Long term follow up and retrospective study on 533 gastric cancer cases

Abstract

BackgroundGastric cancer (GC) is the third leading cause of cancer death in China and the outcome of GC patients is poor. The aim of the research is to study the prognostic factors of gastric cancer patients who had curative intent or palliative resection, completed clinical database and follow-up.MethodsThis retrospective study analyzed 533 GC patients from three tertiary referral teaching hospitals from January 2004 to December 2010 who had curative intent or palliative resection, complete clinical database and follow-up information. The GC-specific overall survival (OS) status was determined by the Kaplan-Meier method, and univariate analysis was conducted to identify possible factors for survival. Multivariate analysis using the Cox proportional hazard model and a forward regression procedure was conducted to define independent prognostic factors.ResultsBy the last follow-up, the median follow-up time of 533 GC patients was 38.6 mo (range 6.9-100.9 mo), and the median GC-specific OS was 25.3 mo (95% CI: 23.1-27.4 mo). The estimated 1-, 2-, 3- and 5-year GC-specific OS rates were 78.4%, 61.4%, 53.3% and 48.4%, respectively. Univariate analysis identified the following prognostic factors: hospital, age, gender, cancer site, surgery type, resection type, other organ resection, HIPEC, LN status, tumor invasion, distant metastases, TNM stage, postoperative SAE, systemic chemotherapy and IP chemotherapy. In multivariate analysis, seven factors were identified as independent prognostic factors for long term survival, including resection type, HIPEC, LN status, tumor invasion, distant metastases, postoperative SAE and systemic chemotherapy.ConclusionsResection type, HIPEC, postoperative SAE and systemic chemotherapy are four independent prognostic factors that could be intervened for GC patients for improving survival.

Survival outcomes after D1 and D2 lymphadenectomy with R0 resection in stage II–III gastric cancer: Longitudinal follow-up in a single center

“…In addition, post-hoc analysis of randomized trials in a recent meta-analysis of extended lymphadenectomy for gastric cancer suggested a possible survival benefit in Stage T3+ tumors, non-randomized comparisons revealed the benefit in Stage II and IIIA, and observational studies reported better survival outcomes of D2 surgery (14). In a recent retrospective study conducted on 533 gastric cancer patients, the median survival by Stages IIIB and IIIC were 28.0 and 14.8 mo., and D2-LND appeared as the major prognosticator of survival (15). These findings are consistent with our results in which patients with gastric cancer and the pathological Stage III and beyond, that had at least a loco-regional or a distant metastases, had benefited much from D2-LND with regard to OS, with a median OS of 20.0±5.0 months.…”

Long-term clinicopathological prognosis on 609 cases after gastrectomy: A 10-year follow up single-institutional retrospective analysis

“…Univariate analysis showed that sex was not an independent prognostic factor of GC, which was keeping with previous studies [20][21]. We indicated that prognosis was associated with tumor size, location, type of gastrectomy and BMI.…”

“…There was no statistical difference between them [18]. Otherwise, univariate and multivariate analysis both indicated that the degree of differentiation and radical treatment were two independent prognostic factors of GC, consistent with previous studies [19][20].…”

“…5. Whereas multivariate analysis showed that these outcomes were not independent prognostic factors in GC, inconsistent with some studies [7,20,21]. The type of gastrectomy mainly depends on tumor location and size in clinical practice.…”

Current perspectives on hyperthermic intraperitoneal chemotherapy in gastric cancer

“…In patients with both HIPEC and surgery, the rate of liver, lung, and bone metastases, as well as peritoneal metastases recurrence, was also lower. 9 A large meta-analysis by Zeng et al, 10 also showed that treatment with HIPEC was an independent prognostic factor that increased survival times in patients with gastric cancers. A study by Ji et al combined the published clinical trials on CRS-HIPEC.…”