Research Paper Volume 13, Issue 1 pp 376—388
Genetic alterations in gastric cancer patients according to sex
- 1 Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei, Taiwan
- 2 School of Medicine, National Yang-Ming University, Taipei, Taiwan
- 3 Center of Immuno-Oncology, Department of Oncology, Taipei Veterans General Hospital, Taipei, Taiwan
- 4 National Yang-Ming University Hospital, Yilan, Taiwan
- 5 Department of Pathology, Taipei Veterans General Hospital, Taipei, Taiwan
Received: August 10, 2020 Accepted: October 9, 2020 Published: December 3, 2020https://doi.org/10.18632/aging.202142
How to Cite
Copyright: © 2020 Hsu et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (CC BY 3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
To date, few reports have investigated the genetic alterations and clinicopathological features in gastric cancer (GC) according to sex. In total, 2673 GC patients receiving curative surgery were enrolled. Among the 2673 GC patients, 1979 (74.0%) patients were male. After propensity-score matching, 846 patients were enrolled for the analysis, including 423 males and 423 females. There was no significant difference in the clinicopathological features between the sexes. Regarding the initial recurrence pattern, the males were more likely to develop tumor recurrence and liver metastasis than the females, especially in stage III GC. Regarding the molecular analysis, the males had higher PD-L1 expression than the females, especially in stage III GC. In addition, the patients aged ≥ 65 years had higher PD-L1 expression than the patients younger than 65 years. The multivariate analysis demonstrated that sex was among the independent prognostic factors affecting overall survival (OS) and disease-free survival (DFS). Among the patients with liver metastases, PD-L1 expression was more common among the aged male patients. The males were associated with more tumor recurrence and higher PD-L1 expression than the females, especially in stage III GC. For GC patients with liver metastases, PD-L1 testing is recommended, especially among aged male patients.
AJCC: American Joint Committee on Cancer; CPS: combined positive score; DFS: Disease-free survival; GC: Gastric cancer; MSI: Microsatellite instability; MSI-H: Microsatellite instability-high; MSI-L/S: Microsatellite instability-low/stable; OS: Overall survival; PCR: Polymerase chain reaction; PD-L1: programmed death-ligand 1; TCGA: The Cancer Genome Atlas; TNM: Tumor, Node, Metastasis; UICC: Union for International Cancer Control.