BMC Cancer (Jun 2012)

Survival in patients with stage IV noncardia gastric cancer - the influence of DNA ploidy and <it>Helicobacter Pylori</it> infection

  • Syrios John,
  • Sougioultzis Stavros,
  • Xynos Ioannis D,
  • Kavantzas Nikolaos,
  • Kosmas Christos,
  • Agrogiannis George,
  • Griniatsos John,
  • Karavokyros Ioannis,
  • Pikoulis Emmanouil,
  • Patsouris Efstratios S,
  • Tsavaris Nikolas

DOI
https://doi.org/10.1186/1471-2407-12-264
Journal volume & issue
Vol. 12, no. 1
p. 264

Abstract

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Abstract 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 vs. >3.6 HR 3.059; CI 2.185-4.283, p vs. >3.6 HR; 4.207 CI 2.751-6.433 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.