Predictors of outcome after surgery for gastric cancer in a Western cohort.
BACKGROUND
Gastric cancer (GC) is a common cause of cancer mortality. There are well-documented prognostic factors for GC but these have not been rigorously examined in an Australian context. This study examines the clinical, surgical and histopathological variables associated with survival in a GC cohort from a predominantly Caucasian-based population.


METHODS
A multi-centre cohort of patients undergoing curative resection for GC enrolled in an ongoing tissue bank study from 1999 to 2009 was retrospectively analysed. Prospectively collected demographic, surgical and pathological variables were available for this cohort. The primary endpoints investigated were cancer-specific survival and recurrence-free survival using multivariate Cox proportional hazard modelling.


RESULTS
Five-year cancer-specific survival was 45.9%, 5-year relapse-free survival was 44.7% and 30-day mortality was 2.2%. Variables showing significance on multivariate analysis for cancer-specific and relapse-free survival were AJCC stage, Lauren classification and age at surgery.


CONCLUSIONS
This study demonstrates that the prognostic variables for a predominantly Caucasian GC population are congruent with published prognostic features. These findings emphasize the importance of the pathological review in allocating prognosis in GC.
Cancer Genetics and Genomics Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.|Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
Sharon
S
Pattison
Department of Surgery, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
G Bruce
GB
Mann
Department of Surgery, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
Gary
G
Crosthwaite
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Stephen
S
Lade
Department of Pathology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Catherine
C
Mitchell
Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Radiation Oncology, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Trevor
T
Leong
Cancer Genetics and Genomics Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.|Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.
Rita A
RA
Busuttil
Cancer Genetics and Genomics Laboratory, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.|Sir Peter MacCallum Department of Oncology, The University of Melbourne, Melbourne, Victoria, Australia.|Department of Medicine, Royal Melbourne Hospital, The University of Melbourne, Melbourne, Victoria, Australia.|Cancer Genomics and Predictive Medicine, Peter MacCallum Cancer Centre, Melbourne, Victoria, Australia.
Alex
A
Boussioutas
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D014739:Victoria / Q000453:epidemiology
Lauren classification; gastric cancer; multivariate analysis; relapse-free survival; stage; survival