Objective To explore the influencing factors related to survival prognosis after surgery for progressive gastric cancer.
Methods A retrospective case series study was conducted, and 577 stage cⅡ-ⅣA gastric cancer patients undergoing radical gastrectomy were selected.The influence of clinical characteristic, surgical method, pathological feature, adjuvant chemotherapy, etc.on postoperative disease-free survival (DFS) and overall survival (OS) of patients was analyzed.
Results The the median DFS of 577 cases with progressive gastric cancer was 48 months, and the median OS was 53 months.Among the patients, 294 cases experienced metastasis and recurrence, 302 cases died, and 275 survived.Kaplan-Meier survival analysis showed that age, tumor site, tumor size, Borrmann classification, differentiation degree, lymph node metastasis, neurovascular invasion, infiltration depth, clinical stage, chemotherapy or not, chemotherapy cycle, positive human epidermal growth factor 2 (HER2) expression or not, and positive Ki-67 expression or not were related factors for the prognosis of gastric cancer, which were correlated with DFS and OS of gastric cancer (P < 0.05 to P < 0.01).Cox proportional hazards regression model analysis showed that Borrmann classification, lymph node metastasis, infiltration depth, chemotherapy cycle, HER2, and Ki-67 were independent prognostic factors for DFS (P < 0.05 to P < 0.01), while Borrmann classification, lymph node metastasis, infiltration depth, chemotherapy cycle, and HER2 were independent prognostic factors for OS (P < 0.05 to P < 0.01).The recurrence risk of positive HER2 and Ki-67 expression was 1.868 times and 1.665 times higher than that of negative HER2 and Ki-67 expression, respectively, and the death risk of positive HER2 expression was 1.832 times higher than that of negative HER2 expression.
Conclusions Surgical method, pathological feature and adjuvant chemotherapy have impacts on DFS and OS in progressive gastric cancer.
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