Cancer Medicine (Feb 2023)
Predictors of survival outcomes among patients with gastric cancer in a leading tertiary, teaching and referral hospital in Kenya
Abstract
Abstract Introduction The incidence of gastrointestinal malignancies in Kenya is increasing, although there is a paucity of data on survival outcomes among gastric cancer patients. Hence, this study aimed to assess survival outcomes among adult gastric cancer patients at Kenyatta National Hospital. Methods A retrospective cohort study design was used to assess the survival outcomes among 247 gastric cancer patients. All medical records of adult (≥18 years) gastric cancer patients with complete medical records of diagnosis, stage of cancer, and treatment regimen in the study setting in the last 5 years (2016–2020) were included. A simple random sampling technique was employed to select the study participants. Data were collected using a data abstraction tool composed of socio‐demographic and clinical characteristics. Survival outcomes were reported as the percentage of mortality, mean survival estimate, and mean cancer‐specific survival. The data were entered and analyzed using version 20.0 SPSS statistical software. The mean survival estimates and predictors of mortality were computed using the Kaplan–Meier and Cox regression analysis. Results The study showed that 33.3% (64) had new distant metastasis, and 42.1% (104) had disease progression. Besides, the mortality rate was high (33.6%), and 14.6% and 7.7% of patients had complete and partial responses, respectively. The five‐year survival was 32.7% among gastric cancer patients. Comorbidity (p = 0.014), advanced‐stage diseases (p = 0.03), chemotherapy (p = 0.008), and gastrectomy (p = 0.016) were significant determinants of mortality. Conclusions A significant proportion of patients had distant metastasis, disease progression, and a low five‐year survival rate. Hence, early cancer‐screening programs are indispensable to circumvent disease progression and improve survival outcomes.
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