Retrospective Study
Copyright ©The Author(s) 2016. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. Jun 27, 2016; 8(6): 444-451
Published online Jun 27, 2016. doi: 10.4240/wjgs.v8.i6.444
How does epidemiological and clinicopathological features affect survival after gastrectomy for gastric cancer patients-single Egyptian center experience
Ehab El Hanafy, Ayman El Nakeeb, Helmy Ezzat, Emad Hamdy, Ehab Atif, Tharwat Kandil, Amgad Fouad, Mohamed Abdel Wahab, Ahmed Monier
Ehab El Hanafy, Ayman El Nakeeb, Helmy Ezzat, Emad Hamdy, Ehab Atif, Tharwat Kandil, Amgad Fouad, Mohamed Abdel Wahab, Ahmed Monier, Gastroenterology Surgical Center, Mansoura University, Mansoura 35516, Egypt
Author contributions: El Hanafy E and El Nakeeb A concepted and designed this study; El Hanafy E, Hamdy E, Atif E, Kandil T, Fouad A and Wahab MA acquisited the data; El Hanafy E, El Nakeeb A, Ezzat H and Monier A analysis and interpretation of data; Atif E, Kandil T and Fouad A drafting of manuscript; El Hanafy E and Wahab MA critical revision of manuscript.
Institutional review board statement: This study was approved by institutional review board Mansoura University.
Informed consent statement: Informed consent was obtained from all patients to undergo surgery after a careful explanation of the nature of the disease and possible treatment with its complications.
Conflict-of-interest statement: The authors declare that they have no conflict of interest.
Data sharing statement: No additional data are available.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (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/
Correspondence to: Ehab El Hanafy, MD, Assistant Professor, Gastroenterology Surgical Center, Mansoura University, Elgomhouria St. Mansoura 35516, Egypt. dr_ehab_elhanafy@yahoo.com
Telephone: +20-50-2243220 Fax: +20-50-2236868
Received: February 12, 2016
Peer-review started: February 14, 2016
First decision: March 14, 2016
Revised: March 19, 2016
Accepted: April 5, 2016
Article in press: April 6, 2016
Published online: June 27, 2016
Abstract

AIM: To investigate the clinicopathological features and the significance of different prognostic factors which predict surgical overall survival in patients with gastric carcinoma.

METHODS: This retrospective study includes 80 patients diagnosed and treated at gastroenterology surgical center, Mansoura University, Egypt between February 2009 to February 2013. Prognostic factors were assessed by cox proportional hazard model.

RESULTS: There were 57 male and 23 female. The median age was 57 years (24-83). One, 3 and 5 years survival rates were 71%, 69% and 46% respectively. The median survival was 69.96 mo. During the follow-up period, 13 patients died (16%). Hospital morbidity was reported in 10 patients (12.5%). The median number of lymph nodes removed was 22 (4-41). Lymph node (LN) involvement was found in 91% of cases. After R0 resection, depth of wall invasion, LN involvement and the number (> 15) of retrieved LN, LN ratio and tumor differentiation predict survival. In multivariable analysis, tumor differentiation, curability of resection and a number of resected LN superior to 15 were found to be independent prognostic factors.

CONCLUSION: Surgery remains the cornerstone of treatment. Tumor differentiation, curability of resection and a number of resected LN superior to 15 were found to be independent prognostic factors. Extended LN dissection does not increase the morbidity or mortality rate but markedly improves long term survival.

Keywords: Cancer stomach, Prognostic factors, Lymph node metastasis, Recurrence after gastrectomy, Lymph node ratio

Core tip: The epidemiology and the surgical outcomes for patients with carcinoma of the stomach vary significantly from one part of the world to another. Surgery remains the cornerstone of treatment. Tumor differentiation, curability of resection and a number of resected lymph node (LN) superior to 15 were found to be independent prognostic factors. Extended LN dissection does not increase the morbidity or mortality rate but markedly improves long term survival.