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

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.