Περίληψη:
Background: Palliative surgery followed by postoperative chemotherapy is
a challenging approach in the treatment of stage IV gastric cancer yet
patients must be carefully selected on the basis of likely clinical
benefit.
Methods: The records of 218 patients with histological diagnosis of
gastric adenocarcinoma who underwent palliative surgery followed by
postoperative chemotherapy were retrospectively reviewed. Twelve
potential prognostic variables including tumour DNA index and serum IgG
anti-Helicobacter pylori (HP) antibodies were evaluated for their
influence on overall survival by multivariate analysis.
Results: The median survival was 13.25 months [95% Confidence
Interval (CI) 12.00, 14.50]. Three factors were found to have an
independent effect on survival: performance status (PS) [PS 60-70 vs.
90-100 Hazard Ratio (HR) 1.676; CI 1.171-2.398, p = 0.005], liver
metastases (HR 1.745; CI 1.318-2.310, p<0.001), and DNA Index as
assessed by Image cytometry (2.2-3.6 vs. >3.6 HR 3.059; CI 2.185-4.283,
p<0.001 and <2.2 vs. >3.6 HR; 4.207 CI 2.751-6.433 <0.001). HP infection
had no statistically significant effect on survival by either univariate
or multivariate analysis.
Conclusion: Poor pre-treatment PS, the presence of liver metastasis and
high DNA Index were identified factors associated with adverse survival
outcome in patients with Stage IV gastric cancer treated with palliative
gastrectomy and postoperative chemotherapy. HP infection had no
influence on survival of these patients.
Συγγραφείς:
Syrios, John
Sougioultzis, Stavros
Xynos, Ioannis D. and
Kavantzas, Nikolaos
Kosmas, Christos
Agrogiannis, George and
Griniatsos, John
Karavokyros, Ioannis
Pikoulis, Emmanouil and
Patsouris, Efstratios S.
Tsavaris, Nikolas
