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AIM:To investigate differences between common gastric cancer andα-fetoprotein(AFP)-producing gastric cancer according to the presence or absence of liver metastasis.METHODS:Between 1997 and 2011,1299 patients underwent gastrectomy for gastric cancer(GC)at our institute and their hospital records were reviewed retrospectively.Patients were immunohistochemically divided into two groups:23 patients(1.8%)with AFPproducing GC and 1276 patients(98.2%)without it.RESULTS:AFP-producing GC patients had a significantly higher incidence of deeper tumors,venous invasion,lymphatic invasion,lymph node metastasis,and liver metastasis and a poorer prognosis(P<0.005)than those without AFP-producing GC.However,multi-variate analysis revealed that AFP-positivity was not an independent prognostic factor.The prognosis of AFPproducing GC was similar to that of AFP-non producing GC according to the presence or absence of liver metastasis.Concerning recurrence,47.8%of patients(11/23)with AFP-producing GC and 20.0%of patients(256/1276)without AFP-producing GC exhibited recurrence.Liver metastasis[90.9%(10/11)]was the most prevalent in AFP-producing GC patients.Multivariate analysis revealed that liver metastasis was the only independent prognostic factor in AFP-producing GC(HR=17.6,95%CI:2.1-147.1;P=0.0081).CONCLUSION:AFP-producing GC is similar to common GC without liver metastasis,which should be specifically targeted in an effort to improve the prognosis of AFP-producing GC patients.
AIM: To investigate differences between common gastric cancer and α-fetoprotein (AFP) -producing gastric cancer according to the presence or absence of liver metastasis. METHODS: Between 1997 and 2011,1299 patients underwent gastrectomy for gastric cancer (GC) at our institute and their hospital records were reviewed retrospectively. Patients were immunohistochemically divided into two groups: 23 patients (1.8%) with AFPproducing GC and 1276 patients (98.2%) without it .RESULTS: AFP- producing GC patients had a significantly higher incidence of more tumors, venous invasion, lymphatic invasion, lymph node metastasis, and liver metastasis and a poorer prognosis (P <0.005) than those without AFP-producing GC. Yet, multi-variate analysis revealed that AFP-positivity was not an independent prognostic factor. prognosis of AFPproducing GC was similar to that of AFP-non producing GC according to the presence or absence of liver metastasis. Concerning recurrence, 47.8% of patients (11/23) with AFP-producing GC and 20.0% of patients (256/1276) without AFP-producing GC showed recurrence. Liver metastasis [90.9% (10/11)] was the most prevalent in AFP-producing GC patients. Multivariate analysis revealed that liver metastasis was the only independent prognostic factor in AFP-producing GC (HR = 17.6, 95% CI: 2.1-147.1; P = 0.0081) .CONCLUSION: AFP-producing GC is similar to common GC without liver metastasis, which should be specifically targeted in an effort to improve the prognosis of AFP-producing GC patients.