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What Factors Influence Survival in Gastric Adenocarcinoma?

Summary and Comment |
January 9, 2014

What Factors Influence Survival in Gastric Adenocarcinoma?

  1. David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)

In Taiwan, tumor location in the cardia and male sex were each associated with reduced life expectancy.

  1. David J. Bjorkman, MD, MSPH (HSA), SM (Epid.)

Gastric adenocarcinoma is a common cause of death, particularly in Asian countries. Factors that predict survival are not well defined.

Delving into this issue, researchers used national cancer and mortality registry data in Taiwan to identify 35,576 patients (23,173 men and 12,403 women) who received gastric cancer diagnoses between 1998 and 2007. Researchers predicted lifetime survival using an estimated regression line of the survival curves based on data through 2010. They compared life expectancy (LE) and expected years of life lost (EYLL) based on sex, tumor type, and location.

Cumulative incidence of gastric cancer was higher in men than in women. Of all cancers diagnosed, 88.6% were adenocarcinomas. Tumor location in the cardia was associated with shorter LE and greater EYLL than other locations. Cancers were diagnosed at an earlier age in women, who had longer LE but greater EYLL compared with men. Assuming that 90% of adenocarcinomas diagnosed and treated at an early stage can be cured, researchers estimated that early detection would increase life expectancy for both women (2.62 years/case) and men (1.97 years/case).

Comment

This study has several methodological weaknesses. No data from controls are included. Lifetime survival was estimated using a statistical model based on the survival seen in the database. As such, conclusions may not be generalizable to other countries. Also, the estimation of years of life saved with early cancer detection was based on the assumption that 90% of early gastric cancers are cured, which may not be true in other settings.

  • Disclosures for David J. Bjorkman, MD, MSPH (HSA), SM (Epid.) at time of publication Leadership positions in professional societies World Gastroenterology Organization (Treasurer)

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