title: Prognostic factors and survival in stomach cancer - analysis of 15 years of data from a referral hospital in iran and evaluation of international variation.
abstract: BACKGROUND
  Stomach cancer is the most common cancer among Iranian men. We studied survival rates and prognostic factors of stomach cancer in a referral hospital in Tehran, Iran.
  
  
  METHODS
  We followed 367 stomach cancer patients hospitalized between 1991 and 2007 in the Baqyiatallah Hospital. We estimated survival rates overall and among operable patients exclusively. Hazard ratios (HR) for the different prognostic factors were estimated with the Cox regression model. Furthermore, we studied international variations in stage distribution and 5 year survival for stomach cancer.
  
  
  RESULTS
  Overall, 5 year survival of stomach cancer was low (14%), and the majority of patients (53%) were diagnosed at stage IV. Stage, tumor size, age, and gender were statistically significant prognostic factors. Relative risk of mortality in stage IV compared to stage IA was 9.9 (95% confidence interval 5.8-16.9). The highest 5 year survival was reported from Japan, particularly among screening detected patients (89.4%). Among operable patients, 5 year survival was 32.6% in France, 26% in the USA, and 30.5% in China, which was close to the rates estimated in our study (24%).
  
  
  CONCLUSIONS
  Due to stomach cancer being frequently diagnosed in advanced stages, its prognosis is poor in Iran. Early diagnosis and downstaging strategies need to be prioritized to improve the prognosis of stomach cancer.
authors: Baqyiatallah Research Center for Gastroenterology and Liver Diseases, Department of Internal Medicine, Baqyiatallah University of Medical Sciences, Tehran, Iran.
authors: Hossein
authors: H
authors: Khedmat
authors: Mohammad
authors: M
authors: Panahian
authors: Mehrdad
authors: M
authors: Mashahdian
authors: Mojtaba Vand
authors: MV
authors: Rajabpour
authors: Kazem
authors: K
authors: Zendehdel
mesh_terms: D005260:Female; D006801:Humans; D038622:Internationality; D007492:Iran / Q000453:epidemiology; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011379:Prognosis; D016016:Proportional Hazards Models; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D018570:Risk Assessment; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality*; D016019:Survival Analysis; D015996:Survival Rate