TPW 6.17 Clinicopathological Characteristics and Survival Outcomes of Gastric Hepatoid Adenocarcinoma: A Multicenter Retrospective Study

Abstract

To investigate the clinicopathological characteristics, immunohistochemical features, treatment patterns, and survival outcomes of patients with gastric hepatoid adenocarcinoma (HAS). Clinicopathological data of 37 patients diagnosed with HAS between July 2008 and February 2023 were retrospectively collected from seven medical centers. Demographic characteristics, clinical presentations, pathological and immunohistochemical findings, treatment strategies, and prognostic outcomes were analyzed. Among the 37 patients, 30 were male and 7 were female, with a mean age of 61.95 years. Abdominal pain was the most common initial symptom. Elevated serum alpha-fetoprotein levels were observed in 21 patients. Thirty patients underwent surgical treatment, including 27 radical and 3 palliative procedures. Tumor stages I, II, III, and IV accounted for 1, 6, 18, and 12 cases, respectively. Immunohistochemical positivity rates were 51.35% for GPC-3, 32.43% for HepPar-1, 16.22% for SALL4, and 13.51% for CDX-2. Five patients who received six or more cycles of postoperative adjuvant chemotherapy achieved favourable survival outcomes, with the longest survival reaching 54 months. HAS is a rare and aggressive subtype of gastric cancer, predominantly affecting elderly men and often presenting at an advanced stage. Radical surgery remains the cornerstone of treatment, and postoperative adjuvant chemotherapy with more than six cycles may contribute to improved long-term survival.