Prognostic significance of alarm symptoms in patients with gastric cancer
| Autor: | Wyn G. Lewis, Jonathan D. Barry, Michael R. Stephens, Miles C. Allison, Guy Blackshaw, Paul Edwards, S R White |
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| Rok vydání: | 2005 |
| Předmět: |
Adult
Male medicine.medical_specialty medicine.medical_treatment Adenocarcinoma Weight loss Stomach Neoplasms Internal medicine Gastroscopy Weight Loss medicine Humans Age of Onset Stomach cancer Aged Aged 80 and over Wales business.industry Incidence (epidemiology) Hazard ratio Cancer Middle Aged medicine.disease Prognosis Confidence interval Surgery Early Diagnosis Gastrectomy Female Antacids medicine.symptom Age of onset business Epidemiologic Methods Gastrointestinal Hemorrhage |
| Zdroj: | The British journal of surgery. 92(7) |
| ISSN: | 0007-1323 |
| Popis: | Background The aim of this study was to determine the incidence and spectrum of alarm symptoms in patients with newly diagnosed gastric cancer, and to examine the relationship between symptoms and outcome. Methods Three hundred consecutive patients with gastric adenocarcinoma were studied prospectively. The outcomes of 40 patients (13·3 per cent) without alarm symptoms (21 men; median age 69 years) were compared with those of the 260 patients (86·7 per cent) with alarm symptoms (175 men; median age 72 years). Results It was possible to perform an R0 gastrectomy more often in patients without alarm symptoms (21 patients; 52 per cent) than in those with alarm symptoms (71 patients; 27·3 per cent) (χ2 = 10·35, 1 d.f., P = 0·001). The cumulative survival rate at 5 years was 38 per cent for patients without alarm symptoms versus 15·0 per cent for those with alarm symptoms (χ2 = 10·18, 1 d.f., P = 0·001). In a multivariate analysis, distant metastasis (hazard ratio (HR) 2·73 (95 per cent confidence interval (c.i.) 2·04 to 3·66); P < 0·001), overall stage of cancer (HR 1·83 (95 per cent c.i. 1·53 to 2·19); P < 0·001) and persistent vomiting at diagnosis (HR 1·66 (95 per cent c.i. 1·26 to 2·18); P < 0·001) were independently associated with length of survival. Conclusion Alarm symptoms are absent in a significant minority of patients with gastric cancer at diagnosis; these patients stand a better chance of curative surgery and long-term survival than those with alarm symptoms. |
| Databáze: | OpenAIRE |
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