Trends and results in treatment of gastric cancer over last two decades at single East European centre: a cohort study

BMC Surgery

Zilvinas Dambrauskas²  Almantas Maleckas³  Zilvinas Endzinas³  Mindaugas Kiudelis³  Dainora Butkute¹  Audrius Parseliunas³  Rytis Markelis³  Povilas Ignatavicius²  Antanas Mickevicius³ 

[1] Department of Oncology, Lithuanian University of Health Sciences, Eivenių str. 2, Kaunas LT-50009, Lithuania;Laboratory of Surgical Gastroenterology, Institute for Digestive System Research, Lithuanian University of Health Sciences, Eivenių str. 2, Kaunas LT-50009, Lithuania;Department of Surgery, Lithuanian University of Health Sciences, Eiveniu Str. 2, Kaunas LT-50009, Lithuania

关键词: Mortality;    Survival;    Complications;    Gastric cancer;   

Others  :  1091079
DOI  :  10.1186/1471-2482-14-98

 received in 2014-05-28, accepted in 2014-11-17,  发布年份 2014

【 摘 要 】

Background

A steady decline in gastric cancer mortality rate over the last few decades is observed in Western Europe. However it is still not clear if this trend applies to Eastern Europe where high incidence rate of gastric cancer is observed.

Methods

This was a retrospective non-randomized, single center, cohort study. During the study period 557 consecutive patients diagnosed with gastric cancer in which curative operation was performed met the inclusion criteria. The study population was divided into two groups according to two equal time periods: 01-01-1994 – 31-12-2000 (Group I – 273 patients) and 01-01-2001 – 31-12-2007 (Group II – 284 patients). Primary (five-year survival rate) and secondary (postoperative complications, 30-day mortality rate and length of hospital stay) endpoints were evaluated and compared.

Results

Rate of postoperative complications was similar between the groups, except for Grade III (Clavien-Dindo grading system for the classification of surgical complications) complications that were observed at significantly lower rates in Group II (26 (9.5%) vs. 11 (3.9%), p = 0.02). Length of hospital stay was significantly (p = 0.001) shorter (22.6 ± 28.9 vs. 16.2 ± 17.01 days) and 30-day mortality was significantly (p = 0.02) lower (15 (5.5%) vs. 4 (1.4%)) in Group II. Similar rates of gastric cancer related mortality were observed in both groups (92.3% vs. 90.7%). However survival analysis revealed significantly (p = 0.02) better overall 5-year survival rate in Group II (35.6%, 101 of 284) than in Group I (23.4%, 64 of 273). There was no difference in 5-year survival rate when comparing different TNM stages.

Conclusions

Gastric cancer treatment results remain poor despite decreasing early postoperative mortality rates, shortening hospital stay and improved overall survival over the time. Prognosis of treatment of gastric cancer depends mainly on the stage of the disease. Absence of screening programs and lack of clinical symptoms in early stages of gastric cancer lead to circumstances when most of the patients presenting with advanced stage of the disease can expect a median survival of less than 30 months even after surgery with curative intent.

【 授权许可】

   
2014 Mickevicius et al.; licensee BioMed Central Ltd.

【 图 表 】

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