Analysis of survival factors in patients with advanced-stage gastric adenocarcinoma.

ABSTRACT

BACKGROUND: Prognosis in patients with gastric cancer is determined by the tumor itself, as well as certain patient-related factors. MATERIAL/METHODS: In this study, 138 patients with high-grade gastric adenocarcinoma who were admitted to our hospital between September 1999 and April 2002 were retrospectively evaluated in terms of the effects of clinicopathological parameters and treatment approaches on survival by single and multiple variable analyses. Patients histopathologically diagnosed as having gastric adenocarcinomas with stage IV M0 (without distant organ metastasis) or stage IV M1, (with distant organ metastasis) were included in the study. RESULTS: Overall median survival time was 3.1 months and three-year survival rate was 8%. With single variable analysis, body mass index (BMI), clinical stage, surgery, type of surgery, and serum level of albumin were significant prognostic factors related to overall median survival time. Gender, clinical stage, surgery, type of surgery, hemoglobin concentration, and serum level of albumin were found to be significant prognostic factors related to survival without progression (p < 0.05). No surgical treatment, palliative surgery (compared with radical surgery), and BMI below 20 were found to be the statistically significant poor prognostic factors related to survival in multiple variable analysis. In terms of both overall survival and survival without progression, performing surgery or not was statistically the most significant independent prognostic factor. CONCLUSIONS: No surgical treatment, palliative surgery instead of radical surgery, and BMI below 20 on first admission were determined as poor prognostic factors related to survival in patients with high-grade gastric adenocarcinoma.