Long-term survival results and prognostic factors of early gastric cancer

Huang,Baojun; Wang,Zhenning; Xing,Chengzhong; Sun,Zhe; Zhao,Bo; Xu,Huimian

doi:10.3892/etm.2011.323

Long-term survival results and prognostic factors of early gastric cancer

Authors:
- Baojun Huang
- Zhenning Wang
- Chengzhong Xing
- Zhe Sun
- Bo Zhao
- Huimian Xu
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Affiliations: Department of Surgical Oncology, First Affiliated Hospital of China Medical University, Shenyang 110001, P.R. China, Department of Medicine, Saint Barnabas Medical Center, Livingston, NJ 07039, USA
Published online on: July 26, 2011 https://doi.org/10.3892/etm.2011.323
Pages: 1059-1064

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Abstract

In spite of the favorable prognosis of early gastric cancer (EGC), recurrence or second primary cancers present in certain patients after curative surgery. It is crucial to identify who are at high risk and when. In the present study, 323 patients with EGC who underwent curative surgery were studied. A total of 22 patients (6.8%) died of recurrence, 9 patients (2.8%) died of a second primary cancer and 65 patients (20.1%) died of comorbid diseases during the 0.3-33 years of follow‑up. Among the 22 patients with recurrence, hematogenous metastases were noted in over half of the cases (77.3%, 17/22); of these cases 15 patients had a recurrence within the first decade after surgery. Histological differentiation and nodal status were correlated with recurrence. Among the second primary cancers, remnant gastric, liver, lung and colon were the most common sites, and the second primary cancers primarily occurred in the second decade after surgery (6/9). Multivariate analysis identified nodal status (HR=4.20), vessel involvement (HR=3.40) and histological differentiation (HR=3.52) as independent prognostic factors for disease-free survival. However, gender, age and differentiation were independent influencing factors for overall survival. Comorbid diseases, recurrence and second primary cancers are the main cause of death in EGC patients after curative resection. Thus, treatment of comorbid diseases and a periodic follow-up schedule may contribute to improved prognosis.

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