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Scand J Gastroenterol ; 40(11): 1351-7, 2005 Nov.
Artículo en Inglés | MEDLINE | ID: mdl-16334445

RESUMEN

OBJECTIVE: Socio-economic deprivation has an influence on the outcome for patients diagnosed with breast, colorectal and bronchial cancer, but there are few data on its association with gastric cancer. The aim of this study was to determine the influence of socio-economic deprivation on outcomes for patients with gastric cancer. MATERIAL AND METHODS: Three hundred and thirty consecutive patients with gastric adenocarcinoma presenting to a single hospital between 1 October 1995 and 30 June 2004 were studied prospectively and deprivation scores calculated using the National Assembly for Wales Indices of Multiple Deprivation. The patients were subdivided into quintiles for analysis. RESULTS: Inhabitants of the most deprived areas (quintile 5) were younger at presentation (median 70 years versus 74 years, p=0.007), and experienced longer delays in diagnosis (18 weeks versus 9 weeks, p=0.02) when compared with patients from the least deprived areas (quintile 1). Operative mortality was 3-fold higher for patients from the most deprived areas when compared with patients from less deprived areas (15% versus 5%, p=0.03). There was no correlation between stage of disease and socio-economic deprivation. For patients undergoing potentially curative surgery, the 5-year survival for patients from the most deprived areas was 32%, compared with 66% for patients from the least deprived areas (p=0.03). CONCLUSIONS: Socio-economic deprivation was associated with younger age at diagnosis, longer diagnostic delay, greater operative mortality and a shorter duration of survival following R0 gastrectomy. These poorer outcomes were not explained by the stage of disease at diagnosis.


Asunto(s)
Adenocarcinoma/mortalidad , Adenocarcinoma/cirugía , Causas de Muerte , Atención al Paciente/normas , Neoplasias Gástricas/mortalidad , Neoplasias Gástricas/cirugía , Adenocarcinoma/patología , Adulto , Factores de Edad , Anciano , Anciano de 80 o más Años , Estudios de Cohortes , Supervivencia sin Enfermedad , Diagnóstico Precoz , Femenino , Gastrectomía/efectos adversos , Gastrectomía/métodos , Humanos , Masculino , Persona de Mediana Edad , Estadificación de Neoplasias , Atención al Paciente/tendencias , Complicaciones Posoperatorias/terapia , Modelos de Riesgos Proporcionales , Estudios Retrospectivos , Medición de Riesgo , Factores Sexuales , Factores Socioeconómicos , Neoplasias Gástricas/diagnóstico , Tasa de Supervivencia , Reino Unido
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