Evaluation of Prognostic Factors of Advanced Gastric Cancer by Cox Proportional Hazards Model

Takafumi Bandoh, Hiroshi Toyoshima, Touru Isoyama

Department of Gastroenterological Surgery, The Japanese Red Cross Medical Center

We performed a univariate and multivariate analysis of 682 patients with advanced gastric cancer and determined its prognostic factors. The univariate analysis showed that the 5- and l0-year survival rates were significantly different between each strata of the prognostic factors including tumors size, macroscopic pattern, serosal invasion, lymphatic invasion, vascular invasion, peritoneal dissemination, liver metastases, lymph node metastases, histologic stage and operative curability. Age, sex and histologic type did not change the survival rates significantly. Multivariate analysis using Cox proportional hazards model determined curability, serosal invasion, lymphatic invasion, lymph node metastases, vascular invasion and tumor size as the significant and independent prognostic factors affecting advanced gastric cancers. Hazard ratios (weights of prognostic factors) were estimated as follows: serosal invasion 1.67, curability 1.53, lymphatic invasion 1.33, lymph node metastases 1.19, vascular invasion 1.16 and tumor size 1.04. These statistically estimated prognostic factors and weights are clinically acceptable and useful.

Key words
advanced gastric cancer, prognostic factor, univariate analysis, multivariate analysis, Cox proportional hazards model

Reprint requests
Takafumi Bandoh Department of Gastroenterological Surgery, The Japanese Red Cross Medical Center
4-l-22 Hiroo, Shibuya, Tokyo, 150 JAPAN

Accepted
July 7, 1993

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