Table 4.
Prognostic factors for overall and cancer specific survival in patients underwent surgery for stage IV gastric cancer.
| Variable | Overall survival | Cancer-specific survival | ||||||
|---|---|---|---|---|---|---|---|---|
| Univariate | Multivariariate* n = 1839 | Univariate | Multivariate* n = 1805 | |||||
| HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | HR (95% CI) | p | |
| Year of diagnosis | ||||||||
| 2004–2006 | Reference | Reference | Reference | |||||
| 2007–2010 | 0.88 (0.79–0.98) | 0.026 | 0.86 (0.77–0.96) | 0.010 | 0.95 (0.84–1.07) | 0.366 | ||
| 2011–2015 | 0.77 (0.68–0.87) | < 0.001 | 0.73 (0.64–0.83) | < 0.001 | 0.82 (0.71–0.94) | 0.004 | ||
| Sex | ||||||||
| Male | Reference | Reference | ||||||
| Female | 1.03 (0.94–1.13) | 0.512 | 1.05 (0.95–1.16) | 0.308 | ||||
| Age | ||||||||
| < 65 | Reference | Reference | Reference | |||||
| ≥ 65 | 1.26 (1.14–1.38) | < 0.001 | 1.15 (1.03–1.27) | 0.01 | 1.21 (1.09–1.33) | < 0.001 | ||
| Race | ||||||||
| White | Reference | Reference | ||||||
| Black | 0.91 (0.8–1.04) | 0.175 | 0.87 (0.75–1) | 0.053 | ||||
| Other | 0.89 (0.79–1) | 0.064 | 0.9 (0.8–1.02) | 0.092 | ||||
| Marital status | ||||||||
| Unmarried | Reference | Reference | ||||||
| Married | 0.94 (0.85–1.04) | 0.21 | 0.95 (0.86–1.06) | 0.951 | ||||
| Insurance status | ||||||||
| Insured | Reference | Reference | ||||||
| Uninsured | 1.14 (1.03–1.25) | 0.009 | 1.18 (1.07–1.30) | 0.001 | ||||
| Performance status | ||||||||
| Good | Reference | < 0.001 | Reference | |||||
| Poor | 1.35 (1.24–1.5) | 1.32 (1.19–1.47) | < 0.001 | |||||
| Complicated disease | ||||||||
| No | Reference | Reference | Reference | Reference | ||||
| Yes | 1.25 (1.14–1.38) | < 0.001 | 1.14 (1.03–1.27) | 0.014 | 1.27 (1.15–1.4) | < 0.001 | 1.14 (102–1.27) | 0.022 |
| Site of tumor | ||||||||
| Fundus-Body | Reference | Reference | Reference | Reference | ||||
| Antrum-Pylorus | 1.13 (0.97–1.31) | 0.111 | 1.13 (0.97–1.32) | 0.1 | 1.12 (0.97–1.3) | 0.163 | 1.13 (0.96–1.32) | 0.143 |
| Overlapping lesion of the stomach | 1.40 (1.18–1.68) | < 0.001 | 1.32 (1.1–1.59) | 0.003 | 1.4 (1.17–1.67) | < 0.001 | 1.3 (1.08–1.57) | 0.005 |
| Stomach, NOS | 1.21 (1.04–1.41) | 0.012 | 1.16 (0.99–1.35) | 0.073 | 1.2 (1.02–1.4) | 0.024 | 1.14 (0.97–1.35) | 0.114 |
| Histology | ||||||||
| Adenocarcinoma/Carcinoma, NOS | Reference | Reference | ||||||
| Signet ring cell adenocarcinoma | 1.17 (1.04–1.32) | 0.008 | 1.19 (1.05–1.34) | 0.006 | ||||
| Linitis plastica | 1.53 (1.09–2.12) | 0.013 | 1.33 (0.98–1.99) | 0.067 | ||||
| Adenocarcinoma, intestinal type | 0.91 (0.78–1.06) | 0.233 | 0.89 (0.75–1.05) | 0.158 | ||||
| Adenocarcinoma, diffuse type | 0.98 (0.81–1.18) | 0.818 | 1.01 (0.84–1.23) | 0.883 | ||||
| Other | 0.88 (0.74–1.05) | 0.158 | 0.89 (0.74–1.06) | 0.200 | ||||
| T stage, 8th ed | ||||||||
| Tx | Reference | Reference | ||||||
| T1-2 | 0.60 (0.41–0.87) | 0.007 | 0.57 (0.39–0.84) | 0.005 | ||||
| T3-4 | 1.12 (0.82–1.54) | 0.464 | 1.14 (0.82–1.58) | 0.435 | ||||
| N stage, 8th ed | ||||||||
| N0 | Reference | Reference | Reference | Reference | ||||
| N1-2 | 1.23 (1.05–1.43) | 0.009 | 1.23 (1.04–1.45) | 0.016 | 1.23 (1.05–1.44) | 0.012 | 1.21 (1.02–1.45) | 0.03 |
| N3 | 1.56 (1.33–1.81) | < 0.001 | 1.72 (1.44–2.05) | < 0.001 | 1.58 (1.35–1.85) | < 0.001 | 1.7 (1.42–2.05) | < 0.001 |
| Nx | 1.79 (1.33–2.42) | < 0.001 | 1.52 (1.08–2.15) | 0.018 | 1.88 (1.38–2.55) | < 0.001 | 1.55 (1.08–2.21) | 0.017 |
| Grade | ||||||||
| Well/Moderate differentiated | Reference | Reference | Reference | < 0.001 | Reference | |||
| Poorly/Undifferentiated | 1.36 (1.2–1.55) | < 0.001 | 1.39 (1.21–1.59) | < 0.001 | 1.41 (1.23–1.61) | 1.38 (1.2–1.58) | < 0.001 | |
| Metastatic spread | ||||||||
| Distant lymphnodes | Reference | Reference | Reference | Reference | ||||
| Distant metastases | 1.41 (1.22–1.62) | < 0.001 | 1.38 (1.19–1.6) | < 0.001 | 1.44 (1.24–1.67) | < 0.001 | 1.48 (1.24–1.69) | < 0.001 |
| Distant lymphnodes + metastases | 1.63 (1.32–2.01) | < 0.001 | 1.55 (1.28–1.93) | < 0.001 | 1.64 (1.32–2.04) | < 0.001 | 1.54 (1.23–1.94) | < 0.001 |
| Type of gastrectomy | ||||||||
| Partial | Reference | Reference | ||||||
| Total (near total) | 1.04 (0.94–1.16) | 0.468 | 1.03 (0.92–1.15) | 0.615 | ||||
| Number of retrieved lymphnodes | ||||||||
| ≤ 15 | Reference | Reference | Reference | Reference | ||||
| > 15 | 0.82 (0.75–0.9) | < 0.001 | 0.70 (0.63–0.79) | < 0.001 | 0.83 (0.75–0.92) | < 0.001 | 0.71 (0.64–0.80) | < 0.001 |
| Radical intent | ||||||||
| No | Reference | Reference | ||||||
| Yes | 0.86 (0.78–0.94) | 0.002 | 0.87 (0.78–0.96) | 0.005 | ||||
| Type of surgery | ||||||||
| Gastrectomy alone | Reference | Reference | Reference | Reference | ||||
| Primary gastrectomy | 0.6 (0.55–0.67) | < 0.001 | 0.6 (0.54–0.66) | < 0.001 | 0.61 (0.55–0.68) | < 0.001 | 0.59 (0.52–0.65) | < 0.001 |
| Secondary gastrectomy | 0.49 (0.41–0.59) | < 0.001 | 0.5 (0.41–0.61) | < 0.001 | 0.5 (0.42–0. 61) | < 0.001 | 0.53 (0.43–0.65) | < 0.001 |
Statistically significant p values are given in bold
NOS Not otherwise specified.
*Forward selection model.