title: The contributions of patient factors, physician delay, and tumor biology to the outcome of gastric cancer.
abstract: Patients with gastric cancer were presenting at advanced stage to our hospital. We were concerned that patient or physician controlled factors might have been responsible. A retrospective review of 49 analytic gastric cancer cases presenting to UCIMC between 1984 and 1989 was conducted. Twenty-four patients were determined to have gastric cancer as outpatients, with a median duration of symptoms of 4 months. The other 25 patients had initial physician contact in the emergency room, with a median duration of symptoms of only 1.5 months (P = 0.007). Minority ethnic groups were urgently admitted more frequently than Caucasians (P = 0.004). Multivariate analysis revealed that the worst prognostic factors for gastric cancer were urgent admission of Caucasians and Asians (P = 0.0013) and distant metastases (P = 0.005). Age, gender, duration of symptoms, and physician delay, could not be shown to have any effect on survival. This study demonstrates that the aggressive nature of gastric cancer, particularly in certain minority ethnic groups, is the overriding prognostic feature.
authors.affiliation: Department of Surgery, University of California Irvine, Orange.
authors.forename: A G
authors.initials: AG
authors.lastname: Wile
authors.forename: L
authors.initials: L
authors.lastname: Hourani
authors.forename: M J
authors.initials: MJ
authors.lastname: Schell
mesh_terms: D000230:Adenocarcinoma / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D000328:Adult; D004630:Emergencies; D016145:Endoscopy, Digestive System; D005006:Ethnicity; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D013274:Stomach Neoplasms / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000601:surgery; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D015431:Weight Loss