Different pathological features and prognosis in gastric cancer patients coming from high-risk and low-risk areas of Italy

Daniele Marrelli, Corrado Pedrazzani, Giovanni Corso, Alessandro Neri, Marianna Di Martino, Enrico Pinto, Franco Roviello

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Abstract

OBJECTIVE: To compare clinicopathological features and long-term outcome in gastric cancer patients coming from high-risk and low-risk areas of Italy. SUMMARY BACKGROUND DATA: Better survival rates have been reported from countries with higher incidence of gastric cancer. METHODS: Data regarding 829 patients coming from Tuscany (group A) and 143 patients coming from Southern Italy (group B) were analyzed. Mean follow-up time was 56 ± 57 months; it was 85 ± 63 months in surviving patients or not tumor-related deaths. Prognostic factors were investigated by multivariate analysis with Cox proportional hazard model after verifying the assumption of proportionality of the risk associated with covariates. RESULTS: Lauren diffuse-mixed histotype, younger age, extended lymphadenectomy, and advanced stages were more common in group B. Gastric cancer-related 10-year survival probability was 48% in group A versus 29% in group B (log-rank test: P <0.001). By multivariate analysis, geographic area was confirmed as a significant prognostic factor (hazard ratio for group B vs. group A: 1.52, 95% confidence interval: 1.12-2.06, P = 0.006). The influence of this factor on long-term survival was independent from other clinical, surgical, and pathologic factors, and was notable in neoplasms involving the serosa (10-year survival probability: 15% in group A vs. 3% in group B, log-rank test: P = 0.005). CONCLUSIONS: Patients coming from low-risk area of Italy showed distinct pathologic features, more advanced stage, and worse prognosis when compared with patients coming from high-risk area. These findings may be indicative of different tumor biology, and may contribute to partly explain worldwide geographic variability in prognosis reported in different series.

Original languageEnglish
Pages (from-to)43-50
Number of pages8
JournalAnnals of Surgery
Volume250
Issue number1
DOIs
Publication statusPublished - Jul 2009

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Italy
Stomach Neoplasms
Survival
Multivariate Analysis
Serous Membrane
Neoplasms
Lymph Node Excision
Proportional Hazards Models
Survival Rate
Confidence Intervals
Incidence

ASJC Scopus subject areas

  • Surgery

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Different pathological features and prognosis in gastric cancer patients coming from high-risk and low-risk areas of Italy. / Marrelli, Daniele; Pedrazzani, Corrado; Corso, Giovanni; Neri, Alessandro; Di Martino, Marianna; Pinto, Enrico; Roviello, Franco.

In: Annals of Surgery, Vol. 250, No. 1, 07.2009, p. 43-50.

Research output: Contribution to journalArticle

Marrelli, Daniele ; Pedrazzani, Corrado ; Corso, Giovanni ; Neri, Alessandro ; Di Martino, Marianna ; Pinto, Enrico ; Roviello, Franco. / Different pathological features and prognosis in gastric cancer patients coming from high-risk and low-risk areas of Italy. In: Annals of Surgery. 2009 ; Vol. 250, No. 1. pp. 43-50.
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