Gastroenterol Res

Gastroenterology Research, ISSN 1918-2805 print, 1918-2813 online, Open Access

Article copyright, the authors; Journal compilation copyright, Gastroenterol Res and Elmer Press Inc

Journal website http://www.gastrores.org

Original Article

Volume 2, Number 6, December 2009, pages 317-323

Prognostic Factors of Patients With Transmural Advanced Gastric Carcinoma

Figure 1. Overall survival curve of the patients with transmural gastric carcinoma calculated by the method of Kaplan-Meier.

Figure 2. Survival according to nodal involvement. The survival rate for the patients with pN2 lymph node metastases was lower than the rate for pN1 and pN0 cases. (P = 0.0400, log-rank test).

Figure 3. Survival according to lymph vessel invasion. The survival rate for patients with lymph vessel invasion was lower than the rate for the patients without lymph vessel invasion. (P = 0.0003, log-rank test).

Figure 4. Survival according to blood transfusion. Survival rate for the patients that received blood transfusions more than or equal to 500 ml was lower than the rate for the patients that received less than 500 ml. (P = 0.0166, log-rank test).

Figure 5. Survival according to lymph node ratio. Survival rate for patients with a lymph node ratio greater than or equal to 0.2 was lower then the rate for those with a lymph node ratio less than 0.2. (P = 0.0012, log-rank test).

**Table 1.** Univariate Analysis of The Prognostic Factors In Patients With Transmural Gastric Cancer
Parameters	No. of patients		95% Confidence	Survival rate (%)	P†
SE: Standard error, P *: Log-rank test, P†: Chi-square test, NS: Not significant
Age (years)				NS				NS
≤65	30	25.0 ± 7.25	27.88 – 48.77		52	40	20
>65	15	16.0 ± 9.02	0 – 33.67		39	13	13
Gender				NS				NS
Male	27	21.0 ± 3.44	14.25 – 27.75		44	25	25
Female	18	27.0 ± 7.80	11.70 – 42.30		53	41	0
Tumor location				NS				NS
Cardia	9	30.0 ± 7.28	15.73 – 44.27		49	32	0
Corpus	11	18.0 ± 3.48	11.17 – 24.83		35	35	35
Antrum	22	24.0 ± 3.03	18.07 – 29.93		55	35	35
Diffuse	3	0	0		-	-	-
Tumor size (cm)				NS				NS
>10 in diameter	24	24.0 ± 5.30	13.61 – 34.39		54	36	18
≤10 in diameter	21	21.0 ± 2.28	16.53 – 25.47		43	28	28
Depth of tumor invasion				NS				NS
pT2	11	62.0 ± 19.12	24.52 – 99.48		53	53	26
pT3	34	18.0 ± 5.38	7.45 – 28.55		46	26	18
Lymph node metastases				0.04				0.03
pN0	10	-	-		78	65	65
pN1	25	21.0 ± 2.38	16.33 – 25.67		37	27	13
pN2	10	16.0 ± 6.39	3.47 – 28.53		46	11	11
Stage				NS				NS
I B	3	-	-		100	100	100
II	16	21.0 ± 5.04	11.13 – 30.87		46	37	0
III A	17	18.0 ± 4.84	8.52 – 27.48		38	25	25
III B	9	24.0 ± 6.01	12.21 – 35.79		51	13	-
Grading				0.017				NS
G1	6	-	-		100	100	100
G2	6	21.0 ± 9.19	3.0 – 39.0		50	33	0
G3	33	18.0 ± 3.39	11.36 – 24.64		38	19	19
Type of Surgery				NS				NS
Subtotal gastrectomy	22	24.0 ± 3.03	18.07 – 29.93		55	35	35
Total gastrectomy	23	20.0 ± 3.16	13.81 – 26.19		41	28	0
Vascular invasion				NS				NS
Absent	26	25.0 ± 5.07	15.07 – 34.93		54	35	35
Present	19	21.0 ± 2.05	16.99 – 25.01		39	26	9
Lymph vessel invasion				0.0003				0.001
Absent	17	62.0 ± 22.96	17.0 – 107.0		80	64	22
Present	28	15.0 ± 2.55	10.01 – 19.99		29	12	12
Blood transfusions				0.0166				0.021
< 500 ml	27	27.0 ± 6.85	13.58 – 40.42		57	44	44
≥ 500 ml	18	16.0 ± 5.63	4.97 – 27.03		32	13	4
Lauren’s classification				NS				NS
Intestinal	16	25.0 ± 6.0	13.24 – 36.76		63	42	42
Diffuse	29	18.0 ± 3.62	10.90 – 25.10		39	25	8
Lymph node ratio				0.0012				0.006
LNR < 0.2	12	24.0 ± 2.45	19.19 – 28.81		52	34	20
LNR ≥ 0.2	33	5.0 ± 2.0	1.08 – 8.92		-	-	-
All patients	45	23.0 ± 2.51	18.07 – 27.93		48	31	19

Table 1. Univariate Analysis of The Prognostic Factors In Patients With Transmural Gastric Cancer

Parameters

No. of patients

95% Confidence

Survival rate (%)

P†

Median survival (month) ± SE

Interval

1-year

3-years

5-years

SE: Standard error, P *: Log-rank test, P†: Chi-square test, NS: Not significant

Age (years)

≤65

25.0 ± 7.25

27.88 – 48.77

>65

16.0 ± 9.02

0 – 33.67

Gender

Male

21.0 ± 3.44

14.25 – 27.75

Female

27.0 ± 7.80

11.70 – 42.30

Tumor location

Cardia

30.0 ± 7.28

15.73 – 44.27

Corpus

18.0 ± 3.48

11.17 – 24.83

Antrum

24.0 ± 3.03

18.07 – 29.93

Diffuse

Tumor size (cm)

>10 in diameter

24.0 ± 5.30

13.61 – 34.39

≤10 in diameter

21.0 ± 2.28

16.53 – 25.47

Depth of tumor invasion

pT2

62.0 ± 19.12

24.52 – 99.48

pT3

18.0 ± 5.38

7.45 – 28.55

Lymph node metastases

0.04

0.03

pN0

pN1

21.0 ± 2.38

16.33 – 25.67

pN2

16.0 ± 6.39

3.47 – 28.53

Stage

I B

100

21.0 ± 5.04

11.13 – 30.87

III A

18.0 ± 4.84

8.52 – 27.48

III B

24.0 ± 6.01

12.21 – 35.79

Grading

0.017

100

21.0 ± 9.19

3.0 – 39.0

18.0 ± 3.39

11.36 – 24.64

Type of Surgery

Subtotal gastrectomy

24.0 ± 3.03

18.07 – 29.93

Total gastrectomy

20.0 ± 3.16

13.81 – 26.19

Vascular invasion

Absent

25.0 ± 5.07

15.07 – 34.93

Present

21.0 ± 2.05

16.99 – 25.01

Lymph vessel invasion

0.0003

0.001

Absent

62.0 ± 22.96

17.0 – 107.0

Present

15.0 ± 2.55

10.01 – 19.99

Blood transfusions

0.0166

0.021

< 500 ml

27.0 ± 6.85

13.58 – 40.42

≥ 500 ml

16.0 ± 5.63

4.97 – 27.03

Lauren’s classification

Intestinal

25.0 ± 6.0

13.24 – 36.76

Diffuse

18.0 ± 3.62

10.90 – 25.10

Lymph node ratio

0.0012

0.006

LNR < 0.2

24.0 ± 2.45

19.19 – 28.81

LNR ≥ 0.2

5.0 ± 2.0

1.08 – 8.92

All patients

23.0 ± 2.51

18.07 – 27.93

**Table 2.** Multivariate Analysis of the Independent Prognostic Factors
Parameters	RR	95% CI	P
P: Cox’s proportional hazards model. CI: Confidence Interval. RR: Relative Risk.
Lymph node metastases
(pN1 vs pN0)	1.11	0.285 – 4.341	0.877
(pN2 vs pN0)	1.46	0.282 – 7.544	0.652
Lymph vessel invasion (Extensive vs not extensive)	1.39	0.444 – 4.379	0.559
Blood transfusions (≥ 500 ml vs < 500 ml)	1.01	0.433 – 2.362	0.979
Lymph node ratio (≥ 0.2 vs < 0.2)	4.47	1.168 – 17.117	0.029

Table 2. Multivariate Analysis of the Independent Prognostic Factors

Parameters

95% CI

P: Cox’s proportional hazards model. CI: Confidence Interval. RR: Relative Risk.

Lymph node metastases

(pN1 vs pN0)

1.11

0.285 – 4.341

0.877

(pN2 vs pN0)

1.46

0.282 – 7.544

0.652

Lymph vessel invasion (Extensive vs not extensive)

1.39

0.444 – 4.379

0.559

Blood transfusions (≥ 500 ml vs < 500 ml)

1.01

0.433 – 2.362

0.979

Lymph node ratio (≥ 0.2 vs < 0.2)

4.47

1.168 – 17.117

0.029