Predictors of outcome after surgery for gastric cancer in a Western cohort (#259)
Background and Aims: 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 using an Australian context. This study examines the clinical, surgical and histopathological variables associated with survival in a GC cohort from a predominantly European-based population in Australia, and compares these to known prognostic variables.
Methods: A cohort of patients undergoing curative resection for GC enrolled in an ongoing tissue bank study from 1999-2009 was analysed. Prospectively collected demographic, surgical and pathological variables were available for this cohort. The primary endpoints investigated were cancer specific overall survival (CS) and recurrence free survival (RFS) using multivariate cox-proportional hazards modelling.
Results. Overall five-year CS was 45.9%, five-year RFS was 44.7%, and 30-day mortality was 2.2%. Variables showing significance on multivariate analysis for CS and RFS were AJCC stage, Lauren classification, and age. Five-year overall survival (OS) was 39.7%. The poorer OS seen in this cohort relative to some international cohorts may reflect lower rates of D2 resection and lymph node sampling. The difference in survival seen by Lauren classification in this cohort adds further evidence to this being an important prognostic factor in GC.
Conclusion. This study demonstrates that the prognostic variables for a predominantly Western GC population are congruent with published prognostic features of GC. These findings emphasise the importance of the pathological review as well as the surgical procedure in allocating prognosis in GC.