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Prognostic Factors that Affect the Survival of Gastric Cancer

Year 2012, Volume: 34 Issue: 2, 173 - 182, 21.06.2012

Birsen Yücel , Saadettin Kılıçkap Yıllar Lehimcioğlu , Eda Erdiş Ebru Atasever Akkaş , Mine Şalk

Abstract

Abstract

Aims. The purpose of this study is to review the factors that affect the survival and clinicopathological characteristics of gastric cancer cases monitored and treated at our centre. Method. 112 gastric cancer patients who admitted to the Radiation Oncology Department of Cumhuriyet University Medical Faculty Research and Application Hospital between 2006 and 2010 were included in the study. The demographic, clinical, and histopathology data of the patients were obtained from the patient files and the hospital records. Results. This study analysed data of 112 patients of whom 90 (80%) were men, and 22 (20%) were women. The factors that determined survival were stage of the cancer, T and N stages, high grade, performance status, presence of anemia and hypoalbuminemia, presence of metastasis, extravascular invasion, weight loss, metastatic lymph node ratio (>50%) and a high level of serum CEA and CA19-9. The stage, performance status, anemia at the time of diagnosis were determined as independent prognostic factors that affect survival after performing multivariate analysis. Conclusion. Many studies have defined numerous prognostic factors for gastric cancer. In concordance with the literature, this study sets forth that the most important factors in terms of prognosis are the stage, the performance status, and the presence of anemia at diagnosis the time of diagnosis.

Keywords: Gastric cancer, prognosis, anemia, stage, performance status

 

Özet

Amaç. Bu çalışmanın amacı, kliniğimizde takip ve tedavi edilen mide kanserli vakaların sağkalımını etkileyen faktörleri ve klinikopatolojik özellikleri gözden geçirmektir. Yöntem. 2006-2010 yılları arasında Cumhuriyet Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi Radyasyon Onkolojisi Bölümüne başvuran 112 mide kanserli hasta bu çalışmaya dahil edildi. Hastaların demografik, klinik ve histopatolojik verileri hasta dosyaları ve hastane kayıtlarından elde edildi. Bulgular. Bu çalışmada, 90'ı (%80) erkek ve 22'si (%20) kadın 112 hastanın verisi analiz edildi. Kanserin evresi, T ve N evresi, yüksek grade, performans durumu, anemi ve hipoalbuminemi varlığı, metastaz varlığı, ekstravasküler invazyon, kilo kaybı, metastatik lenf nodu oranı (>%50), yüksek CEA ve CA19-9 seviyesi sağkalımı belirleyen faktörlerdi. Çok değişkenli analizde, evre, performans durumu, tanı anında aneminin olması sağkalımı bağımsız olarak etkileyen prognostik faktörlerdi. Sonuç. Mide kanseri için birçok prognostik faktör tanımlamıştır. Bu çalışmada literatürle uyumlu olarak, evre, performans durumu ve tanıda aneminin varlığı en önemli prognostik faktörlerdi.

Anahtar sözcükler: Gastrik kanser, prognoz, anemi, evre, performans durumu

Keywords

-

References

  • Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55: 74-108.
  • Ferlay J, Bray F, Pisani P. Parkin DM. Globocan 2002 cancer incidence, mortality and prevalence worldwide. IARC cancerbase no. 5, version 2.0 Lyon: IARC Press; 2004.
  • El-Serag HB, Mason AC, Petersen N, Key CR. Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA. Gut 2002; 50: 368-72.
  • Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J. Cancer incidence in five continents, vol VII. Lyon: IARC Scientific Publications, 1997: 822-3.
  • Roviello F, Marrelli D, Morgagni P, de Manzoni G, Di Leo A, Vindigni C, Saragoni L, Tomezzoli A, Kurihara H; Italian Research Group for Gastric Cancer. Survival benefit of extended D2 lymphadenectomy in gastric cancer with involvement of second level lymph nodes: a longitudinal multicenter study.Ann Surg Oncol 2002; 9: 894-900.
  • 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.
  • Gunderson LL. Gastric cancer--patterns of relapse after surgical resection. Semin Radiat Oncol 2002; 12: 150-61.
  • Siewert JR, Böttcher K, Stein HJ, Roder JD. Relevant prognostic factors in gastric cancer: ten-year results of the German Gastric Cancer Study. Ann Surg 1998; 228: 449-61.
  • Wu CW, Hsieh MC, Lo SS, Tsay SH, Li AF, Lui WY, P'eng FK. Prognostic indicators for survival after curative resection for patients with carcinoma of the stomach. Dig Dis Sci 1997; 42: 1265-9.
  • Wu CW, Hsieh MC, Lo SS, Tsay SH, Lui WY, P'eng FK. Relation of number of positive lymph nodes to the prognosis of patients with primary gastric adenocarcinoma. Gut 1996; 38: 525-7.
  • Hyung WJ, Lee JH, Choi SH, Min JS, Noh SH. Prognostic impact of lymphatic and/or blood vessel invasion in patients with node-negative advanced gastric cancer. Ann Surg Oncol 2002; 9: 562-7.
  • Kooby DA, Suriawinata A, Klimstra DS, Brennan MF, Karpeh MS. Biologic predictors of survival in node-negative gastric cancer. Ann Surg 2003; 237: 828- 35.
  • Hakama M, Stenman UH, Knekt P, Järvisalo J, Leino A, Hakulinen T, Maatela J, Aromaa A. Tumour markers and screening for gastrointestinal cancer: a follow up study in Finland. J Med Screen 1994; 1: 60-4.
  • Pectasides D, Mylonakis A, Kostopoulou M, Papadopoulou M, Triantafillis D, Varthalitis J, Dimitriades M, Athanassiou A. CEA, CA 19-9, and CA-50 in monitoring gastric carcinoma. Am J Clin Oncol 1997; 20: 348-53.
  • Gunji Y, Suzuki T, Hori S, Hayashi H, Matsubara H, Shimada H, Ochiai T. Prognostic significance of the number of metastatic lymph nodes in early gastric cancer. Dig Surg 2003; 20: 148.
  • Okajima K. Prognostic factors of gastric cancer patients a study by univariate analysis (in Japanese, with English abstract). Jpn J Gastroenterol Surg 1997; 30: 700-11.
  • Marchet A, Mocellin S, Ambrosi A, de Manzoni G, Di Leo A, Marrelli D, Roviello F, Morgagni P, Saragoni L, Natalini G, De Santis F, Baiocchi L, Coniglio A, Nitti D; Italian Research Group for Gastric Cancer Study (GIRCG). The prognostic value of N-ratio in patients with gastric cancer. Eur J Surg Oncol 2008; 34: 159-65.
  • Sobin LH, Witekind CN. TNM classification of malignant tumors. International Union Cancer. 6th ed. New York: John Wiley & Sons; 2002.
  • Dockerty MB: Pathology aspects of primary malignant neoplasms of stomach. In ReMine WH, Priestly JT, Berkson J (eds): Cancer os the Stomach. Phladelphia, WB Saunders, 1964; pp: 173.
  • Yu CC, Levison DA, Dunn JA, Ward LC, Demonakou M, Allum WH, Hallisey MT. Pathological prognostic factors in the second British Stomach Cancer Group trial of adjuvant therapy in resectable gastric cancer. Br J Cancer 1995; 71: 1106- 10.
  • Saito H, Osaki T, Murakami D, Sakamoto T, Kanaji S, Oro S, Tatebe S, Tsujitani S, Ikeguchi M. Macroscopic tumor size as a simple prognostic indicator in patients with gastric cancer. Am J of Surg 2006; 192: 296-300.
  • Wang X, Wan F, Pan J, Yu GZ, Chen Y, Wang JJ. Tumor size: a non-neglectable independent prognostic factor for gastric cancer. J Surg Oncol 2008; 97: 236-40.
  • Shiraishi N, Sato K, Yasuda K, Inomata M, Kitano S. Multivariate prognostic study on large gastric cancer. J Surg Oncol 2007; 96: 14-8.
  • Van Krieken JHJM, Sasako M, Van de Vele CJH. Gastric cancer. In: Gospodarowicz MK, Henson DE, Hutter RVP, O’Sullivan B, Sobin LH, Wittekind C, eds. Prognostic Factors in Cancer. New York: Wiley-Liss; 2001:251-265.
  • Bunt AM, Hogendoorn PC, van de Velde CJ, Bruijn JA, Hermans J. Lymph node staging standards in gastric cancer. J Clin Oncol 1995; 13: 2309-16.
  • Lee CC, Wu CW, Lo SS, Chen JH, Li AF, Hsieh MC, Shen KH, Lui WY. Survival predictors in patients with node-negative gastric carcinoma. J Gastroenterol Hepatol 2007; 22: 1014-8.
  • Dent DM, Werner ID, Novis B, Cheverton P, Brice P. Prospective randomized trial of combined oncological therapy for gastric carcinoma. Cancer 1979; 44: 385.
  • Tsukiyama I, Akine Y, Kajiura Y, Ogino T, Yamashita K, Egawa S, Hijikata J, Kitagawa T. Radiation therapy for advanced gastric cancer. Int J Radiat Oncol Biol Phys 1988; 15: 123.
  • Maguire A, Porta M, Sanz-Anquela JM, Ruano I, Malats N, Piñol JL. Sex as a prognostic factor in gastric cancer. Eur J Cancer 1996; 32A: 1303-9.
  • Kodera Y, Yamamura Y, Torii A, Uesaka K, Hirai T, Yasui K, Morimoto T, Kato T, Kito T. The prognostiv value of preoperatif serum levels of CEA and Ca19, 9 inpatient with gastric cancer: Am J Gastroenterol 1996; 91: 149-53.
  • Nakane Y, Okamura S, Akehira K, Boku T, Okusa T, Tanaka K, Hioki K. Correlation of preoperative carcinoembryonic antigen levels and prognosis of gastric cancer patients. Cancer 1994; 73: 2703-8.
  • Sakamoto J, Nakazato H, Teramukai S, Ohashi Y, Takahashi Y, Mai M, Toge T, Okura H, Kodaira S, Maetani S, Okajima K, Nomoto K, Hattori T, Inokuchi K. Association between preoperative plasma CEA levels and the prognosis of gastric cancer following curative resection. Tumor Marker Committee, Japanese Foundation for Multidisciplinary Treatment of Cancer, Tokyo, Japan. Surg Oncol 1996; 5: 133-9.
  • Maehara Y, Kusumoto T, Takahashi I, Kakeji Y, Baba H, Akazawa K, Sugimachi K. Predictive value of preoperative carcinoembryonic antigen levels for the prognosis of patients with well-differentiated gastric cancer. A multivariate analysis. A multivariate analysis. Oncology 1994; 51: 234-7.
  • Nozoe T, Mori E, Takahashi I, Ezaki T. Preoperative elevation of serum C- reactive protein as an independent prognostic indicator of colorectal carcinoma. Surg Today 2008; 38: 597-602.
  • Lien YC, Hsieh CC, Wu YC, Hsu HS, Hsu WH, Wang LS, Huang MH, Huang BS. Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia. J Gastrointest Surg 2004; 8: 1041-8.
  • Oñate-Ocaña LF, Aiello-Crocifoglio V, Gallardo-Rincón D, Herrera-Goepfert R, Brom-Valladares R, Carrillo JF, Cervera E, Mohar-Betancourt A. Serum albumin as a significant prognostic factor for patients with gastric carcinoma. Ann Surg Oncol 2007; 14: 381-9.
  • Maehara Y, Kakeji Y, Oda S, Takahashi I, Akazawa K, Sugimachi K. Time trends of surgical treatment and the prognosis for Japanese patients with gastric cancer. Br J Cancer 2000; 83: 986-91.

Original research-Orijinal araştırma

Year 2012, Volume: 34 Issue: 2, 173 - 182, 21.06.2012

Birsen Yücel , Saadettin Kılıçkap Yıllar Lehimcioğlu , Eda Erdiş Ebru Atasever Akkaş , Mine Şalk

Abstract

Amaç. Bu çalışmanın amacı, kliniğimizde takip ve tedavi edilen mide kanserli vakaların sağkalımını etkileyen faktörleri ve klinikopatolojik özellikleri gözden geçirmektir. Yöntem. 20062010 yılları arasında Cumhuriyet Üniversitesi Tıp Fakültesi Araştırma ve Uygulama Hastanesi Radyasyon Onkolojisi Bölümüne başvuran 112 mide kanserli hasta bu çalışmaya dahil edildi. Hastaların demografik, klinik ve histopatolojik verileri hasta dosyaları ve hastane kayıtlarından elde edildi. Bulgular. Bu çalışmada, 90'ı (%80) erkek ve 22'si (%20) kadın 112 hastanın verisi analiz edildi. Kanserin evresi, T ve N evresi, yüksek grade, performans durumu, anemi ve hipoalbuminemi varlığı, metastaz varlığı, ekstravasküler invazyon, kilo kaybı, metastatik lenf nodu oranı (>%50), yüksek CEA ve CA19-9 seviyesi sağkalımı belirleyen faktörlerdi. Çok değişkenli analizde, evre, performans durumu, tanı anında aneminin olması sağkalımı bağımsız olarak etkileyen prognostik faktörlerdi. Sonuç. Mide kanseri için birçok prognostik faktör tanımlamıştır. Bu çalışmada literatürle uyumlu olarak, evre, performans durumu ve tanıda aneminin varlığı en önemli prognostik faktörlerdi

Keywords

Gastrik kanser prognoz anemi evre performans durumu

References

  • Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer J Clin 2005; 55: 74-108.
  • Ferlay J, Bray F, Pisani P. Parkin DM. Globocan 2002 cancer incidence, mortality and prevalence worldwide. IARC cancerbase no. 5, version 2.0 Lyon: IARC Press; 2004.
  • El-Serag HB, Mason AC, Petersen N, Key CR. Epidemiological differences between adenocarcinoma of the oesophagus and adenocarcinoma of the gastric cardia in the USA. Gut 2002; 50: 368-72.
  • Parkin DM, Whelan SL, Ferlay J, Raymond L, Young J. Cancer incidence in five continents, vol VII. Lyon: IARC Scientific Publications, 1997: 822-3.
  • Roviello F, Marrelli D, Morgagni P, de Manzoni G, Di Leo A, Vindigni C, Saragoni L, Tomezzoli A, Kurihara H; Italian Research Group for Gastric Cancer. Survival benefit of extended D2 lymphadenectomy in gastric cancer with involvement of second level lymph nodes: a longitudinal multicenter study.Ann Surg Oncol 2002; 9: 894-900.
  • 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.
  • Gunderson LL. Gastric cancer--patterns of relapse after surgical resection. Semin Radiat Oncol 2002; 12: 150-61.
  • Siewert JR, Böttcher K, Stein HJ, Roder JD. Relevant prognostic factors in gastric cancer: ten-year results of the German Gastric Cancer Study. Ann Surg 1998; 228: 449-61.
  • Wu CW, Hsieh MC, Lo SS, Tsay SH, Li AF, Lui WY, P'eng FK. Prognostic indicators for survival after curative resection for patients with carcinoma of the stomach. Dig Dis Sci 1997; 42: 1265-9.
  • Wu CW, Hsieh MC, Lo SS, Tsay SH, Lui WY, P'eng FK. Relation of number of positive lymph nodes to the prognosis of patients with primary gastric adenocarcinoma. Gut 1996; 38: 525-7.
  • Hyung WJ, Lee JH, Choi SH, Min JS, Noh SH. Prognostic impact of lymphatic and/or blood vessel invasion in patients with node-negative advanced gastric cancer. Ann Surg Oncol 2002; 9: 562-7.
  • Kooby DA, Suriawinata A, Klimstra DS, Brennan MF, Karpeh MS. Biologic predictors of survival in node-negative gastric cancer. Ann Surg 2003; 237: 828- 35.
  • Hakama M, Stenman UH, Knekt P, Järvisalo J, Leino A, Hakulinen T, Maatela J, Aromaa A. Tumour markers and screening for gastrointestinal cancer: a follow up study in Finland. J Med Screen 1994; 1: 60-4.
  • Pectasides D, Mylonakis A, Kostopoulou M, Papadopoulou M, Triantafillis D, Varthalitis J, Dimitriades M, Athanassiou A. CEA, CA 19-9, and CA-50 in monitoring gastric carcinoma. Am J Clin Oncol 1997; 20: 348-53.
  • Gunji Y, Suzuki T, Hori S, Hayashi H, Matsubara H, Shimada H, Ochiai T. Prognostic significance of the number of metastatic lymph nodes in early gastric cancer. Dig Surg 2003; 20: 148.
  • Okajima K. Prognostic factors of gastric cancer patients a study by univariate analysis (in Japanese, with English abstract). Jpn J Gastroenterol Surg 1997; 30: 700-11.
  • Marchet A, Mocellin S, Ambrosi A, de Manzoni G, Di Leo A, Marrelli D, Roviello F, Morgagni P, Saragoni L, Natalini G, De Santis F, Baiocchi L, Coniglio A, Nitti D; Italian Research Group for Gastric Cancer Study (GIRCG). The prognostic value of N-ratio in patients with gastric cancer. Eur J Surg Oncol 2008; 34: 159-65.
  • Sobin LH, Witekind CN. TNM classification of malignant tumors. International Union Cancer. 6th ed. New York: John Wiley & Sons; 2002.
  • Dockerty MB: Pathology aspects of primary malignant neoplasms of stomach. In ReMine WH, Priestly JT, Berkson J (eds): Cancer os the Stomach. Phladelphia, WB Saunders, 1964; pp: 173.
  • Yu CC, Levison DA, Dunn JA, Ward LC, Demonakou M, Allum WH, Hallisey MT. Pathological prognostic factors in the second British Stomach Cancer Group trial of adjuvant therapy in resectable gastric cancer. Br J Cancer 1995; 71: 1106- 10.
  • Saito H, Osaki T, Murakami D, Sakamoto T, Kanaji S, Oro S, Tatebe S, Tsujitani S, Ikeguchi M. Macroscopic tumor size as a simple prognostic indicator in patients with gastric cancer. Am J of Surg 2006; 192: 296-300.
  • Wang X, Wan F, Pan J, Yu GZ, Chen Y, Wang JJ. Tumor size: a non-neglectable independent prognostic factor for gastric cancer. J Surg Oncol 2008; 97: 236-40.
  • Shiraishi N, Sato K, Yasuda K, Inomata M, Kitano S. Multivariate prognostic study on large gastric cancer. J Surg Oncol 2007; 96: 14-8.
  • Van Krieken JHJM, Sasako M, Van de Vele CJH. Gastric cancer. In: Gospodarowicz MK, Henson DE, Hutter RVP, O’Sullivan B, Sobin LH, Wittekind C, eds. Prognostic Factors in Cancer. New York: Wiley-Liss; 2001:251-265.
  • Bunt AM, Hogendoorn PC, van de Velde CJ, Bruijn JA, Hermans J. Lymph node staging standards in gastric cancer. J Clin Oncol 1995; 13: 2309-16.
  • Lee CC, Wu CW, Lo SS, Chen JH, Li AF, Hsieh MC, Shen KH, Lui WY. Survival predictors in patients with node-negative gastric carcinoma. J Gastroenterol Hepatol 2007; 22: 1014-8.
  • Dent DM, Werner ID, Novis B, Cheverton P, Brice P. Prospective randomized trial of combined oncological therapy for gastric carcinoma. Cancer 1979; 44: 385.
  • Tsukiyama I, Akine Y, Kajiura Y, Ogino T, Yamashita K, Egawa S, Hijikata J, Kitagawa T. Radiation therapy for advanced gastric cancer. Int J Radiat Oncol Biol Phys 1988; 15: 123.
  • Maguire A, Porta M, Sanz-Anquela JM, Ruano I, Malats N, Piñol JL. Sex as a prognostic factor in gastric cancer. Eur J Cancer 1996; 32A: 1303-9.
  • Kodera Y, Yamamura Y, Torii A, Uesaka K, Hirai T, Yasui K, Morimoto T, Kato T, Kito T. The prognostiv value of preoperatif serum levels of CEA and Ca19, 9 inpatient with gastric cancer: Am J Gastroenterol 1996; 91: 149-53.
  • Nakane Y, Okamura S, Akehira K, Boku T, Okusa T, Tanaka K, Hioki K. Correlation of preoperative carcinoembryonic antigen levels and prognosis of gastric cancer patients. Cancer 1994; 73: 2703-8.
  • Sakamoto J, Nakazato H, Teramukai S, Ohashi Y, Takahashi Y, Mai M, Toge T, Okura H, Kodaira S, Maetani S, Okajima K, Nomoto K, Hattori T, Inokuchi K. Association between preoperative plasma CEA levels and the prognosis of gastric cancer following curative resection. Tumor Marker Committee, Japanese Foundation for Multidisciplinary Treatment of Cancer, Tokyo, Japan. Surg Oncol 1996; 5: 133-9.
  • Maehara Y, Kusumoto T, Takahashi I, Kakeji Y, Baba H, Akazawa K, Sugimachi K. Predictive value of preoperative carcinoembryonic antigen levels for the prognosis of patients with well-differentiated gastric cancer. A multivariate analysis. A multivariate analysis. Oncology 1994; 51: 234-7.
  • Nozoe T, Mori E, Takahashi I, Ezaki T. Preoperative elevation of serum C- reactive protein as an independent prognostic indicator of colorectal carcinoma. Surg Today 2008; 38: 597-602.
  • Lien YC, Hsieh CC, Wu YC, Hsu HS, Hsu WH, Wang LS, Huang MH, Huang BS. Preoperative serum albumin level is a prognostic indicator for adenocarcinoma of the gastric cardia. J Gastrointest Surg 2004; 8: 1041-8.
  • Oñate-Ocaña LF, Aiello-Crocifoglio V, Gallardo-Rincón D, Herrera-Goepfert R, Brom-Valladares R, Carrillo JF, Cervera E, Mohar-Betancourt A. Serum albumin as a significant prognostic factor for patients with gastric carcinoma. Ann Surg Oncol 2007; 14: 381-9.
  • Maehara Y, Kakeji Y, Oda S, Takahashi I, Akazawa K, Sugimachi K. Time trends of surgical treatment and the prognosis for Japanese patients with gastric cancer. Br J Cancer 2000; 83: 986-91.
There are 37 citations in total.

Details

Primary Language English
Journal Section Medical Science Research Articles
Authors

Birsen Yücel

Saadettin Kılıçkap

Yıllar Lehimcioğlu

Eda Erdiş

Ebru Atasever Akkaş

Mine Şalk

Publication Date June 21, 2012
Published in Issue Year 2012Volume: 34 Issue: 2

Cite

AMA Yücel B, Kılıçkap S, Lehimcioğlu Y, Erdiş E, Atasever Akkaş E, Şalk M. Prognostic Factors that Affect the Survival of Gastric Cancer. CMJ. June 2012;34(2):173-182.