Evaluation of prognostic factors and survival results in gastric carcinoma: single center experience from Northeast Turkey


CANYILMAZ E., Soydemir G., Serdar L., HANEDAN USLU G. D., Sahbaz A., Colak F., ...More

INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE, vol.7, no.9, pp.2656-2666, 2014 (SCI-Expanded) identifier identifier

  • Publication Type: Article / Article
  • Volume: 7 Issue: 9
  • Publication Date: 2014
  • Journal Name: INTERNATIONAL JOURNAL OF CLINICAL AND EXPERIMENTAL MEDICINE
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.2656-2666
  • Keywords: Chemoradiotherapy, gastric cancer, stage, surgical margin, RING CELL-CARCINOMA, INTENSITY-MODULATED RADIOTHERAPY, UNIQUE CLINICAL-FEATURES, POSTOPERATIVE CHEMORADIATION, UNITED-STATES, CANCER, ADENOCARCINOMA, RESECTION, CHEMOIRRADIATION, STOMACH
  • Recep Tayyip Erdoğan University Affiliated: No

Abstract

Objective: To evaluate the prognostic factors affecting overall survival (OS), disease-free survival (DFS), and survival among patients undergoing chemoradiotherapy (CRT) for locally advanced gastric carcinoma. Methods: Between January 2001 and May 2014, 257 patients who presented to our clinic with a diagnosis of stage I-IIIC gastric cancer were evaluated. The male/female ratio of the cases was 2.02: 1 and the median age was 55.16 +/- 11.8 (20-80) years. Four of the cases (1.6%) were stage IA, 13 (5.1%) were stage 1B, 41 (16%) were stage IIA, 40 (15.6%) were stage IIB, 50 (19.5%) were stage IIIA, 51 (19.8%) were stage IIIB, and 58 (22.6%) were stage IIIC. Results: The mean follow-up time was 22.5 months (3.3-155.0); loco-regional recurrence was noted in 34 (13.2%) patients who underwent postoperative chemoradiotherapy, and metastases were observed in 108 (42%) patients. The median OS duration was 26.7 months (95% confidence interval, 20-33.5) and the 2-, 5-, and 10-year OS was 52.8% (standard error [S.E.] 0.032), 36.1% (S.E. 0.032), and 26.9% (S.E. 0.034) respectively. The median DFS was 53.7 months and the 2-, 5-, and 10-year DFS were 58.9% (S.E. 0.034), 47.4% (S.E. 0.037), and 40.7% (S.E. 0.042), respectively. In multivariate analysis of prognostic factors, advanced T stage (p<0.0001), advanced nodal stage (p=0.001), and surgical margin status (p<0.0001) were related to decreased OS and DFS. Conclusion: R1 resection, advanced T stage, and advanced nodal stage were adverse prognostic factors in gastric cancer patients who had undergone CRT after the operation.