Surgical treatment in late-stage gastric cancer. A retrospective analysis of 26 cases

Abstract

BACKGROUND: Gastric cancer represents the fourth most common form of cancer and the second most common cause of death in the world. It is also one of the most common cancers leading to mortality in Italy. Therefore, this study aimed to determine the survival rate of patients with advanced gastric cancer and its affecting factors in our experience at AOU Federico II.

METHODS: 26 patients with late-stage T4N2M0 and T4N2M1 gastric cancer that were diagnosed and registered during 2008 to 2018 in Federico II Surgical department, were studied. All patients were followed to the end of 2019.

Kaplan-Meier method was used to draw survival curves and to determine the effective factors on the survival rate of surveyed patients. Moreover, Log-rank test was used to evaluate whether or not survival curves for different patients, related to residual tumor, are statistically equivalent (p<0.05).

RESULTS: The mean age of the study population was 49±29, and most of them were males (57,8% (15 patients). After diagnosis, the survival rates for 1, 2, 3 and 4 years, were 26,9%, 11,5 %, 3,8%, 19,2 %; 11,5% of patients with residual tumors survived 6 months respectively. Overall average survival was of 20.61 sd 17.52 months with a median of 12. No statistical difference was detected in terms of survival among M0 and M1 sub-groups.

CONCLUSION: Based on the findings of the present study, T4 gastric cancer has a poor prognosis. Survival rate was decreased over time after diagnosis. Tumoral stage at the time of diagnosis is the most important factor affecting the survival of surveyed patients. This shows that there is a crucial need to diagnose the gastric cancer in early stages.