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Open Access Highly Accessed Research article

Long term follow up and retrospective study on 533 gastric cancer cases

Wei-Juan Zeng1, Wen-Qin Hu2, Lin-Wei Wang1, Shu-Guang Yan2, Jian-Ding Li3*, Hao-Liang Zhao4, Chun-Wei Peng1, Gui-Fang Yang1 and Yan Li1*

Author Affiliations

1 Departments of Oncology & Pathology, Zhongnan Hospital of Wuhan University, Hubei Key Laboratory of Tumor Biological Behaviors & Hubei Cancer Clinical Study Center, Wuhan 430071, China

2 Department of Surgery, Heji Hospital Affiliated to Changzhi Medical College, Changzhi 046000, China

3 Department of Medical Imaging, The First Affiliated Hospital of Shanxi Medical University, No 85, South Jiefang Road, Taiyuan City 030001, Shangxi Province, China

4 Department of General Surgery, Shanxi University Hospital, No 99, Longcheng Street, Taiyuan City 046000 Shangxi Province, China

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BMC Surgery 2014, 14:29  doi:10.1186/1471-2482-14-29

Published: 16 May 2014

Abstract

Background

Gastric cancer (GC) is the third leading cause of cancer death in China and the outcome of GC patients is poor. The aim of the research is to study the prognostic factors of gastric cancer patients who had curative intent or palliative resection, completed clinical database and follow-up.

Methods

This retrospective study analyzed 533 GC patients from three tertiary referral teaching hospitals from January 2004 to December 2010 who had curative intent or palliative resection, complete clinical database and follow-up information. The GC-specific overall survival (OS) status was determined by the Kaplan-Meier method, and univariate analysis was conducted to identify possible factors for survival. Multivariate analysis using the Cox proportional hazard model and a forward regression procedure was conducted to define independent prognostic factors.

Results

By the last follow-up, the median follow-up time of 533 GC patients was 38.6 mo (range 6.9-100.9 mo), and the median GC-specific OS was 25.3 mo (95% CI: 23.1-27.4 mo). The estimated 1-, 2-, 3- and 5-year GC-specific OS rates were 78.4%, 61.4%, 53.3% and 48.4%, respectively. Univariate analysis identified the following prognostic factors: hospital, age, gender, cancer site, surgery type, resection type, other organ resection, HIPEC, LN status, tumor invasion, distant metastases, TNM stage, postoperative SAE, systemic chemotherapy and IP chemotherapy. In multivariate analysis, seven factors were identified as independent prognostic factors for long term survival, including resection type, HIPEC, LN status, tumor invasion, distant metastases, postoperative SAE and systemic chemotherapy.

Conclusions

Resection type, HIPEC, postoperative SAE and systemic chemotherapy are four independent prognostic factors that could be intervened for GC patients for improving survival.

Keywords:
Gastric cancer; GC-specific overall survival; Prognosis; Multivariate analysis; Clinical pathological factors