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Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients

Year 2020, Volume: 47 Issue: 1, 34 - 42, 17.03.2020
https://doi.org/10.5798/dicletip.705908

Abstract

Objective: In stage III gastric cancer patients who underwent resection, prognostic factors related to patient, tumor and treatment and their survival effects were investigated.
Method: One-hundred sixty three patients were included in the study and data was obtained retrospectively from hospital records. Investigated parameters; patient-related factors (age,gender,bloodgroup,preoperativehemoglobin,albumin and serum tumor marker (carcinoembryonic antigen(CEA), cancer antigen 19-9(CA 19-9) levels), tumor related factors (tumor localization, tumor size , T and N stage, total lymph node count, metastatic/total lymph node ratio, surgical margin of tumor, pathology, differentiation, lymphovascular and perineural invasion status) and treatment-related factors (adjuvant treatment, nutritional support, and blood transfusion).
Results: Fifty-one out of the 163 patients were female, and the median age was 60. In univariate analysis, serum Ca19-9 level(p=0,03), serum CEA level(p=0.01) and the lymph node ratio(p=0.002) were found to be an independent factors associated with overall survival whereas only lymph node ratio was an effective parameter in multivariate analysis[(p = 0.004, relative risk =0.50, 95% confidence interval (0.32-0.80)]. When the study was finalized, patients were followed for a median of 16 months, 87 patients(53.4%) died due to the disease.
Conclusion: The metastatic tumor load in the lymph nodes around the stomach was negatively effective on survival. This result demonstrates the importance of lymphatic dissection.

References

  • 1. Karimi P, Islami F, Anandasabapathy S, Freedman Nd, Kamangar F. Gastric Cancer: Descriptive Epidemiology, Risk Factors, Screening, And Prevention. Cancer Epidemiol Biomarkers Prev. 2014; 23: 700-13.
  • 2. World Health Organization. International Agency For Research On Cancer. Globocan Turkey. 2012.
  • 3. World Health Organization. Cancer. Accessed 11 Aug 2013. Available From: Url: Http://Www.Who.Int/Mediacentre/Factsheets/Fs297/En/
  • 4. Ajani Ja, In H, Sano T, et al. Stomach. In: AJCC Cancer Staging Manual, 8th, Amin Mb. (Ed), AJCC, Chicago. 2017;pp. 203.
  • 5. Amini N, Spolverato G, Kim Y, etal.Clinicopathological Features And Prognosis Of Gastric Cardia Adenocarcinoma: A Multi-Institutional U.S. Study. J Surg Oncol.2015;111: 285-92.
  • 6. Song P, Wu L, Jiang B, et al. Age-Specific Effects On The Prognosis After Surgery For Gastric Cancer: A Seer Population-Based Analysis. Oncotarget. 2016; 7: 48614-24.
  • 7. Wesołowska M, Pawlik P, Jagodziński Pp. The Clinicopathologic Significance Of Estrogen Receptors In Human Gastric Carcinoma. Biomed Pharmacother.2016; 83: 314-22.
  • 8. Etemadi A, Kamangar F, Islami F, et al. Mortality And Cancer In Relation To Abo Blood Group Phenotypes In The Golestan Cohort Study. BMC Med. 2015;13:8.
  • 9. Kim Sg, Seo Hs, Lee Hh, Song Ky, Park Ch. Comparison Of The Differences In Survival Rates Between The 7th And 8th Editions Of The AJCC TNM Staging System For Gastric Adenocarcinoma: A single-institution study of 5,507 patients in Korea. J Gastric Cancer. 2017;17: 212-9. 10. Jun Kh, Jung H, BaekJm, Chin Hm, Park Wb. Does Tumor Size Have An Impact On Gastric Cancer? A Single Institute Experience. Langenbecks Arch Surg. 2009; 394: 631-5.
  • 11. Adachi Y, Oshiro T, Mori M, et al. Tumor Size As A Simple Prognostic Indicator For Gastric Carcinoma. Ann SurgOncol. 1997; 4: 137-40.
  • 12. Saito H, Osaki T, Murakami D, et al. Macroscopic Tumor Size As A Simple Prognostic Indicator In Patients With Gastric Cancer. Am J Surg. 2006;192: 296-300.
  • 13. Zhou Y, Cui Jg, Huang F, et al. Prognostic Factors For Survival In Node-Negative Gastric Cancer Patients Who Underwent Curative Resection.Scand J Surg. 2017;106: 235-40.
  • 14. Wang Z, Zhang X, Hu J, Zeng W, Zhou Z. Clinicopathological Features And Outcomes In Patients Undergoing Radical Resection For Early Gastric Cancer With Signet Ring Cell Histology. J Visc Surg. 2015; 152:357-61.
  • 15. Ji X, Bu Zd, Li Zy, et al. Prognostic Significance Of The Total Number Of Harvested Lymph Nodes For Lymph Node-Negative Gastric Cancer Patients. BMC Cancer. 2017; 17:558.
  • 16. Espín F, Bianchi A, Llorca S, et al. Metastatic Lymph Node Ratio Versus Number Of Metastatic Lymph Nodes As A Prognostic Factor In Gastric Cancer. Eur J SurgOncol. 2012; 38:497-502.
  • 17. Cheong O, Kim Bs, YookJh, et al. Modified radical lymphadenectomy without splenectomy in patients with proximal gastric cancer: Comparison with standard D2 lymphadenectomy for distal gastric cancer. Journal of Surgical Oncol. 2008; 98: 500-4.
  • 18. Chen Y, Li C, Du Y, et al. Prognostic And Predictive Value Of Metastatic Lymph Node Ratio In Stage Iii Gastric Cancer After D2 Nodal Dissection. Oncotarget.2017;8: 70841-6.
  • 19. Ersan Y, Ertürk S, Çiçek Y, et al. Early And Late Results Of Curative Resection In Cases Of Gastric Carcinoma. Cerrahpaşa J Med 2003; 34: 178-84.
  • 20. Bilici A, Seker M, Ustaalioglu Bb, et al. Prognostic Significance Of Perineural Invasion In Patients With Gastric Cancer Who Underwent Curative Resection. Ann SurgOncol. 2010;17: 2037-44.
  • 21. Ohe H, Lee Wy, Hong Sw, Chang Yg, Lee B. Prognostic Value Of The Distance Of Proximal Resection Margin In Patients Who Have Undergone Curative Gastric Cancer Surgery. World J SurgOncol. 2014;12: 296.
  • 22. Smalley Sr, Benedetti Jk, Haller Dg, et al. Updated Analysis Of Swog-Directed Intergroup Study 0116: A Phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J ClinOncol. 30: 2327; 2012
  • 23. Ronellenfitsch U, Schwarzbach M, Hofheinz R, et al. Adenocarcinoma meta‐analysis group. Perioperative chemo(radio)therapy versus primary surgery for resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus. Cochrane Database Syst Rev. 2013; Cd008107.
  • 24. Lee J, Lim Do H, Kim S, 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.
  • 25. Kim Th, Park Sr, RyuKw, et al. Phase III trial of postoperative chemotherapy alone versus chemoradiation therapy in Stage III-IV gastric cancer treated with R0 gastrectomy and D2 lymph node dissection. Int J RadiatOncolBiol Phys2012;84: E585-92.
Year 2020, Volume: 47 Issue: 1, 34 - 42, 17.03.2020
https://doi.org/10.5798/dicletip.705908

Abstract

References

  • 1. Karimi P, Islami F, Anandasabapathy S, Freedman Nd, Kamangar F. Gastric Cancer: Descriptive Epidemiology, Risk Factors, Screening, And Prevention. Cancer Epidemiol Biomarkers Prev. 2014; 23: 700-13.
  • 2. World Health Organization. International Agency For Research On Cancer. Globocan Turkey. 2012.
  • 3. World Health Organization. Cancer. Accessed 11 Aug 2013. Available From: Url: Http://Www.Who.Int/Mediacentre/Factsheets/Fs297/En/
  • 4. Ajani Ja, In H, Sano T, et al. Stomach. In: AJCC Cancer Staging Manual, 8th, Amin Mb. (Ed), AJCC, Chicago. 2017;pp. 203.
  • 5. Amini N, Spolverato G, Kim Y, etal.Clinicopathological Features And Prognosis Of Gastric Cardia Adenocarcinoma: A Multi-Institutional U.S. Study. J Surg Oncol.2015;111: 285-92.
  • 6. Song P, Wu L, Jiang B, et al. Age-Specific Effects On The Prognosis After Surgery For Gastric Cancer: A Seer Population-Based Analysis. Oncotarget. 2016; 7: 48614-24.
  • 7. Wesołowska M, Pawlik P, Jagodziński Pp. The Clinicopathologic Significance Of Estrogen Receptors In Human Gastric Carcinoma. Biomed Pharmacother.2016; 83: 314-22.
  • 8. Etemadi A, Kamangar F, Islami F, et al. Mortality And Cancer In Relation To Abo Blood Group Phenotypes In The Golestan Cohort Study. BMC Med. 2015;13:8.
  • 9. Kim Sg, Seo Hs, Lee Hh, Song Ky, Park Ch. Comparison Of The Differences In Survival Rates Between The 7th And 8th Editions Of The AJCC TNM Staging System For Gastric Adenocarcinoma: A single-institution study of 5,507 patients in Korea. J Gastric Cancer. 2017;17: 212-9. 10. Jun Kh, Jung H, BaekJm, Chin Hm, Park Wb. Does Tumor Size Have An Impact On Gastric Cancer? A Single Institute Experience. Langenbecks Arch Surg. 2009; 394: 631-5.
  • 11. Adachi Y, Oshiro T, Mori M, et al. Tumor Size As A Simple Prognostic Indicator For Gastric Carcinoma. Ann SurgOncol. 1997; 4: 137-40.
  • 12. Saito H, Osaki T, Murakami D, et al. Macroscopic Tumor Size As A Simple Prognostic Indicator In Patients With Gastric Cancer. Am J Surg. 2006;192: 296-300.
  • 13. Zhou Y, Cui Jg, Huang F, et al. Prognostic Factors For Survival In Node-Negative Gastric Cancer Patients Who Underwent Curative Resection.Scand J Surg. 2017;106: 235-40.
  • 14. Wang Z, Zhang X, Hu J, Zeng W, Zhou Z. Clinicopathological Features And Outcomes In Patients Undergoing Radical Resection For Early Gastric Cancer With Signet Ring Cell Histology. J Visc Surg. 2015; 152:357-61.
  • 15. Ji X, Bu Zd, Li Zy, et al. Prognostic Significance Of The Total Number Of Harvested Lymph Nodes For Lymph Node-Negative Gastric Cancer Patients. BMC Cancer. 2017; 17:558.
  • 16. Espín F, Bianchi A, Llorca S, et al. Metastatic Lymph Node Ratio Versus Number Of Metastatic Lymph Nodes As A Prognostic Factor In Gastric Cancer. Eur J SurgOncol. 2012; 38:497-502.
  • 17. Cheong O, Kim Bs, YookJh, et al. Modified radical lymphadenectomy without splenectomy in patients with proximal gastric cancer: Comparison with standard D2 lymphadenectomy for distal gastric cancer. Journal of Surgical Oncol. 2008; 98: 500-4.
  • 18. Chen Y, Li C, Du Y, et al. Prognostic And Predictive Value Of Metastatic Lymph Node Ratio In Stage Iii Gastric Cancer After D2 Nodal Dissection. Oncotarget.2017;8: 70841-6.
  • 19. Ersan Y, Ertürk S, Çiçek Y, et al. Early And Late Results Of Curative Resection In Cases Of Gastric Carcinoma. Cerrahpaşa J Med 2003; 34: 178-84.
  • 20. Bilici A, Seker M, Ustaalioglu Bb, et al. Prognostic Significance Of Perineural Invasion In Patients With Gastric Cancer Who Underwent Curative Resection. Ann SurgOncol. 2010;17: 2037-44.
  • 21. Ohe H, Lee Wy, Hong Sw, Chang Yg, Lee B. Prognostic Value Of The Distance Of Proximal Resection Margin In Patients Who Have Undergone Curative Gastric Cancer Surgery. World J SurgOncol. 2014;12: 296.
  • 22. Smalley Sr, Benedetti Jk, Haller Dg, et al. Updated Analysis Of Swog-Directed Intergroup Study 0116: A Phase III trial of adjuvant radiochemotherapy versus observation after curative gastric cancer resection. J ClinOncol. 30: 2327; 2012
  • 23. Ronellenfitsch U, Schwarzbach M, Hofheinz R, et al. Adenocarcinoma meta‐analysis group. Perioperative chemo(radio)therapy versus primary surgery for resectable adenocarcinoma of the stomach, gastroesophageal junction, and lower esophagus. Cochrane Database Syst Rev. 2013; Cd008107.
  • 24. Lee J, Lim Do H, Kim S, 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.
  • 25. Kim Th, Park Sr, RyuKw, et al. Phase III trial of postoperative chemotherapy alone versus chemoradiation therapy in Stage III-IV gastric cancer treated with R0 gastrectomy and D2 lymph node dissection. Int J RadiatOncolBiol Phys2012;84: E585-92.
There are 24 citations in total.

Details

Primary Language English
Subjects Health Care Administration
Journal Section Original Articles
Authors

Yavuz Pirhan This is me

Publication Date March 17, 2020
Submission Date October 10, 2019
Published in Issue Year 2020 Volume: 47 Issue: 1

Cite

APA Pirhan, Y. (2020). Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients. Dicle Tıp Dergisi, 47(1), 34-42. https://doi.org/10.5798/dicletip.705908
AMA Pirhan Y. Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients. diclemedj. March 2020;47(1):34-42. doi:10.5798/dicletip.705908
Chicago Pirhan, Yavuz. “Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients”. Dicle Tıp Dergisi 47, no. 1 (March 2020): 34-42. https://doi.org/10.5798/dicletip.705908.
EndNote Pirhan Y (March 1, 2020) Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients. Dicle Tıp Dergisi 47 1 34–42.
IEEE Y. Pirhan, “Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients”, diclemedj, vol. 47, no. 1, pp. 34–42, 2020, doi: 10.5798/dicletip.705908.
ISNAD Pirhan, Yavuz. “Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients”. Dicle Tıp Dergisi 47/1 (March 2020), 34-42. https://doi.org/10.5798/dicletip.705908.
JAMA Pirhan Y. Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients. diclemedj. 2020;47:34–42.
MLA Pirhan, Yavuz. “Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients”. Dicle Tıp Dergisi, vol. 47, no. 1, 2020, pp. 34-42, doi:10.5798/dicletip.705908.
Vancouver Pirhan Y. Analysis of Prognostic Factors Affecting Postoperative Survival in Stage III Gastric Cancer Patients. diclemedj. 2020;47(1):34-42.