Retrospective Cohort Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. May 6, 2020; 8(9): 1608-1619
Published online May 6, 2020. doi: 10.12998/wjcc.v8.i9.1608
Prognosis factors of advanced gastric cancer according to sex and age
Abdulaziz Alshehri, Hussain Alanezi, Beom Su Kim
Abdulaziz Alshehri, Hussain Alanezi, Beom Su Kim, Department of Gastric Surgery, Ulsan University School of Medicine, Asan Medical Center, Seoul 05505, South Korea
Abdulaziz Alshehri, General Surgery Department, King Fahad Military Medical Complex, Dhahran 31932, Saudi Arabia
Hussain Alanezi, Department of General Surgery, Northern Area Armed Forces Hospital, Hafar Al Batin 31991, Saudi Arabia
Institutional review board statement: The study was reviewed and approved for publication by our Institutional Reviewer.
Informed consent statement: Patients were not required to give informed consent to the study because the analysis used anonymous data that were obtained after each patient agreed to treatment by written consent.
Conflict-of-interest statement: All the Authors have no conflict of interest related to the manuscript.
Data sharing statement: No additional data are available.
STROBE statement: The authors have read the STROBE Statement—checklist of items, and the manuscript was prepared and revised according to the STROBE Statement—checklist of items.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Beom Su Kim, MD, PhD, Professor, Surgeon, Department of Gastric Surgery, Ulsan University School of Medicine, Asan Medical Center, 88 Olympic-ro 43-gil, Songp-gu, Seoul 05505, South Korea. bskim0251@naver.com
Received: February 22, 2020
Peer-review started: February 22, 2020
First decision: March 18, 2020
Revised: March 26, 2020
Accepted: April 24, 2020
Article in press: April 24, 2020
Published online: May 6, 2020
Processing time: 67 Days and 23.4 Hours
Abstract
BACKGROUND

Gastric cancer has a relatively high prevalence and is one of the most common causes of cancer-related death worldwide. However, the prognosis for gastric cancer remains poor, especially in the advanced stages, despite many improvements in diagnosis and treatment.

AIM

To evaluate the outcomes regarding advanced gastric cancer development according to sex and age.

METHODS

We retrospectively reviewed 2005 patients who underwent curative gastrectomy for advanced gastric cancer between 2002 and 2007 at a single Korean centre. Prognosis and risk factors for nodal involvement were evaluated according to sex and age.

RESULTS

In this retrospective cohort study, we examined the cases of 2005 patients [sex, 1384 men (69%), 621 women (31%)] with advanced gastric cancer. The patients’ age range was 22-87 years (mean age: 57.7 ± 12.3 years), with approximately 53.3% of the patients being ≤ 60 years old. Based on a Cox proportional hazards model, overall survival was independently predicted by older age, larger tumour size, lymphovascular invasion, lymph node metastasis, deeper tumour invasion, moderately-to-poorly differentiated tubular adenocarcinoma, and signet ring cell carcinoma. The same model revealed that relapse-free survival was independently predicted by advanced age, larger tumour size, lymphovascular invasion, deeper tumour invasion, poorly differentiated tubular adenocarcinoma, and signet ring cell carcinoma.

CONCLUSION

Among patients with advanced gastric cancer, older age independently predicted poor overall survival and relapse-free survival. However, there were no significant sex-based differences in relapse-free and overall survival.

Keywords: Carcinoma; Prognosis; Gastrectomy; Risk factors; Age; Adenocarcinoma

Core tip: Understanding the association between age and the survival rate for gastric cancer might be helpful to clarify the prognostic value of age and potentially improve treatment efficacy. However, few studies have evaluated the effects of sex or age on gastric cancer outcomes, especially for advanced gastric cancer. Thus, we evaluated the relationships of age and sex with advanced gastric cancer outcomes in 2005 patients at our center.