Prognostic Factors of Gastric Cancer Patients -A Study by Univariate and Multivariate Analysis-

Kazuo Okajima

Department of Surgical Oncology, National Cancer Center Central Hospital
Department of Surgery, Osaka Medical College

To determine the most important prognostic factors for patients with gastric cancer, 23 factors were evaluated by uni- and multivariate analyses. A total 6,540 patients with primary gastric cancer treated in the National Cancer Center, Tokyo, between 1962 and 1991 were studied. In 22 factors (excluding sex), a significant difference was seen in cumulative survival rate (univariate analysis), and they seemed to be the important prognostic factors. However, 11 factors were excluded after checking for independence (by Spearman's correlation) and checking for multivariate analysis (by the stepwise method), and the remaining 12 factors were finally studied by Cox's proportional hazard model (multivariate analysis); i.e. age, sex, depth of invasion, lymph node metastasis, liver/peritonal metastasis, maximal tumor diameter, location, infiltrative growth, lymphatic invasion, venous invasion, lymph node dissection, and resection margins. The most important prognostic factor was depth of invasion (hazard ratio: 4.62), followed by lymph node metastsis (3.63), age (2.07), liver/peritoneal metastasis (1.91), and lymph node dissection (1.58). The important prognostic factors changed in rank in the 30-year period. Depth of invasion and lymph node metastasis kept their first and second position during the whole period. Liver/peritoneal metastasis dropped in rank from the third to the fourth place. Age rose in rank from the fourth to the third place, and lymph node dissection also increased in prognostic significance, rising in rank from the seventh to the fifth place.

Key words
gastric cancer, prognostic factor, multivariate analysis

Reprint requests
Kazuo Okajima Department of Surgery, Himeji Central Hospital
2-36 Miyake, Shikama-ku, Himeji-shi, 672 JAPAN

Accepted
October 9, 1996

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