Risk Factors and Survival of Gastric Cancer Patients Following Curative Stomach Resection: Analysis of a Homogeneous Population of Patients in Warsaw, Poland

Abstract

Background: The aim of the study was to evaluate the prognostic factors for survival in a homogeneous population of gastric cancer patients in Warsaw, Poland. Patients and Methods: In a 2-year period, 167 inhabitants of Warsaw with stomach cancer underwent curative gastric resection. The overall 5-year survival rates of the patients were assessed. The pathologic stage of the disease was assessed according to the Tumor Node Metastasis (TNM) classification. Prognostic factors were determined by multivariate analysis. Results: Overall survival rates were equal to 64, 46, and 31% at 12, 24, and 60 months, respectively. Younger age (20–59 years) was an independent factor associated with better survival. In multivariate analysis, advanced tumor stage T3–T4 vs. T1–T2 (T3: hazard ratio (HR) 2.49, 95% confidence interval (CI) 1.44–4.31; T4: HR 2.84, 95% CI 1.25–6.47), lymph node involvement N+ vs. N0 (HR 1.74, 95% CI 1.1–2.78), positive resection margin status R1 vs. R0 (HR 1.78, 95% CI 1.06–2.98), and metastatic lymph node ratio >50% vs. <50% (HR 1.85, 95% CI 1.17–2.91) were associated with poorer prognosis. Patients’ sex and location of the tumor had no impact on overall survival. According to our results, the entire study population showed a low percentage of early gastric cancer (3.5%). Although there were twice as many male than female patients, gender had no impact on overall survival. Conclusion: Factors such as advanced tumor stage (T3–T4), lymph node involvement, positive resection margins, and a higher metastatic lymph node ratio were associated with poorer prognosis. The impact of the latter factor on survival indirectly suggests that extended lymphadenectomy could be a predictor for better prognosis.