Prognostic factors for survival in patients with gastric adenocarcinoma

Abstract

Background: Gastric cancer ranks as a leading cause of cancer deaths worldwide. Information of prognostic factors related to gastric cancer are limited. Aim: This study aimed to gather clinical data and prevalence of prognostic factors related to gastric adenocarcinoma in Thailand. Methods and results: This retrospective cohort study was conducted at Thammasat University Hospital, Thailand between January 2010 and July 2018. Gastric adenocarcinoma patients were enrolled and followed up for at least 5 years. Total of 210 gastric tumor patients were enrolled. One hundred patients were diagnosed with gastric adenocarcinomas (57 men and 43 women, mean age = 61.1 years). The leading presenting symptoms were weight loss (65%), followed by dyspepsia (54%) and UGI bleeding. Common clinical manifestations were thrombocytosis (26%), followed by syndrome of inappropriate antidiuretic hormone (SIADH; 15%). Eosinophilia was present in early cancer (25.0% vs 6.5%, P =.123), while SIADH and thrombocytosis were more common in advanced stages (16.3% vs 0%, P =.602, and 28.3% vs 0%, P =.108, respectively). SIADH was significantly related to reduced 1-year survival rate compared to normal serum sodium levels (21.4% vs 71.4%, OR 0.109, 95% CI 0.024-0.497, P =.004). Five-year survival rates were worse in patients with SIADH, but better in patients with eosinophilia compared to patients without these conditions (0% vs 27.8%, P =.058 and 20.0% vs 7.8%, P =.375, respectively). Conclusion: Thrombocytosis and SIADH were common in gastric cancer. SIADH was significantly correlated with poor 1-year survival. These clinical manifestations might be useful for predicting gastric cancer prognosis.