title: Survival after gastric adenocarcinoma resection: eighteen-year experience at a single institution.
abstract: Gastric adenocarcinoma is the second leading cause of cancer death worldwide. In Western series, survival rates vary widely and are generally lower than those reported from Eastern series. We performed a retrospective analysis of cases operated on at the Johns Hopkins Hospital over the past 18 years and collected data on demographics, tumor characteristics, pathologic stage, treatment methods, complications, survival time, and other relevant factors. Survival according to stage of disease, Lauren tumor type, tumor location, time period, and administration of adjuvant therapy was analyzed, and results were compared with those of other Western series. During this period, 436 patients with gastric adenocarcinoma underwent resection. We have shown a statistically significant association between survival and margin status, stage of disease, and Lauren tumor type. Overall 5-year survival was 26%, and 5-year survival after R0 resection was 33%. No significant difference was detected between survival and tumor location, time period of treatment, or administration of adjuvant therapy. Analysis of various Western series reveals major differences between the cohorts under study, such as stage of disease, extent of resection, tumor type, and tumor location. Many of the reported differences among Western series may be due to cohort differences, such as stage of disease, extent of resection, tumor type, and tumor location.
authors.affiliation: Department of Oncology, The Johns Hopkins University School of Medicine, Baltimore, Maryland 21231-1000, USA.
authors.forename: Steven C
authors.initials: SC
authors.lastname: Cunningham
authors.forename: Farin
authors.initials: F
authors.lastname: Kamangar
authors.forename: Min P
authors.initials: MP
authors.lastname: Kim
authors.forename: Sommer
authors.initials: S
authors.lastname: Hammoud
authors.forename: Raqeeb
authors.initials: R
authors.lastname: Haque
authors.forename: Anirban
authors.initials: A
authors.lastname: Maitra
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Montgomery
authors.forename: Richard E
authors.initials: RE
authors.lastname: Heitmiller
authors.forename: Michael A
authors.initials: MA
authors.lastname: Choti
authors.forename: Keith D
authors.initials: KD
authors.lastname: Lillemoe
authors.forename: John L
authors.initials: JL
authors.lastname: Cameron
authors.forename: Charles J
authors.initials: CJ
authors.lastname: Yeo
authors.forename: Richard D
authors.initials: RD
authors.lastname: Schulick
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D017677:Age Distribution; D000368:Aged; D001707:Biopsy, Needle; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods* / Q000401:mortality; D006785:Hospitals, University; D006801:Humans; D007150:Immunohistochemistry; D008297:Male; D008396:Maryland; D008875:Middle Aged; D009367:Neoplasm Staging; D011336:Probability; D012189:Retrospective Studies; D018570:Risk Assessment; D017678:Sex Distribution; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome