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. 2012 Jun 21:12:264.
doi: 10.1186/1471-2407-12-264.

Survival in patients with stage IV noncardia gastric cancer - the influence of DNA ploidy and Helicobacter pylori infection

John Syrios  1 , Stavros Sougioultzis, Ioannis D Xynos, Nikolaos Kavantzas, Christos Kosmas, George Agrogiannis, John Griniatsos, Ioannis Karavokyros, Emmanouil Pikoulis, Efstratios S Patsouris, Nikolas Tsavaris
Affiliations

Survival in patients with stage IV noncardia gastric cancer - the influence of DNA ploidy and Helicobacter pylori infection

John Syrios et al. BMC Cancer. .

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 < 0.001), and DNA Index as assessed by Image cytometry (2.2-3.6 vs. >3.6 HR 3.059; CI 2.185-4.283, p < 0.001 and <2.2 vs. >3.6 HR; 4.207 CI 2.751-6.433 <0.001). HP infection had no statistically significant effect on survival by either univariate or multivariate analysis.

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.

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Figures

Figure 1
Figure 1
Overall Survival.
Figure 2
Figure 2
Overall Survival according to Performance Status.
Figure 3
Figure 3
Overall Survival according to Liver metastasis.
Figure 4
Figure 4
Overall Survival according to DNA Index.
See this image and copyright information in PMC

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