Abstract
Background/Aims
Methods
Results
Conclusions
References
Table 1.
Characteristics Mean age (yr) | Age<65 (n=205) No. (%)51.8±9.2 | Age≥65 (n=165) No. (%) 72.9±5.7 | p-value | |
---|---|---|---|---|
Gender | Male | 135 (65.9) | 82 (49.7) | 0.002 |
Female | 70 (34.1) | 83 (50.3) | ||
Chief complaint | Screening | 32(15.6) | (9.1)15 | 0.062 |
Advanced cancer | (34.4)11/32 | (53.3)8/15 | 0.217 | |
III, IV | (21.9)7/32 | (26.7)4/15 | 0.718 | |
Abdominal pain | 113 (55.1) | 84 (50.9) | 0.419 | |
Dyspepsia | 31 (15.1) | 29 (17.6) | 0.524 | |
Bleeding a | 17 (8.3) | 17 (10.3) | 0.506 | |
Others b | 39 (19.0) | 53 (32.1) | 0.004 | |
ASA | I | 109 (53.2) | 54 (32.7) | <0.001 |
II | 89 (43.4) | 94 (57.0) | ||
III | 7 (3.4) | 17 (10.3) | ||
Associated disease | Hypertension | 31 (15.6) | 51 (30.9) | <0.001 |
Diabetes mellitus | 25 (12.2) | 28 (17.0) | 0.193 | |
Cardiac disease c | 8 (3.9) | 16 (9.7) | 0.024 | |
Pulmonary disease d | 7 (3.4) | 10 (6.1) | 0.227 | |
Liver disease e | 8 (3.9) | 6 (3.6) | 0.894 | |
Neurologic disease f | 4 (2.0) | 6 (3.6) | 0.324 | |
Chronic renal failure g | 2 (1.0) | 1 (0.6) | 0.808 | |
Other diseases h | 2 (1.0) | 2 (1.2) | 0.827 | |
Family history of gastric cancer | 10 (4.9) | 4 (2.4) | 0.230 | |
Tumor marker | CEA ≤5 ng/mL | 162/192 (84.4) | 131/161 (81.4) | 0.455 |
>5 ng/mL | 30/192 (15.6) | 30/161 (18.6) | ||
CA 19-9 ≤27 U/mL | 160/188 (85.1) | 117/154 (76.0) | 0.032 | |
>27 U/mL | 28/188 (14.9) | 37/154 (24.0) | ||
Gross feature | Early cancer | 82 (40.0) | 47 (28.5) | 0.021 |
Advanced cancer | 123 (60.0) | 118 (71.5) | ||
Tumor location | Upper third | 19 (9.3) | 14 (8.5) | 0.094 |
Middle third | 83 (40.5) | 48 (29.1) | ||
Lower third | 97 (47.3) | 96 (58.2) | ||
Whole | 6 (2.9) | 7 (4.2) | ||
No. of tumor | 1 | 200(97.6) | (95.8)158 | 0.330 |
≥2 | 5(2.4) | (4.2)7 | ||
WHO classification | Well-differentiated | 30 (14.6) | 31 (18.8) | 0.021 |
Moderately-differentiated | 76 (37.1) | 67 (40.6) | 0.450 | |
Poorly-differentiated | 65 (31.7) | 46 (27.9) | 0.478 | |
Mucinous adenocarcinoma | 2 (1.0) | 1 (0.6) | 0.878 | |
Signet ring cell | 32 (15.6) | 20 (12.1) | 0.486 | |
TNM stage | I | 89 (43.4) | 53 (32.2) | 0.092 |
II | 21 (10.2) | 16 (9.7) | ||
III | 47 (23.0) | 41 (24.8) | ||
IV | 48 (23.4) | 55 (33.3) | ||
Treatment modality | Surgery group | 180 (87.8) | 121 (73.3) | 0.001 |
Conservative group | 25 (12.2) | 44 (26.7) |
ASA, American Society of Anesthesiologists; WHO classification, World Health Organization classification; TNM stage, tumor-node-metastasis stage.
c Heart failure; arrhythmia; valvular disease; coronary heart disease; old myocardial infarction; pericardial effusion.
d Pneumonia; pulmonary tuberculosis; emphysema; asthma; chronic obstructive pulmonary disease; pleural effusion.
Table 2.
Age<65 (n=180) No. (%) | Age≥65 (n=121) No. (%) | p-value | ||
---|---|---|---|---|
Clinical characteristics | ||||
Preoperative ASA | I | 89 (49.4) | 23 (19.0) | <0.001 |
II | 84 (46.7) | 84 (69.4) | ||
III | 7 (3.9) | 14 (11.6) | ||
Associated disease | Hypertension | 28 (15.6) | 38 (31.4) | 0.001 |
Diabetes mellitus | 21 (11.7) | 21 (17.4) | 0.164 | |
Cardiac disease a | 8 (4.4) | 9 (7.4) | 0.271 | |
Pulmonary disease b | 7 (3.9) | 5 (4.1) | 0.916 | |
Liver disease c | 6 (3.3) | 4 (3.3) | 0.990 | |
Neurologic disease d | 3 (1.7) | 2 (1.7) | 0.993 | |
Chronic renal failure e | 2 (1.1) | 1 (0.8) | 0.808 | |
Other diseases f | 2 (1.1) | 2 (1.7) | 0.689 | |
No. of associated disease | 0 | 122 (67.8) | 63 (52.1) | 0.019 |
1 | 44 (24.4) | 37 (30.5) | ||
2 | 11 (6.1) | 18 (14.9) | ||
≥3 | 3 (1.7) | 3 (2.5) | ||
Pathologic characteristics | ||||
Tumor location | Upper third | 16 (8.9) | 6 (5.0) | 0.030 |
Middle third | 74 (41.1) | 36 (29.7) | ||
Lower third | 88 (48.9) | 74 (61.2) | ||
Whole | 2 (1.1) | 5 (4.1) | ||
Tumor size ≥5 cm | 43 (23.9) | 40 (33.1) | 0.081 | |
No. of tumor | 1 | 177 (98.3) | 116 (95.9) | 0.193 |
≥2 | 3 (1.7) | 5 (4.1) | ||
N staging | N0 | 96 (53.3) | 56 (46.3) | 0.232 |
N1-N3 | 84 (46.7) | 65 (53.7) | ||
TNM stage | I | 88 (48.9) | 49 (40.5) | 0.070 |
II | 20 (11.1) | 11 (9.0) | ||
III | 46 (25.6) | 36 (29.8) | ||
IV | 26 (14.4) | 25 (20.7) | ||
Mode of operation and postoperative complications | ||||
Laparoscopic surgery | 43 (23.9) | 17 (14.0) | 0.036 | |
Lymph node dissection | D1 | (5.0)9 | 6(5.0) | |
D2 | (90.6)163 | 107(88.4) | 0.713 | |
D3 | 8(4.4) | 8(6.6) | ||
Associated resection | 14 (7.8) | 16 (13.2) | 0.123 | |
Postoperative complications | 12(6.7) | 12(9.9) | 0.309 | |
Surgically related | 10(5.6) | 10(8.2) | ||
Leakage | 2(1.1) | (1.7)2 | 0.687 | |
Abscess | 2(1.1) | (1.7)2 | 0.687 | |
Bleeding | 3(1.7) | (2.5)3 | 0.621 | |
Ileus | 1(1.0) | (0.0)0 | 0.411 | |
Wound problem | 2(1.1) | (3.3)4 | 0.182 | |
Nonsurgically related | 2(1.1) | (1.7)2 | ||
Mortality | 1(1.0) | (1.7)2 | 0.852 | |
Postoperative hospital stay (days) | 14.7±9.8 | 15.8±10.6 | 0.361 | |
Operation time (min) | 257.3±83.8 | 242.6±70.7 | 0.115 |
ASA, American Society of Anesthesiologists; D, Lymph node dissection; TNM stage, tumor-node-metastasis stage.
a Heart failure; arrhythmia; valvular disease; coronary heart disease; old myocardial infarction; pericardial effusion.
b Pneumonia; pulmonary tuberculosis; emphysema; asthma; chronic obstructive pulmonary disease; pleural effusion.
Table 3.
No. of patients (total=301) |
Univariate analysis |
Multivariate analysis |
|||||
---|---|---|---|---|---|---|---|
OS (mo) Median | HR (95% CI) | p-value | HR a (95% CI) | p-value | |||
Demographic featur | res | ||||||
Age (yr) | <65 | 180 | 77 | 1.00 | 0.009 | - | NS |
≥65 | 121 | 62 | 1.60 (1.12-2.29) | - | |||
Gender | Male | 181 | 72 | 1.00 | 0.367 | ||
Female | 120 | 72 | 0.84 (0.58-1.22) | ||||
ASA | I | 112 | 72 | 1.00 | 0.273 | ||
II | 168 | 71 | 1.01 (0.76-1.53) | ||||
III | 21 | 45 | 1.15 (0.85-1.56) | ||||
CEA (ng/mL) | ≤5 | 251 | 74 | 1.00 | <0.001 | 1.00 | <0.001 |
>5 | 34 | 19 | 2.64 (1.67-4.17) | 1.59 (1.00-2.53) | |||
CA19-9 (U/mL) | ≤27 | 237 | 75 | 1.00 | 0.003 | - | NS |
>27 | 42 | 22 | 1.33 (1.02-1.72) | - | |||
Associated disease | Hypertension No | 235 | 75 | 1.00 | 0.075 | ||
Yes | 66 | 51 | 1.43 (0.95-2.17) | ||||
Diabetes mellitus No | 259 | 72 | 1.00 | 0.832 | |||
Yes | 42 | 66 | 1.02 (0.60-1.76) | ||||
Cardiac disease No | 284 | 72 | 1.00 | 0.251 | |||
Yes | 17 | 71 | 1.36 (0.67-2.77) | ||||
Pulmonary disease No | 289 | 72 | 1.00 | 0.406 | |||
Yes | 12 | 39 | 1.36 (0.58-3.22) | ||||
Liver disease No | 291 | 72 | 1.00 | 0.352 | |||
Yes | 10 | 32 | 1.38 (0.54-3.53) | ||||
Neurologic disease No | 296 | 72 | 1.00 | 0.413 | |||
Yes | 5 | 31 | 1.37 (0.41-4.54) | ||||
Characteristics of gastric cancer | |||||||
Tumor location | Upper third | 22 | 55 | 1.00 | 0.001 | - | NS |
Middle third | 110 | 75 | 1.29 (0.61-2.74) | - | |||
Lower third | 162 | 67 | 1.30 (0.62-2.70) | - | |||
Whole | 7 | 12 | 2.65 (0.91-7.72) | - | |||
WHO classification | Well-differentiated | 44 | 84 | 1.00 | 0.106 | - | NS |
Moderately-differentiated | 115 | 72 | 1.81 (0.91-3.59) | - | |||
Poorly-differentiated | 84 | 40 | 2.75 (1.38-5.46) | - | |||
Signet ring cell | 42 | 70 | 2.00 (0.92-4.34) | - | |||
TNM stage | I | 137 | 85 | 1.00 | <0.001 | 1.00 | <0.001 |
II | 31 | 84 | 0.77 (0.22-2.72) | 1.28 (0.38-3.45) | |||
III | 82 | 38 | 3.77 (1.93-7.36) | 5.90 (3.37-10.35) | |||
IV | 51 | 14 1 | 13.65 (6.96-26.74 | 4) | 21.77 (12.18-33.41) | ||
Operation method | Laparoscopy | 60 | 88 | 1.00 | <0.001 | - | NS |
Open surgery | 241 | 62 | 2.95 (1.85-10.25) | - |
Table 4.
No. of patients (total=165) |
Univariate analysis |
Multivariate analysis |
||||||
---|---|---|---|---|---|---|---|---|
OS (mo) Median | HR (95% CI) | p-value | HR a (95% CI) | p-value | ||||
Demographic features | ||||||||
Age (yr) | 65-69 | 56 | 41 | 1.00 | 0.044 | - | NS | |
70-74 | 50 | 33 | 1.63 (0.95-2.89) | - | ||||
≥75 | 59 | 29 | 1.91 (1.14-3.21) | - | ||||
Gender | Male | 82 | 34 | 1.00 | 0.925 | |||
Female | 83 | 30 | 0.99 (0.65-1.49) | |||||
ASA | 1 | 75 | 60 | 1.00 | 0.118 | |||
2 | 73 | 20 | 1.33 (0.86-2.07) | |||||
3 | 17 | 36 | 1.17 (0.58-2.34) | |||||
CEA (ng/mL) | ≤5 | 131 | 60 | 1.00 | <0.001 | 1.00 | <0.001 | |
>5 | 30 | 7 | 2.62 (1.63-4.20) | 1.59 (1.00-2.53) | ||||
CA19-9 (U/mL) | ≤27 | 117 | 54 | 1.00 | 0.001 | - | NS | |
>27 | 37 | 9 | 2.05 (1.30-3.25) | - | ||||
Associated diseas | Hypertension | No | 114 | 38 | 1.00 | 0.305 | ||
Yes | 51 | 51 | 1.18 (0.78-1.80) | |||||
Diabetes mellitus | No | 137 | 33 | 1.00 | 0.997 | |||
Yes | 28 | 28 | 0.92 (0.53-1.62) | |||||
Cardiac disease | No | 149 | 36 | 1.00 | 0.096 | |||
Yes | 16 | 17 | 1.50 (0.81-2.77) | |||||
Pulmonary disease | No | 155 | 35 | 1.00 | 0.010 | - | NS | |
Yes | 10 | 5 | 2.14 (1.04-4.41) | - | ||||
Liver disease | No | 159 | 33 | 1.00 | 0.816 | |||
Yes | 6 | 30 | 0.73 (0.22-2.75) | |||||
Neurologic disease | No | 159 | 34 | 1.00 | 0.562 | |||
Yes | 6 | 10 | 1.55 (0.54-4.49) | |||||
Characteristics of | gastric cancer | |||||||
Tumor location | Upper third | 96 | 45 | 1.00 | 0.102 | - | NS | |
Middle third | 48 | 30 | 1.28 (0.83-2.00) | - | ||||
Lower third | 14 | 18 | 1.64 (0.83-3.23) | - | ||||
Whole | 7 | 12 | 2.36 (1.01-5.52) | - | ||||
WHO classification | Well-differentiated | 25 | 78 | 1.00 | 0.001 | - | NS | |
Moderately-different | 71 | 24 | 3.32 (1.50-7.37) | - | ||||
Poorly-differentiated | 45 | 26 | 4.11 (1.81-9.34) | - | ||||
Signet ring cell | 19 | 19 | 4.12 (1.64-10.35) | ) | - | |||
TNM stage | I | 54 | 72 | 1.00 | <0.001 | 1.00 | <0.001 | |
II | 16 | 66 | 2.49 (1.06-5.83) | 1.28 (0.44-3.72) | ||||
III | 47 | 28 | 4.32 (2.26-8.26) | 4.06 (2.08-7.92) | ||||
IV | 48 | 6 | 13.48 (7.04-25.80) | 9.78 (4.97-19.26) | ||||
Treatment modality | Surgery group | 121 | 94 | 1.00 | <0.001 | 1.00 | <0.001 | |
Conservative group | 44 | 5 | 4.86 (3.15-7.47) | 3.90 (2.43-6.26) |