No abstract

Gastric cancer is one of the most common gastrointestinal malignancies and is a lethal cancer. This study aimed to assess the factors affecting the survival and benefit of various therapeutic modalities in gastric adenocarcinoma (GAC) patients. Between March 2006 and October 2015, 121 GAC cases were identified by pathology and divided into groups I (surgery group; n = 41), II (IIa: 19 cases without treatment; IIb: 27 cases with palliative treatment), and III (combined surgery and postoperative chemotherapy; n = 34). Furthermore, the factors affecting early (12‐month) mortality and therapeutic outcomes between these groups were assessed over the study period. Patients who underwent treatment had longer survival than those who did not (groups I+IIb+III vs IIa, P < .001); group I provided the longest survival benefit among groups over the study period (Figure 2). Analyzing 12‐month mortality, significant differences were found in groups I vs IIa (P < .001), groups I vs IIb (P < .001), groups III vs IIa (P < .001), and groups III vs IIb (P < .001) in overall patients and in groups I vs IIa (P < .001), groups I vs IIb (P = .017), groups III vs IIa (P < .001), and groups III vs IIb (P < .001) in advanced‐stage patients (Table 2). Overall, the independent factors included advanced tumor stage (hazard ratio = 8.038, P = .007), absent treatment (hazard ratio = 14.009, P = .009), higher bilirubin (hazard ratio = 8.198, P = .047), and higher CEA (hazard ratio = 3.999, P = .030). Surgery provides better survival benefit, but palliative chemotherapy could also prolong unresectable GAC patients' survival. Factors of better liver preservation, lower carcinoembryonic antigen (CEA), and less aggressive tumor condition play crucial roles in predicting patients' survival.