Mürşit DİNÇER, Koray KARABULUT, Fadlı DOĞAN

Determinants of survival in gastric cancer: A single center experience

Aim: Gastric cancer is the second leading cause of cancer deaths worldwide. The effect of lymph node dissection and the extent of gastric resection on survival remains controversial, while improved survival has been reported with combined chemotherapy and radiotherapy. In this study, we aimed to present a single center experience.Material and Methods: Patients undergoing gastric resection due to gastric cancer were retrospectively assessed in order to examine the determinants of survival in gastric adenocarcinoma. Gastric malignancies other than adenocarcinoma were excluded from the study. Result of preoperative diagnostic work up, operative data, histopathology of the surgical specimen, and postoperative follow up parameters were evaluated and recorded.Results: Among a total of 139 patients operated due to gastric malignancy between January 2008 and January 2014 in our unit, 124 were diagnosed with an adenocarcinoma. The median duration of follow up was 6 months, during which 53 patients (42.7%) were found to have disease recurrence (10 local, and 43 systemic). A higher T stage was associated with shorter survival (p

PDF

___

1. Jemal A, Bray F, Center MM, et al. Global cancer statistics. CA Cancer J Clin 2011;61: 69-90.
2. Santoro R, Carboni F, Lepiane P, et al. Clinicopathological features and prognosis of gastric cancer in young European adults. Br J Surg 2007;94:737-42.
3. Sano T, Katai H, Sasako M, The management of early gastric cancer. Surg Oncol 2000;1:17-22.
4. Sano T, Katai H, Sasako M, et al. One thousand consecutive gastrectomies without operative mortality. Br J Surg 2002;89:122-123.
5. Ajani JA, Baker J, Pisters PW, et al. Irinotecan plus cisplatin in advanced gastric or gastroesophageal junction carcinoma. Oncology 2001;15:52-4.
6. Gunderson LL. Gastric cancer--patterns of relapse after surgical resection. Semin Radiat Oncol 2002;12:150-61.
7. Songun I, Putter H, Kranenbarg EM, et al. Surgical treatment of gastric cancer: 15-year follow-up results of the randomised nationwide Dutch D1D2 trial. Lancet Oncol 2010;11:439-49.
8. Zhang M, Li Z, Zhao B, et al. Predictors of long-term survival in large gastric carcinoma patients. Hepatogastroenterology 2011;58:2162-5.
9. Saka M, Katai H, Fukagawa T, et al. Recurrence in early gastric cancer with lymph node metastasis. Gastric Cancer 2008;11:214-8.
10. Roviello F, Rossi S, Marrelli D, et al. Number of lymph node metastases and its prognostic significance in early gastric cancer: a multicenter Italian study. J Surg Oncol 2006;94:275-80.
11. Greene FL, Page AL, Fleming ID, et al. American Joint Committee on Cancer: AJCC Cancer Staging Manual. 6th ed. New York: Springer, 2002:99-106.
12. Kim JP. Surgical results in gastric cancer. Semin Surg Oncol 1999;17:132-8.
13. Ding YB, Chen GY, Xia JG, et al. Correlation of tumor-positive ratio and number of perigastric lymph nodes with prognosis of gastric carcinoma in surgically treated patients.Word J Gastroenterol 2004;10:182-5.
14. Marrelli D, Roviello F, de Manzoni G, et al. Different patterns of recurrence in gastric cancer depending on Lauren’s histological type: longitudinal study. World J Surg 2002;26:1160-5. 15. Talamanti MS, Kim SP, Yao KA; et al. Surgical outcomes of patients with gastric carcinoma:the importance of primary tumor location and microvessel invasion. Surgery 2003;134:720-7.
16. Mohri Y, Tanaka K, Ohi M, et al. Prognostic significance of host- and tumor-related factors in patients with gastric cancer. World J Surg 2010;34:285-90.
17. Li C, Oh SJ, Kim S, et al. Risk factors of survival and surgical treatment for advanced gastric cancer with large tumor size. J Gastrointest Surg 2009;13:881-5.
18. Yokota T, Ishiyama S, Saito T, et al. Is tumor size a prognostic indicator for gastric carcinoma? Anticancer Res 2002;22:3673-7.
19. Adachi Y, Oshiro T, Mori M, et al. Tumor size as a simple prognostic indicator for gastric carcinoma. Ann Surg Oncol 1997;4:137-40.
20. Bilici A, Uygun K, Seker M, et al. The effect of tumor size on overall survival in patients with pT3 gastric cancer: experiences from 3 centers. Onkologie 2010;33:676-82.
21. Smith BR, Stabile BE. Extreme aggressiveness and lethality of gastric adenocarcinoma in the very young. Arch Surg 2009;144:506-10.
22. Cho SI, Jang YJ, Kim JH, et al. Aging over 70 Years Is Not a Decisively Dismal Prognostic Factor in Gastric Cancer Surgery. J Gastric Cancer 2011;11:200-5.
23. Nakamura R, Saikawa Y, Takahashi T, et al. Retrospective analysis of prognostic outcome of gastric cancer in young patients. Int J Clin Oncol 2011;16:328-34.
24. Kong X, Wang JL, Chen HM, et al. Comparison of the clinicopathological characteristics of young and elderly patients with gastric carcinoma: a meta analysis. J Surg Oncol 2012;106:346-52.
25. Baba H, Maehara Y, Takeuchi H, et al. Effect of lymph node dissection on the prognosis in patients with node-negative early gastric cancer. Surgery 1995;117:165-9.
26. Saito H, Takaya S, Fukumoto Y, et al. Clinocopathologic characteristics and prognosis of gastric cancer in young patients. Acta Med 2012;55:57-61.
27. Liang YX, Deng JY, Guo HH, et al.. Characteristics and prognosis of gastric cancer in patients aged ≥ 70 years. World J Gastroenterol 2013;19:6568-78.
28. Graziosi L, Marino E, Cavazzoni E, et al. Prognostic value of the seventh AJCC/UICC TNM classification of non-cardia gastric cancer. World J Surg Oncol 2013;11:103. 601