학술논문
Survival outcomes of patients with pathological stage I gastric cancer using the competing risks survival method.
Document Type
Academic Journal
Author
de Jesus VHF; Medical Oncology Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.; da Costa WL Jr; Abdominal Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.; Felismino TC; Medical Oncology Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.; Calsavara VF; Department of Epidemiology and Statistics, International Research Center (CIPE), A.C. Camargo Cancer Center, São Paulo, SP, Brazil.; Diniz AL; Abdominal Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.; de Castro Ribeiro HS; Abdominal Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.; de Godoy AL; Abdominal Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.; de Farias IC; Abdominal Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.; Coimbra FJF; Abdominal Surgery Department, A.C. Camargo Cancer Center, São Paulo, SP, Brazil.
Source
Publisher: AME Publishing Group Country of Publication: China NLM ID: 101557751 Publication Model: Print Cited Medium: Print ISSN: 2078-6891 (Print) Linking ISSN: 20786891 NLM ISO Abbreviation: J Gastrointest Oncol Subsets: PubMed not MEDLINE
Subject
Language
English
ISSN
2078-6891
Abstract
Background: Patients with stage I gastric cancer are considered to have an exquisite prognosis. Nonetheless, the fact that some patients experience disease relapse highlights that a subgroup might benefit from multimodality treatment. We aimed to evaluate the survival of patients with stage I gastric cancer and look for harbingers of gastric cancer recurrence.
Methods: We looked for patients with stage I gastric cancer treated exclusively with surgery from 1996 to 2015. The competing risks survival method was used to allow for concurrent causes of mortality. Also, we calculated subdistribution hazards (SH) to reveal factors associated with cancer recurrence and death from unrelated causes.
Results: A total of 185 patients constitute the study population. Thirty-seven patients had pT2N0 tumors. Most patients (80.5%) were treated with D2 lymphadenectomy. The probability of relapse at 5 years was 3.0% and 8.6% in the study population and the pT2N0 subgroup, respectively. Among all 26 deaths, only six were related to gastric cancer. In multivariate analysis, perineural invasion (PNI) was associated with increased risk of gastric cancer recurrence.
Conclusions: The prognosis of stage I gastric cancer treated with D2 lymphadenectomy is excellent. PNI may indicate higher likelihood of recurrence. Further work in this field should account for the higher risk of death from unrelated causes.
Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
(2019 Journal of Gastrointestinal Oncology. All rights reserved.)
Methods: We looked for patients with stage I gastric cancer treated exclusively with surgery from 1996 to 2015. The competing risks survival method was used to allow for concurrent causes of mortality. Also, we calculated subdistribution hazards (SH) to reveal factors associated with cancer recurrence and death from unrelated causes.
Results: A total of 185 patients constitute the study population. Thirty-seven patients had pT2N0 tumors. Most patients (80.5%) were treated with D2 lymphadenectomy. The probability of relapse at 5 years was 3.0% and 8.6% in the study population and the pT2N0 subgroup, respectively. Among all 26 deaths, only six were related to gastric cancer. In multivariate analysis, perineural invasion (PNI) was associated with increased risk of gastric cancer recurrence.
Conclusions: The prognosis of stage I gastric cancer treated with D2 lymphadenectomy is excellent. PNI may indicate higher likelihood of recurrence. Further work in this field should account for the higher risk of death from unrelated causes.
Competing Interests: Conflicts of Interest: The authors have no conflicts of interest to declare.
(2019 Journal of Gastrointestinal Oncology. All rights reserved.)