Survival in early gastric cancer: Multivariate analysis on 72 consecutive cases

BACKGROUND/AIMS: Few reports from the Western hemisphere have investigated the impact of pathological features and surgical modalities on the prognosi s of patients affected by early gastric cancer (EGC). In particular, the ex tent of lymphadenectomy (limited vs. extended) and the type of gastric rese ction (subtotal vs. total) remain controversial issues in the management of EGG. The aim of this study was to identify factors influencing prognosis i n patients affected by EGG. METHODOLOGY: Hospital records and pathological specimens of 72 patients wit h EGC undergoing resective surgery during the period 1981-1995 were retrosp ectively reviewed. Patient status was determined by follow-up examination o r by telephone contact. Univariate and multivariate analysis was used to ca lculate the 5-year survival probabilities with respect to the following var iables: age (less than or equal to 65, >65), sex, depth of invasion (mucosa l, submucosal) tumor location (upper, middle and lower third), gross appear ance (type I, type II and type III), size (less than or equal to 1.5cm, >1. 5cm), presence or absence of lymph node metastasis, histological type (inte stinal, diffuse),extent of lymphadenectomy (limited or extended), and type of gastrectomy (total or distal subtotal). Survival was the outcome variabl e studied. RESULTS: Multivariate logistic regression analysis showed that age, nodal i nvolvement and depth of invasion were independently associated with poor su rvival. CONCLUSIONS: Results showed a significant dominance of host- and tumor-rela ted factors over the type of surgical procedure on prognosis of EGC patient s.