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[Multivariate prognostic analysis for patients with curative resection of gastric cardia cancer]
Chang-hua Zhang1, Yu-long He, Wen-hua Zhan
1Department of Gastrointestinopancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou 510080, China.
Insights
Tumor invasion depth and lymph node metastasis significantly impact long-term survival in gastric cardia cancer patients after curative resection. These factors are critical for predicting patient outcomes following surgery.
Area of Science:
- Gastroenterology
- Surgical Oncology
- Oncology
Context:
- Gastric cardia cancer (GCC) is a challenging malignancy with variable long-term survival rates after surgical resection.
- Identifying prognostic factors is crucial for optimizing treatment strategies and patient management.
- Previous studies have explored various factors, but specific predictors for long-term survival in GCC remain an area of active investigation.
Purpose:
- To investigate the key factors influencing long-term survival in patients who have undergone curative resection for gastric cardia cancer.
- To identify independent prognostic indicators that can guide clinical decision-making and improve patient outcomes.
Summary:
- This retrospective study analyzed 108 patients with gastric cardia cancer who underwent radical resection between 1994 and 2003.
- Kaplan-Meier and Cox regression analyses identified depth of tumor invasion and lymph node metastasis as independent negative prognostic factors.
- Splenectomy was deemed appropriate only in cases of direct splenic invasion, and gastric resection extent did not affect survival.
Impact:
- The findings highlight the critical role of tumor invasion depth and lymph node status in determining long-term survival for gastric cardia cancer patients.
- This information can aid clinicians in risk stratification and personalized treatment planning for these patients.
- Understanding these prognostic factors can lead to improved patient counseling and potentially enhanced survival rates.
Objective:
To explore the factors affecting the long-term survival of patients with curative resection of gastric cardia cancer.
Methods:
The data of 108 patients who underwent radical resection of gastric cardia cancer from Jul. 1994 to Dec. 2003 in our hospital were investigated retrospectively. The Kaplan-Meier method and long-rank test were used for bivariate comparisons of survival. Multivariate analysis was done by the Cox regression model (Backward Wald).
Results:
Survival status of the 108 patients was ascertained in Dec. 2004. Among them, 68 were Siewert type II and 40 were Siewert type III. Seventy-four patients had lymph node metastases (68.5%). The mean follow-up time was 37 months (95% CI: 29.3-44.7 months) and the middle follow-up time was 26.6 months (95% CI: 25.8-34.2 months). The 1-,3- and 5-year cumulative survival rates were 77.2%, 33.6% and 21.8%, respectively. According to the Kaplan-Meier and log-rank methods, splenectomy, lesion size, depth of tumor invasion and regional lymph node status were prognostic factors. Multivariate regression analysis indicated that only depth of tumor invasion (P=0.009) and lymph node metastases (P=0.001) were independent prognostic factors.
Conclusion:
Depth of tumor invasion and lymph node metastases have negative effects on the survival of patients with gastric cardia cancer undergoing curative resection. Splenectomy may only be appropriate for patients with direct tumor invasion to the spleen and the extent of gastric resection does not influence survival in patients with curative gastric cardia cancer.
