Yıl: 2020 Cilt: 7 Sayı: 2 Sayfa Aralığı: 146 - 152 Metin Dili: İngilizce DOI: 10.14744/nci.2019.73549 İndeks Tarihi: 18-09-2020

Prognostic factors for survival in patients with gastric cancer: Single-centre experience

Öz:
OBJECTIVE: We aimed to investigate survival outcomes and survival-related prognostic factors in gastric cancer patientswho were followed-up or received adjuvant therapy in our center.METHODS: Patients with gastric cancer treated between 2005 and 2016 were evaluated retrospectively. We included 345non-metastatic (stage I-III) gastric cancer patients in the study. The clinical, demographic, histologic data of the patients andtreatment characteristics were obtained from the patient’s files.RESULTS: While 50 patients were stage I, 94 patients were stage II, 201 patients were stage III. While 221 patients (64%)presenting with serosal or adjacent visceral organ invasion or with involved lymph nodes were treated with adjuvant chemoradiotherapy, 124 patients presenting with early-stage disease were followed after surgery. Median follow up time was 34months (4–156 months). While the median overall survival (OS) was 51 months, median disease-free survival (DFS) was 35months. Overall survival and disease-free survival rates for 1st, 3rd and 5th years were 85%, 55%, 45% and 72%, 49%, 38%,respectively. According to univariate analysis, tumor size, T stage (p<0.001), N stage (p<0.001), TNM stage (p<0.001), grade(p<0.001) and presence of lymphovascular invasion (p=0.005) were determined as prognostic factors that affect overallsurvival significantly. According to the multivariate analysis, only T and N stage (p<0.001) were determined as independentprognostic factors for overall survival.CONCLUSION: Many different prognostic factors have been defined for gastric cancer. In concordance with the literature,we found T and N stages as prognostic factors in univariate and multivariate analysis.
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  • 1. Bray F, Ferlay J, Soerjomataram I, Siegel RL, Torre LA, Jemal A. Global cancer statistics 2018: GLOBOCAN estimates of incidence and mortality worldwide for 36 cancers in 185 countries. CA Cancer J Clin 2018;68:394–424.
  • 2. TC Sağlık Bakanlığı Halk Sağlığı Kurumu. Türkiye Kanser İstatistikleri Raporu 2017. Available at: https://hsgm.saglik.gov.tr/depo/birimler/kanser-db/istatistik/2014-RAPOR._uzuuun.pdf. Accessed Mar 19, 2020.
  • 3. Qiu MZ, Cai MY, Zhang DS, Wang ZQ, Wang DS, Li YH, et al. Clinicopathological characteristics and prognostic analysis of Lauren classification in gastric adenocarcinoma in China. J Transl Med 2013;11:58.
  • 4. Chou HH, Kuo CJ, Hsu JT, Chen TH, Lin CJ, Tseng JH, et al. Clinicopathologic study of node-negative advanced gastric cancer and analysis of factors predicting its recurrence and prognosis. Am J Surg 2013;205:623–30.
  • 5. Lagergren J, Bergström R, Lindgren A, Nyrén O. The role of tobacco, snuff and alcohol use in the aetiology of cancer of the oesophagus and gastric cardia. Int J Cancer 2000;85:340–6.
  • 6. Carr JS, Zafar SF, Saba N, Khuri FR, El-Rayes BF. Risk factors for rising incidence of esophageal and gastric cardia adenocarcinoma. J Gastrointest Cancer 2013;44:143–51.
  • 7. Zhang J, Zhou Y, Jiang K, Shen Z, Ye Y, Wang S. Evaluation of the seventh AJCC TNM staging system for gastric cancer: a meta-analysis of cohort studies. Tumour Biol 2014;35:8525–32.
  • 8. Hermanek P, Wittekind C. News of TNM and its use for classification of gastric cancer. World J Surg 1995;19:491–5.
  • 9. Bu Z, Zheng Z, Li Z, Zhang L, Wu A, Wu X, et al. Lymphatic vascular invasion is an independent correlated factor for lymph node metastasis and the prognosis of resectable T2 gastric cancer patients. Tumour Biol 2013;34:1005–12.
  • 10. Cuschieri A, Weeden S, Fielding J, Bancewicz J, Craven J, Joypaul V, et al. Patient survival after D1 and D2 resections for gastric cancer: longterm results of the MRC randomized surgical trial. Surgical Co-operative Group. Br J Cancer 1999;79:1522–30.
  • 11. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, et al; MAGIC Trial Participants. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 2006;355:11–20.
  • 12. Macdonald JS, Smalley SR, Benedetti J, Hundahl SA, Estes NC, Stemmermann GN, et al. Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction. N Engl J Med 2001;345:725–30.
  • 13. Zhang ZX, Gu XZ, Yin WB, Huang GJ, Zhang DW, Zhang RG. Randomized clinical trial on the combination of preoperative irradiation and surgery in the treatment of adenocarcinoma of gastric cardia (AGC)-- report on 370 patients. Int J Radiat Oncol Biol Phys 1998;42:929–34.
  • 14. Neri B, Cini G, Andreoli F, Boffi B, Francesconi D, Mazzanti R, et al Randomized trial of adjuvant chemotherapy versus control after curative resection for gastric cancer: 5-year follow-up. Br J Cancer 2001;84:878–80.
  • 15. Ychou M, Boige V, Pignon JP, Conroy T, Bouché O, Lebreton G, et al. Perioperative chemotherapy compared with surgery alone for resectable gastroesophageal adenocarcinoma: an FNCLCC and FFCD multicenter phase III trial. J Clin Oncol 2011;29:1715–21.
  • 16. Avital I, Pisters PW, Kelsen DP, Willet CG. Cancer of the stomach. In: Devita VT, Lawrence T, Rosenberg SA, editros. Cancer: Principles and Practise of Oncology. 9th ed. Philadelphia: Lippincott Williams &Wilkins; 2011. p. 924–54.
  • 17. Ferlay F, Bray F, Pisani P, Parkin DM. Globocan 2002 cancer incidence, mortality and prevalence worldwide. IARC Cancer. Base No 5. Lyon: IARC Press; 2004.
  • 18. Fidaner C, Eser SY, Parkin DM. Incidence in Izmir in 1993-1994: first results from Izmir Cancer Registry. Eur J Cancer 2001;37:83–92.
  • 19. Yalcin S. Gastric cancer in Turkey-a bridge between west and East. Gastrointest Cancer Res 2009;3:29–32.
  • 20. Catalano V, Labianca R, Beretta GD, Gatta G, de Braud F, Van Cutsem E. Gastric cancer. Crit Rev Oncol Hematol 2009;71:127–64.
  • 21. Demir G, Büyükünal E, Kızılkılıc E, Özgüroglu M, Mandel N, Demirelli F, et al. Gastric cancer in Turkey: a single center experience of 683 cases. J Clin Oncol 2004;22.
  • 22. Li P, He HQ, Zhu CM, Ling YH, Hu WM, Zhang XK, et al. The prognostic significance of lymphovascular invasion in patients with resectable gastric cancer: a large retrospective study from Southern China. BMC Cancer. 2015;15:370.
  • 23. del Casar JM, Corte MD, Alvarez A, García I, Bongera M, González LO, et al. Lymphatic and/or blood vessel invasion in gastric cancer: relationship with clinicopathological parameters, biological factors and prognostic significance. J Cancer Res Clin Oncol 2008;134:153–61.
  • 24. Kim JH, Park SS, Park SH, Kim SJ, Mok YJ, Kim CS, et al. Clinical significance of immunohistochemically-identified lymphatic and/or blood vessel tumor invasion in gastric cancer. J Surg Res 2010;162:177–83.
  • 25. Gunderson LL. Gastric cancer-patterns of relapse after surgical resection. Semin Radiat Oncol 2002;12:150–61.
  • 26. Kim S, Lim DH, Lee J, Kang WK, MacDonald JS, Park CH, et al. An observational study suggesting clinical benefit for adjuvant postoperative chemoradiation in a population of over 500 cases after gastric resection with D2 nodal dissection for adenocarcinoma of the stomach. Int J Radiat Oncol Biol Phys 2005;63:1279–85.
  • 27. Kucukoner M, Isikdogan A, Arpaci E, Bilici M, Uncu D, Cetin B, et al. Adjuvant chemoradiation for gastric cancer: multicentric study of the Anatolian Society of Medical Oncology. Hepatogastroenterology 2012;59:2343–7.
  • 28. Okajima K. Prognostic factors of gastric cancer patients—a study by univariate and multivariate analysis [in Japanese, with English abstract]. Jpn J Gastroenterol Surg 1997;30:700–11.
  • 29. Hochwald SN, Kim S, Klimstra DS, Brennan MF, Karpeh MS. Analysis of 154 actual five-year survivors of gastric cancer. J Gastrointest Surg 2000;4:520–5.
  • 30. Gunji Y, Suzuki T, Hori S, Hayashi H, Matsubara H, Shimada H, et al. Prognostic significance of the number of metastatic lymph nodes in early gastric cancer. Dig Surg 2003;20:148–53.
  • 31. Marchet A, Mocellin S, Ambrosi A, de Manzoni G, Di Leo A, Marrelli D, et al; Italian Research Group for Gastric Cancer Study (GIRCG). The prognostic value of N-ratio in patients with gastric cancer: validation in a large, multicenter series. Eur J Surg Oncol 2008;34:159–65.
  • 32. Dockerty MB. Pathology aspects of primary malignant neoplasms of stomach. In: ReMine WH, Priestly JT, Berkson J, editors. Cancer os the Stomach. Phladelphia: WB Saunders; 1964. p. 173.
  • 33. Lee J, Lim DH, Kim S, Park SH, Park JO, Park YS, et al. Phase III trial comparing capecitabine plus cisplatin versus capecitabine plus cisplatin with concurrent capecitabine radiotherapy in completely resected gastric cancer with D2 lymph node dissection: the ARTIST trial. J Clin Oncol 2012;30:268–73.
  • 34. Kang WK. Phase III Randomized Trial of Adjuvant Chemotherapy With S-1 vs S-1/Oxaliplatin ± Radiotherapy for Completely Resected Gastric Adenocarcinoma: The ARTIST II Trial (ARTIST-II) Available at: https://clinicaltrials.gov/ct2/show/NCT01761461. Accessed Mar 17, 2020.
APA yaprak g, Tataroglu Ozyukseler D, DOĞAN B, pekyürek varan m (2020). Prognostic factors for survival in patients with gastric cancer: Single-centre experience. , 146 - 152. 10.14744/nci.2019.73549
Chicago yaprak gokhan,Tataroglu Ozyukseler Deniz,DOĞAN BEDRİYE,pekyürek varan melike Prognostic factors for survival in patients with gastric cancer: Single-centre experience. (2020): 146 - 152. 10.14744/nci.2019.73549
MLA yaprak gokhan,Tataroglu Ozyukseler Deniz,DOĞAN BEDRİYE,pekyürek varan melike Prognostic factors for survival in patients with gastric cancer: Single-centre experience. , 2020, ss.146 - 152. 10.14744/nci.2019.73549
AMA yaprak g,Tataroglu Ozyukseler D,DOĞAN B,pekyürek varan m Prognostic factors for survival in patients with gastric cancer: Single-centre experience. . 2020; 146 - 152. 10.14744/nci.2019.73549
Vancouver yaprak g,Tataroglu Ozyukseler D,DOĞAN B,pekyürek varan m Prognostic factors for survival in patients with gastric cancer: Single-centre experience. . 2020; 146 - 152. 10.14744/nci.2019.73549
IEEE yaprak g,Tataroglu Ozyukseler D,DOĞAN B,pekyürek varan m "Prognostic factors for survival in patients with gastric cancer: Single-centre experience." , ss.146 - 152, 2020. 10.14744/nci.2019.73549
ISNAD yaprak, gokhan vd. "Prognostic factors for survival in patients with gastric cancer: Single-centre experience". (2020), 146-152. https://doi.org/10.14744/nci.2019.73549
APA yaprak g, Tataroglu Ozyukseler D, DOĞAN B, pekyürek varan m (2020). Prognostic factors for survival in patients with gastric cancer: Single-centre experience. İstanbul Kuzey Klinikleri, 7(2), 146 - 152. 10.14744/nci.2019.73549
Chicago yaprak gokhan,Tataroglu Ozyukseler Deniz,DOĞAN BEDRİYE,pekyürek varan melike Prognostic factors for survival in patients with gastric cancer: Single-centre experience. İstanbul Kuzey Klinikleri 7, no.2 (2020): 146 - 152. 10.14744/nci.2019.73549
MLA yaprak gokhan,Tataroglu Ozyukseler Deniz,DOĞAN BEDRİYE,pekyürek varan melike Prognostic factors for survival in patients with gastric cancer: Single-centre experience. İstanbul Kuzey Klinikleri, vol.7, no.2, 2020, ss.146 - 152. 10.14744/nci.2019.73549
AMA yaprak g,Tataroglu Ozyukseler D,DOĞAN B,pekyürek varan m Prognostic factors for survival in patients with gastric cancer: Single-centre experience. İstanbul Kuzey Klinikleri. 2020; 7(2): 146 - 152. 10.14744/nci.2019.73549
Vancouver yaprak g,Tataroglu Ozyukseler D,DOĞAN B,pekyürek varan m Prognostic factors for survival in patients with gastric cancer: Single-centre experience. İstanbul Kuzey Klinikleri. 2020; 7(2): 146 - 152. 10.14744/nci.2019.73549
IEEE yaprak g,Tataroglu Ozyukseler D,DOĞAN B,pekyürek varan m "Prognostic factors for survival in patients with gastric cancer: Single-centre experience." İstanbul Kuzey Klinikleri, 7, ss.146 - 152, 2020. 10.14744/nci.2019.73549
ISNAD yaprak, gokhan vd. "Prognostic factors for survival in patients with gastric cancer: Single-centre experience". İstanbul Kuzey Klinikleri 7/2 (2020), 146-152. https://doi.org/10.14744/nci.2019.73549