Abstract
Previous studies have generated conflicting evidence regarding associations between family history and survival after gastric cancer surgery. In this study, we investigated this question using a meta-analysis. To identify relevant studies, PubMed and Embase databases were searched up to June 2013. Two reviewers independently assessed search results and data extraction of included studies. Hazard ratios (HRs) and 95% confidence intervals (CIs) for overall survival (OS) were calculated based on fixed- or random- effects models. Homogeneity of effects across studies was assessed using x2 test statistics and quantified by I2. A total of five studies were selected according to the inclusion criteria. The total number of patients included was 2,030, which ranged from 145 to 598 per study. There was no significant difference in OS by family history of cancer (HR=0.83, 95%CIs=0.50-1.38), but subgroup analysis of patients with a first-degree family history of cancer (HR=0.74, 95%CIs=0.60-0.93) and gastric cancer family history (HR=0.56, 95%CIs=0.41-0.76) tended to show better OS in these patients. This meta-analysis suggests that a first-degree family history of cancer or gastric cancer family history is associated with better survival of gastric cancer patients after surgery, after a systematic review of five previous studies. These results can be applied by clinicians when counselling patients regarding their risk of death from gastric cancer. Further study is needed to investigate the underlying mechanism between family history and survival in gastric cancer patients.
Highlights
The incidence of gastric cancer is decreasing globally, it remains the second leading cause of cancer death, in Asia and especially in China, Japan, and Korea (Yoo, 2010; Jiang et al, 2013).Family history of cancer is well accepted as an important risk factor for the development of several types of cancer (Eberl et al, 2005)
Our meta-analysis showed that there were no significant associations between family history and gastric cancer survival
Subgroup analysis, including studies with a family history defined as only first-degree relatives and studies with a family history defined as only of gastric cancer, showed significantly better survival in gastric cancer patients after surgery
Summary
The incidence of gastric cancer is decreasing globally, it remains the second leading cause of cancer death, in Asia and especially in China, Japan, and Korea (Yoo, 2010; Jiang et al, 2013).Family history of cancer is well accepted as an important risk factor for the development of several types of cancer (Eberl et al, 2005). In the majority of studies, the risk ratio for the development of gastric cancer by family history was between 1.5- and 3.5-fold (Yaghoobi et al, 2010; Mansour-Ghanaei et al, 2012). Another study reported that family history had no effect on survival in gastric cancer patients (Gao et al, 2009). Conclusions: This meta-analysis suggests that a first-degree family history of cancer or gastric cancer family history is associated with better survival of gastric cancer patients after surgery, after a systematic review of five previous studies. These results can be applied by clinicians when counselling patients regarding their risk of death from gastric cancer. Further study is needed to investigate the underlying mechanism between family history and survival in gastric cancer patients
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