Factors affecting the survival of patients with gastric cancer undergone surgery at Iran cancer institute: univariate and multivariate analyses

ABSTRACT

Gastric cancer is the most prevalent cancer among men and the third most prevalent cancer among women in Iran. Its most important reason for death is its belated diagnosis at the advanced stages of the disease. Various factors can be effective on the survival of these patients after surgery, which are the major concern in this study. Data from 330 patients with Gastric cancer who had undergone surgery at Iran Cancer Institute from 1995 to 1999 were analyzed. The Survival Time of patients was determined after surgery and the effect of individual and demographic; clinical and diagnostic; and treatment and post-surgical factors on patients' survival was studied. For data analysis, Kaplan- Meier, Log-Rank test and Proportional Hazards Model were used. The median of survival time was 16.33 months. The one-year, three-year, and five-year survival rates were, 0.66, 0.31, and 0.21. Based on univariate analysis results of age[P<0.001], metastases[P=0.012], disease stage[P=0.016], and number of renewed treatments[P<0.001], as well as multivariate analysis which was used to investigate the simultaneous effect of influencing variables on patients' survival showed that age[61-70HR=1.40,>70HR=2.08], marital status[HR=0.39], number of renewed treatments[1HR=0.54,2HR=0.30,3HR=0.22], relapse[HR=1.51], type of gastrectomy [Subtotal HR=1.12, DistalHR=0.49, PartialHR=0.94, ProximalHR=0.52], liver metastases [HR=1.79], distance metastases[HR=1.84], and disease stage[IIHR=1.28,IIIHR=2.12,IVHR=1.90] variables had a significant effect on patients' survival. Patients who call on doctors in early stages of disease will have a higher survival rate due to early diagnosis whereas disease progression will increase the risk and will decrease the survival. Identifying factors affecting patients' survival and improving diagnostic methods can prevent disease progression and increase survival rate