Prognostic factors in patients with loco-regionally advanced gastric cancer

World Journal of Surgical Oncology

Research

Peter Nygren¹  Bengt Glimelius¹  Magnus Sundbom²  Bo Hultman²  Haile Mahteme²  Ulf Gunnarsson³ 

[1] Department of Immunology, Genetics and Pathology, Uppsala University, SE-751 85, Uppsala, Sweden;Department of Surgical Sciences, Uppsala University, SE-751 85, Uppsala, Sweden;Department of Surgical and Perioperative Sciences, Umeå University, SE 901 85, Umeå, Sweden;

关键词: Surgery;    Gastric cancer;    Peritoneal;    Metastases;    Prognostic factor;    Loco-regionally advanced cancer;   

DOI  :  10.1186/s12957-017-1243-z

 received in 2017-02-13, accepted in 2017-09-03,  发布年份 2017

来源: Springer

【 摘 要 】

BackgroundThe aim of this study was to investigate epidemiologic and prognostic factors relevant to the treatment of loco-regionally advanced gastric cancer (GC).MethodsTwo hundred and fifty-five patients with GC were identified in Uppsala County between 2000 and 2009. Patient records were analyzed for loco-regionally advanced GC defined as tumor with peritoneal involvement, excluding serosal invasion from the primary tumor only, at primary diagnosis or during follow-up. The presence or not of distant metastasis (DM), including hematogenous metastases (e.g., liver, lung, and bone) and/or distant lymph node metastases, was also analyzed. The Cox proportional hazard model was used for multivariate analysis of factors influencing survival.ResultsOne hundred and twenty patients (47% of all patients with GC; median age 70.5 years) had loco-regionally advanced disease, corresponding to an incidence of 3.8 per 100,000 person-years. Forty-one percent of these also had DM. Median overall survival (mOS) from the time of the diagnosis of loco-regionally advanced disease was 4.8 months for the total patient cohort, 5.1 months for the subgroup of patients without DM, and 4.7 months for the subgroup with DM. There was no significant difference in mOS between the subgroups with synchronous versus metachronous loco-regionally advanced GC: 4.8 months (range 0.0–67.4) versus 4.7 months (range 0.0–28.3). Using multivariate Cox analysis, positive prognostic factors for survival were good performance status at diagnosis and treatment with palliative chemotherapy and/or radiotherapy. Synchronous DM was a negative prognostic factor. The mOS did not differ when comparing the time period 2000–2004 (5.1 months, range 0–67.4) with the period 2005–2009 (4.0 months, range 0.0–28.3).ConclusionPeritoneal involvement occurred in almost half of the patients with GC in this study and was associated with short life expectancy. New treatment strategies are warranted.

【 授权许可】

CC BY   
© The Author(s). 2017