Estimating Postoperative Survival of Gastric Cancer Patients and Factors Affecting it in Iran: Based on a TNM-7 Staging System
Recently, reports have shown that gastric cancer has high abundance in Iran and is at the second level in men, and fourth in total. This study aimed to determine the 5-year survival of gastric cancer patients and to investigate factors affecting the performance, based on TNM-7 staging system. In this study, we investigated 760 patients with gastric cancer since the beginning of 1993 to the end of 2006 in the Iran Cancer Institute who underwent surgery. Survival of these patients was determined after surgery, and the effects of demographic characteristics such as age (during operation), sex, and information on diseases such as cancer site, pathologic type, stage of disease progress (Stage), metastasis and sites of metastases were evaluated. The 5 -year survival probability of patients was 28 %, and median survival time was 25.69 months. Univariate tests showed that sex, cancer site, and pathologic type have no significant effects on patient’s survival. But the probability of 5-year survival significantly decreases with increasing age, and as it is expected, those with metastases were significantly less likely to have 5-year survival, and disease stage was significantly effective on patients’ life (P<0.001). Simultaneous evaluation of different variables’ effects on the probability of survival using the multiple Cox proportional hazards models showed that age and stage disease variables were effective on the survival of patients. The 5-year survival of patients with gastric cancer is low in Iran, although it is improved compared to the past. It seems that one of the main reasons for low survival rate of these patients is a late referral of patients for diagnosis and treatment. Most patients refer in the final stages of the disease, at this stage most patients are affected by lymph nodes metastases, liver and as the result, their treatment will be more difficult.
Report of Iran Cancer Registry 2007. Management of noncommunicable Diseases Center, Ministry of Health and Medical Education, 2009. (Acceseed in May 15, 2015, at www.irancanreg.ir]
Parkin DM. Epidemiology of cancer: global patterns and trends. Toxicol Lett 1998:102-103:227-34.
Mohagheghi MA. Annual Report of Tehran Cancer Registry 1999. Tehran (Iran): The Cancer Institute Publication; 2004.
Mohagheghi MA, Musavi Jarahi A, Shariat Torbaghan S, et al. Annual Report of Tehran Cancer Registry 1999. Tehran (Iran): The Cancer Institute Publication; 1999.
Mohagheghi MA, Musavi Jarahi A, Shariat Torbaghan S, et al. Annual Report of the Emam Khomeini Medical Center Hospital Based Cancer Registry 1995. Tehran (Iran): The Cancer Institute Publication; 1998. 6. Ding YB, Chen GY, Xia JG, et al. Correlation of tumorpositive ratio and number of perigastric lymph nodes with prognosis of patients with surgically-removed gastric carcinoma. World J Gastroenterol 2004;10(2):182-5.
Thong-Ngam D, Tangkijvanich P, Mahachai V, et al. Current status of gastric cancer in Thai patients. J Med Assoc Thai 2001;84(4):475-82.
Schwarz RE, Zagala-Nevarez K. Recurrence patterns after radical gastrectomy for gastric cancer: Prognostic factors and implications for postoperative adjuant therapy. Ann Surg Oncol 2002;9(4):394-400.
Adachi Y, Tsuchihiashi J, Shiraishi N, et al. AFPproducing gastric carcinoma: multivariate analysis of prognostic factors in 270 patients. Oncology 2003;65(2):95-101.
Triboulet JP, Fabre S, Castel B, et al. Adenocarcinomas of the distal esophagus and cardia:Surgical management.Cancer Radither 2001.5(Suppl 1):90s-7s.
Wang CS, Hsieh CC, Chao TC, et al. Resectable gastric cancer: Operative mortality and survival analysis. Chang Gung Med J 2002; 25(4): 216-27.
Noguchi Y, Yamamoto Y, Morinaga S, et al. Does pancreaticosplenectomy contribute to better survival? Hepatogastroenterology 2002;49(47):1436-40.
Onodera H, Tokunaga A, Yoshiyuki T, et al. Surgical outcome of 483 patients with early gastric cancer: Prognosis postoperative morbidity and mortality, and gastric remnant cancer. Hepatogastroenterology 2004;51(55):82-5.
Chau I, Norman AR, Cunningham D, et al. Multivariate prognostic factor analysis in locally advanced andmetastatic esophago-gastric cancer-pooled analysis from three multicenters, randomized, controlled trials using individual patient data. J Clin Oncol 2004;22(12):2395-403.
Kandasami P, Tan Wj, Norain K. Gastric cancer in Malaysia: the need for early diagnosis. Med J Malaysia 2003:58(5):758-62.
Enzinger PC, Mayer RJ. Gastrointestinal cancer in older patients. Semin Oncol 2004;31(2):206-19.
Saidi RF, Bell JL, Dudrick PS. Surgical resection for gastric cancer in elderly patients: is there a difference in outcome? J Surg Res 2004;118(1):15-20.
Bucchi L, Nanni O, Ravaioli A, et al. Cancer mortality in a cohort of male agricultural workers from northern Italy. J Occup Environ Med 2004;46(3):249-56.
Maetani S, Nakajima T, Nishikawa T. Parametric mean survival time analysis in gastric cancer patients. Med Decis Making 2004;24(2):131-41.
Shao-Liang H, Xiang-Dong C, Rong-Fu S. Multidisciplinary therapy of scirrhous gastric cancer. Asian J Surg 2000; 23(1) : 97-105.
Buonadonna A, Lombardi D, De Paoli A, et al. Adenocarcinoma of the stomach: Univariate and multivariate analysis of factors associated with survival. Suppl Tumori 2003;2(5):S31-4.
Sigon R, Canzonieri V, Rossi C. Early gastric cancer: a single-institution experience on 60 cases. Suppl Tumori 2003;2(5):S23-6.
Zeraati H, Mahmoudi M, Kazemnejad A, et al. Postoperative life expectancy in gastric cancer patients and its associated factors. Saudi Med J 2005;26(8):1203-7.
Otsuji E, Yamaguchi T, Sawai K, et al. Regional lymph node metastasis as a predictor of peritoneal carcinomatosis in patients with borrmann type IV gastric carcinoma. Am J Gastroenterol 1999;94(2):434-7.
Koizumi W, Kuihara M, Tanabeh S, et al. Advantages of Japanese response criteria for estimating the survival of patients with primary gastric cancer. J of Gastric Cancer 1999;2(1):14-9.
Yagi Y, Sehimo A, Kameoka S. Prognostic factors in stage IV gastric cancer: Univariate and multivariate analysis. J of Gastric Cancer 2000;3(2):71-80.
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