and multivariate Cox regression.

Results: A total of 4,696 patients with metastatic GC were included, comprising 3,758 intestinal-type and 938 diffuse-type cases. After PSM, 934 matched pairs were analyzed. Intestinal-type GC was associated with a higher incidence of liver metastasis and a lower incidence of bone metastasis compared with diffuse-type GC. Multivariate Cox regression analysis indicated that diffuse-type GC was an independent adverse prognostic factor for OS and GCSS both before and after PSM adjustment. Kaplan-Meier analyses demonstrated differences in survival outcomes according to metastatic site, with patients presenting with liver metastasis showing relatively longer survival than those with bone, brain, or multiple-site metastases.

Conclusions: Lauren classification is significantly associated with distinct metastatic patterns and survival outcomes in metastatic GC. These findings may help refine prognostic stratification and support more individualized risk assessment based on histological subtype and metastatic distribution.

查看原文本刊更多论文

肠型和弥漫性胃癌的不同转移模式和生存结果：基于seer的倾向评分匹配分析。

背景：探讨Lauren分型在转移性胃癌（GC）中的预后意义、与转移方式的关系以及转移部位对预后的影响。方法：使用监测、流行病学和最终结果（SEER）数据库进行回顾性队列研究。倾向评分匹配（PSM）用于减少基线失衡。生存结局，包括总生存期（OS）和胃癌特异性生存期（GCSS），采用Kaplan-Meier方法和多变量Cox回归进行分析。结果：共纳入转移性胃癌患者4696例，其中肠型3758例，弥漫性938例。经PSM分析934对配对。与弥漫性胃癌相比，肠型胃癌肝转移发生率较高，骨转移发生率较低。多因素Cox回归分析显示，弥漫性GC是PSM调整前后OS和GCSS的独立不良预后因素。Kaplan-Meier分析表明，根据转移部位的不同，生存结果存在差异，肝转移患者的生存时间比骨、脑或多部位转移患者的生存时间更长。结论：Lauren分类与转移性胃癌不同的转移模式和生存结果显著相关。这些发现可能有助于细化预后分层，并支持基于组织学亚型和转移分布的更个性化的风险评估。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

求助全文

约1分钟内获得全文求助全文

来源期刊

Journal of gastrointestinal oncology Medicine-Oncology

CiteScore

3.20

自引率

0.00%

发文量

171

期刊介绍： ournal of Gastrointestinal Oncology (Print ISSN 2078-6891; Online ISSN 2219-679X; J Gastrointest Oncol; JGO), the official journal of Society for Gastrointestinal Oncology (SGO), is an open-access, international peer-reviewed journal. It is published quarterly (Sep. 2010- Dec. 2013), bimonthly (Feb. 2014 -) and openly distributed worldwide. JGO publishes manuscripts that focus on updated and practical information about diagnosis, prevention and clinical investigations of gastrointestinal cancer treatment. Specific areas of interest include, but not limited to, multimodality therapy, markers, imaging and tumor biology.