title: Prognostic factors and outcomes in Italian patients undergoing curative gastric cancer surgery.
abstract: BACKGROUND
  Survival of patients after curative surgical resection for gastric cancer (GC) remains poor, thus emphasizing the need for better definition of prognostic factors to improve the long-term course of disease.
  
  
  METHODS
  From 1999 to 2009, 110 patients had curative-intent gastrectomy for adenocarcinoma. Clinicopathological features, Helicobacter pylori infection, dietary habits and lifestyle, and the presence of proinflammatory gene polymorphisms were evaluated.
  
  
  RESULTS
  At the end of follow-up, 55 deaths had occurred, 48 of them due to GC, whereas the median overall survival (OS) and disease-free survival (DFS) were 62 and 51 months, respectively. From the Kaplan-Meier analysis and log-rank test, statistically significant differences in OS and DFS were found for tumor site (only for DFS), tumor size, lymph node metastasis ratio (NR), and tumor-node-metastasis stage, but not for age, comorbidity, H. pylori infection, cigarette smoking, and IL1B or TNFA polymorphisms. Multivariable Cox regression analysis revealed NR was an independent prognostic factor for OS and DFS. Cardia tumor and patient age 65 years or older were also independent prognostic factors for OS and DFS.
  
  
  CONCLUSIONS
  Tumor-related factors remain strongest predictors of survival in GC patients after surgery. Particularly, NR was an effective feature in identifying patients at high risk for adverse outcome.
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy. Electronic address: bposteraro@rm.unicatt.it.
authors.forename: B
authors.initials: B
authors.lastname: Posteraro
authors.affiliation: Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: R
authors.initials: R
authors.lastname: Persiani
authors.affiliation: Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: V
authors.initials: V
authors.lastname: Dall'Armi
authors.affiliation: Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: A
authors.initials: A
authors.lastname: Biondi
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: Arzani
authors.affiliation: Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: F
authors.initials: F
authors.lastname: Sicoli
authors.affiliation: Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Bonassi
authors.affiliation: Department of Surgery, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: D
authors.initials: D
authors.lastname: D'Ugo
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy.
authors.forename: W
authors.initials: W
authors.lastname: Ricciardi
authors.affiliation: Department of Public Health, Università Cattolica del Sacro Cuore, Rome, Italy; Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Rome, Italy.
authors.forename: S
authors.initials: S
authors.lastname: Boccia
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality* / Q000556:secondary / Q000601:surgery*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007558:Italy; D053208:Kaplan-Meier Estimate; D008198:Lymph Nodes / Q000473:pathology* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018570:Risk Assessment; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: Disease-free survival; Gastric adenocarcinoma; Lymph node metastasis ratio; Overall survival; Tumor-related factors