Affecti̇ng factors of survi̇val on pati̇ents who have been determi̇ned metastati̇c gastri̇c cancer

INTRODUCTION AND PURPOSE: Gastric cancer is one of the most important causes of cancer-related deaths in world. Metastatic gastric cancer (MGC) patients constitute a heterogeneous group in terms of their demographic characteristics, as well as tumor location, histopathologic character and treatment response. We aimed to evaluate the factors affecting overall survival without progression in patients who are determined metastatic gastric cancer in this study. MATERIALS AND METHODS: In this study the patients followed up in Sakarya University Training and Research Hospital Medical Oncology Degree between 2011-2017, treatment and follow-up data of 199 patients older than 18 years old, ECOG PS 2 or less, at least one measurable metastatic lesion with a histologically confirmed gastric adenocarcinoma diagnosis with normal hepatic, hematological and renal functions without peripheral neuropathy anamnesis were retrospectively evaluated from patient files. Demographic data such as gender, age, Eastern Cooperative Oncology Group Performance Status (ECOG PS), weight loss story, palliative total gastrectomy story, prognostic factors such as tumor histopathologic features, primary tumor localization, number of organs involved, and grades 3-4 associated with the applied combination CT regimens and regimens toxicities, median progression-free survival and median overall survival were assessed statistically in the study. RESULTS: 142 (71.4%) patients in this research were male and 57 (28.6%) patients were female. 77 (38.7%) patients were treated with a double combination of CT regimen and 122 (61.3%) with a triple combination CT regimen. Patients whose median progression-free survival times and ECOG PS of 0-1, grade good-moderate, no peritoneal involvement, palliative gastrectomy, and responded to Response Evaluation Criteria In Solid Tumors (RECIST) criteria were determined statistically significantly longer. Patients whose median overall survival times ECOG PS 0-1, no weight loss, single organ involvement, no peritoneal involvement, and responded to RECIST criteria were also found statistically significantly higher. In triple combination chemotherapy group, it was seen that the incidence of febril neutropenia and grade 3-4 nausea was statistically significantly higher. CONCLUSION: In our study, many factors such as ECOG PS, weight loss, type and number of organs affected were found to be effective on survival. Determination of prognostic and predictive factors can prevent the cost increase and treatment-related morbidity and mortality and also caused by unnecessary treatments, and the patient subgroups predicted to be able to respond to treatments can be determined. Our study is remarkable in terms of emphasizing the importance of individualized approaches based on prognostic factors in performing the same treatment for a patient who is diagnosed with any metastatic gastric cancer. Keywords: Metastatic gastric cancer, progression free survival, mean survival, chemotherapy, toxicity