PROGNOSTIC FACTORS IN A SERIES OF 297 PATIENTS WITH GASTRIC ADENOCARCINOMA UNDERGOING SURGICAL RESECTION

Background Gastric cancer has a poor prognosis. The aim of this study was to determine the influence of several clinicopathological variable s on outcome in a series of 297 Western patients undergoing surgical r esection for gastric adenocarcinoma. Methods The results were analysed retrospectively and prognostic factors were identified in a univariat e and Cox proportional hazards regression model. Mean patient age at t he time of operation was 61.9 years; 65.7 per cent were men. Mean foll ow-up was 7.8 (range 1-15) years. Of the 297 patients undergoing surge ry, 70 per cent had subtotal gastrectomy, 26.3 per cent underwent tota l gastrectomy and 3.7 per cent had proximal gastrectomy. Results The o verall survival rate was 38.9 per cent at 5 years. In the univariate a nalysis, survival-related factors were weight loss (P < 0.05), abdomin al mass (P < 0.01), dysphagia (P < 0.001), type of gastrectomy (subtot al gastrectomy versus total gastrectomy, P < 0.001), intention of rese ction (curative versus palliative resection, P < 0.001), tumour site ( P < 0.001), histopathological grade (low versus high grade, P < 0.05), tumour diameter less than 3 cm (P < 0.001), degree of gastric wall in vasion (P < 0.001), degree of lymph node invasion (P < 0.001) and stag e of the neoplasia (P < 0.001). Other variables had no significant inf luence. In the multivariate analysis, degree of gastric wall invasion, lymph node invasion, tumour size and dysphagia at presentation were t he only independent prognostic variables. Conclusion From these data i t was possible to derive a prognostic index with which patients could be classified as at low, intermediate or high risk.