In stomach cancer tumor localization on tumor investigation of the effects of survival factors

Purpose: While in studies related to the prognosis in stomach cancer, the effects of some factors on prognosis are almost always observed, some factors differ between different studies. Purpose of this study is to divide stomach tumors operated in Dokuz Eylul University Medical Faculty Head of the Department General Surgery into two groups which are proximal and distal and to evaluate prognostic factors related to the tumor retrospectively and to examine their effects on survival. Material and Method: Total 240 patients who are applied resection with the diagnosis of stomach cancer in the clinic of Dokuz Eylul Hospital General Surgery between the dates August 2004 and June 2013. Patients who are diagnosed with stomach cancer and operated are divided into two groups as proximal localized and distal localized. Total 240 patients who are applied resection with the diagnosis of stomach cancer in the clinic of Dokuz Eylul Hospital General Surgery between the dates August 2004 and June 2013. Patients who are diagnosed with stomach cancer and operated are divided into two groups as proximal localized and distal localized. While cardia and fundus localized tumors were involved in proximal localized tumor group, corpus, antrum localized tumors were involved in distal localized tumor groups. With the purpose of searching prognostic factors affecting on survival, gender, comorbidity (diabetes, hypertension, COPD, congestive heart failure), age, body mass index, tumor size, tumor stage (TNM 2010 classification), total number of lymph node removed, metastatic lymph node, differentiation degree, lymphovascular invasion and perineural invasion were determined as prognostic parameter and evaluated in two groups as prognostic factors. It was searched that whether present prognostic factors differ between two groups or not and their effects on survival were searched. In the comparison of parameters showing normal distribution, Student T test was used and in the comparison of parameters showing non-normal distribution Mann Whitney U test was used. In the comparison of qualitative data, Chi-square test was used. In survival analyses, Kaplan-Meier analysis and Log Rank test were used. Results were evaluated with a 95% confidence interval and significance was evaluated at the level of p<0.05. Findings It was determined that while totally 175 (72.9%) patients are distal localized, 65 (27.1%) patients are proximal localized. When present prognostic factors in proximal and distal tumor groups were considered separately, no significant difference was determined in both groups with regard to distribution of prognostic factors. Between two groups, proximal tumors were determined significantly low in terms of survival. Median survival in proximal localized tumors was determined as 23 months and as 49 months in distal localized tumors. The effects of advanced age, T stage, having lymph metastasis, lymphovascular invasion, diabetes, tumor size, tumor differentiation, blood vein invasion, perineural invasion , BMI, histological type of the tumor on median survival were determined significantly different in all cases . Result: According to the results of our study, it was determined that age, tumor stage, localization, diameter, histological type, perineural, perivascular, lymphovascular invasion, metastatic lymph node and BMI are prognostic factors in stomach cancer. It was reached the conclusion that determination of these prognostic factors has an important place in planning of the treatment; in addition to these, localization of the tumor is a risk factor due to just its localization independently from other prognostic factors. Keywords: stomach tumor, proximal and distal stomach cancer, stomach tumor prognostic factors