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Journal of Environmental Pathology, Toxicology and Oncology
IF: 1.15 5-Year IF: 1.4 SJR: 0.519 SNIP: 0.613 CiteScore™: 1.61

ISSN Print: 0731-8898
ISSN Online: 2162-6537

Journal of Environmental Pathology, Toxicology and Oncology

DOI: 10.1615/JEnvironPatholToxicolOncol.2016016904
pages 1-14

Impact of High Altitude on Clinicopathological Features and Prognosis after R0 Resection for Gastric Cancer: A Population-Based Multicenter Study

Jiuda Zhao
Department of Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Xining, China
Feng Du
Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
Yu Zhang
Department of Medical Oncology, Qinghai Red Cross Hospital, Xining, 810000, China
Haihong Zhu
People's Hospital of Qinghai province, Xining, China
Li Dong
Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
Guoshuang Shen
Department of Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Xining, China
Fangchao Zheng
Department of Medical Oncology, Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Xining, 810000, China; Department of Medical Oncology, Shouguang Hospital of Traditional Chinese Medicine, Weifang, 261000, China
Hui Chen
Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining, China
Junhui Zhao
Affiliated Hospital of Qinghai University, Qinghai University, Xining, China
Faxiang Ji
Affiliated Hospital of Qinghai University, High Altitude Medical Research Center, Xining, China
Yang Luo
Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, 100021, China
Fei Ma
Institute of Refrigeration and Cryogenics, MOE Key Laboratory for Power Machinery and Engineering, Shanghai Jiao Tong University, Shanghai, 200240, China
Ziyi Wang
Department of Affiliated Hospital of Qinghai University, Affiliated Cancer Hospital of Qinghai University, Xining, China
Binghe Xu
Department of Medical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences, Beijing, China

ABSTRACT

Geographic variation has an important role in both carcinogenesis and prognosis of gastric cancer (GC). High altitude is a special hypoxic environment that is also correlated with the occurrence of GC. Different onset features and prognoses of GC in high altitude with respect to plains are rarely reported and remain unknown. This multicenter study compared different clinicopathological characteristics and prognoses of patients with resected GC who were from locations of both high altitudes and plains in China. From December 2009 to December 2011, patients with resected GC were retrospectively recruited at four centers located at high altitudes and the plains. Clinicopathological data were analyzed to explore the differences between the two groups. The Cox proportional-hazards model was used to investigate the prognostic factors for GC and estimate the independent impact of altitude on long-term survival after adjusting for covariates. Noncardia GC, from a moderate to well tumor grade, was more common in patients from high altitudes. Moreover, a higher proportion of moderate to well and moderate tumor grade and younger age of onset was found in patients with noncardia GC coming from high altitudes. Different overall survival (OS) presented in noncardia GC rather than cardia GC, with 69.94% GC-related 3-yr OS in high altitude versus 75.23% in the plains. High altitude was confirmed as a significant prognostic factor for noncardia GC (the hazard ratio for high altitude vs. plains was 1:50, with a 95% confidence interval; 1.06–1.82, p = 0.018) through a multivariate Cox proportional-hazards model analysis. This prognostic value was independent of all other factors. High altitude has an important role in clinicopathological features and prognosis of GC. Improvements in GC diagnosis and management at high altitudes are urgently needed.


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