Clinicopathological Characteristics and Prognosis of Gastric Cancer With Old Tuberculosis: A Propensity Score Matching Analysis

Abstract Background: It is known that Bacillus Calmette–Guérin (BCG), which serves as an adjuvant immunotherapy, has certain beneficial effects on the prognosis for gastric cancer. However, no existing reports have probed into the impact of old tuberculosis (TB) lesion on patients with gastric cancer. Methods: Using the database from a high-volume center, 2649 consecutive gastric cancer patients admitted to West China Hospital undergoing curative-intent gastrectomy were identified between 2009 and 2016. Patients were divided into TB group and non-tuberculosis (NTB) group based on the presence or absence of a coexistent old pulmonary TB lesion. Then, multinomial logistic regression models tested the risk factors for the postoperative pulmonary complications (PPCs). Kaplan-Meier analyses and Cox regression models tested the effect of old TB lesion on overall survival (OS) rate. The propensity score-matching (PSM) method was used to assemble a well-balanced cohort.Results: Altogether 81 of the enrolled patients had old pulmonary TB lesions. The presence of an old TB lesion was associated with superior overall survival (OS). Besides, the 3-year OS rates were 84.7% in TB group and 69.2% in NTB group, and the difference between two groups was statistically significant (p=0.005). Similarly, in the following analysis on 73 pairs of matched patients, significant differences were also noted between the two cohorts (p=0.001), with the 3-year OS rates of 90.4% and 69.2%, respectively. Further, multivariable Cox regression analysis showed that old TB was an independent positive factor for OS before and after propensity score-matching (PSM) (p=0.002/p<0.001, HR=0.471/0.220, respectively). Additionally, the old TB lesion appeared to be an independent risk factor for postoperative pulmonary complications (PPCs) (both p<0.001, HR=3.375 and HR=3.415 in univariate and multivariate logistic regression, respectively).Conclusions: Old TB lesion is a risk factor for PPCs. Despite that, it represented as an independent positive factor for the prognosis of gastric cancer in general. This study may shed light on further immune therapy for gastric cancer.