Retrospectively evaluating the clinicopathologic features of patients with non-metastatic right gastric cancer at the time of diagnosis and survival analysis

Tanin Hayriye the retrospective evaluation of clinicopathologic parameters and survival analyzes on cancer patients with non-metastatic operated gastric cancer at the time of diagnosis, Van Yüzüncü Yıl University Medical Faculty, Van ,2018 Purpose: To determine the factors that can have prognostic importance and to detect effects of these prognostic factors on survival by evaluating the clinical data of cancer patients with non-metastatic operated gastric cancer at the time of diagnosis retrospectively. Material and method: the patients that applied Van Yüzüncü Yıl University medical oncology clinic between January 2013 and November 2017 and that were diagnosed gastric cancer pathologically were included in the study. 109 patients that were non-metastatic at the time of diagnosis and operated because of gastric cancer were chosen. The prognostic importance of gender, age, the location of tumor, the macroscopic appearance of tumor, histological subgenre, the level of tumor invasion, the phase of tumor, lymphatic invasion, perineural invasion, vascular invasion, patients' ECOG performance score condition was evaluated and also relation of them with survival was evaluated. Results: The non-metastatic operated gastric cancer patient group at the time of diagnosis was composed of 109 individuals. All the patients in the group were histopathologically adenocancer type. %62.3(68 case) of cases were male and %37.6(41case) were female. The youngest age of the diagnose was 24(years) and the oldest one was 81(years) Also it was detected that the median diagnosed age (the diagnosed age in the middle of the list) was 59, the mean diagnosed age (the average diagnosed age) was 58.81. when the localization of tumor situation was considered, the %36.7(39case) were localized in corpus, %27.3(29case) were in cardia, %26.4(28 case) were in antrum, %9.4(10cases) were in esophagogastric intersection. The macroscopic appearances of tumors were evaluated and it was detected that %37.6 cases(41cases) were in ulcerovegetan appearance, %33case(36cases) in ulcer appearance, %14.7case (16cases) in ulcero-infiltrative appearance, %11.9 case (13 cases) in infiltrative. When the tumor's histopathologic subtypes were evaluated, it was seen that %59 (53cases) of the cases were in intestinal type, %30.3(27 cases) in diffuse type, %10.1 (9 cases) in mixte type. According to T staging %6.4 cases(7cases) had T1 stage, %6.4cases(7cases) had T2 stage, %50.9(55cases) had T3 stage and %36.1(39 cases) had T4 stage. According to N staging, %30.5(33 cases) that was N0, %25.9(28 cases) that was N1, %15.7(17 cases) that was N2, %27.7(30cases) that was N3 were detected. When the clinic stage of the patients was evaluated, %13.8(15cases) that was stage 1, %33(36 cases) that was stage2 and %53.2(58 cases) that was stage 3 were seen. The level of tumor differentiation in 89 patients included in study was determined and %10.1(9cases) of them were good differential, %55 (49cases) were medium differential and %34.8(31(cases) were undifferential. In total, 104 cases have lymphatic invasion data and while there were lymphatic invasion in %69.2 (72 cases), there was not lymphatic invasion in %30.7(32 cases). Vascular invasion situation was determined for 105 patients and while there were vascular invasion in %64.7(68cases) of them, there was not vascular invasion in %35.2(37 cases). It was detected that there were perineural invasion data in 103 of the cases and there was perineural invasion in %68.9 (71 cases) and there was not perineural invasion in %31(32 cases). All the cases were evaluated in terms of ECOG performance score. There were %33.9(37cases) included in ECOG 0, %43.1(47cases) included in ECOG1, and %22.9(25 cases) included in ECOG2. When patients' disease-free survivals were defined, the period of disease-free survival was identified as period that passed till the time of metastasis or local relapse development. In our study the data that were related to the tumor localization were contradictory to our knowledge that antrum is the most common place in gastric cancer, and they were coherent with scientific journals that report the increase in proximal gastric cancer. And also in our study, a significant difference was not detected between tumor localization and disease-free survival. When the relation between perineural invasion, lenfovascular invasion and disease-free survival was checked , while a significant correlation was detected between lenfovascular invasion situation and disease-free survival, statistically a significant correlation was not detected between perineural invasion and disease-free survival .In our study, it was seen that the more T stage, N stage, clinical stage, ECOG performance score that belong to our study increase, the more patients' disease-free survival period decrease. The other factors that have a significant relation with survival were the Lauren classification and differentiation level that belonged to tumor Key words: Gastric cancer, prognostic factor, disease-free survival