Características clinicopatológicas y pronóstico de pacientes con HAS/GAED resecables: un estudio multicéntrico...

Hepatoid adenocarcinoma of the stomach (HAS) and gastric adenocarcinoma with enteroblastic differentiation (GAED) are rare and highly aggressive subtypes of gastric cancer (GC).

This study aimed to investigate the clinicopathological characteristics and prognostic outcomes of patients with HAS and GAED.

This multicenter retrospective study compared 107 patients with HAS/GAED with 428 patients with conventional GC (cGC) after 4:1 propensity score matching (PSM). The primary outcomes included disease-free survival (DFS), gastric cancer-specific survival (GCSS), and overall survival (OS). Survival analyses were performed using Cox proportional hazards models and Kaplan-Meier curves.

With a median follow-up of 33 months, patients in the HAS/GAED group, compared with those in the cGC group, exhibited larger tumor size, poorer histological differentiation, higher preoperative carcinoembryonic antigen (CEA) levels, and a higher rate of human epidermal growth factor receptor 2 (HER2) overexpression (all P<0.05). Multivariate analysis identified elevated CEA levels, perineural invasion (PNI), and pathological N (pN) category as independent risk factors for poor prognosis, whereas postoperative chemotherapy was identified as a protective factor. The HAS/GAED group demonstrated significantly worse DFS (P<0.001), GCSS (P=0.001), and OS (P=0.028) compared with the cGC group. No significant prognostic differences were observed between patients with HAS and those with GAED.

HAS and GAED are highly aggressive subtypes of GC, characterized by distinct clinicopathological features and an unfavorable prognosis.