Surgical treatment in late-stage gastric cancer. A retrospective analysis of 26 cases

Gastric cancer represents the fourth most common form of cancer and the second most common cause of death in the world. It is also one of the most common cancers leading to mortality in Italy. Therefore, this study aimed to determine the survival rate of patients with advanced gastric cancer and its affecting factors in our experience at AOU Federico II.26 patients with late-stage T4N2M0 and T4N2M1 gastric cancer that were diagnosed and registered during 2008 to 2018 in Federico II Surgical department, were studied. All patients were followed to the end of 2019. Kaplan-Meier method was used to draw survival curves and to determine the effective factors on the survival rate of surveyed patients. Moreover, Log-rank test was used to evaluate whether or not survival curves for different patients, related to residual tumor, are statistically equivalent (p0.05).The mean age of the study population was 49±29, and most of them were males (57,8% (15 patients). After diagnosis, the survival rates for 1, 2, 3 and 4 years, were 26,9%, 11,5 %, 3,8%, 19,2 %; 11,5% of patients with residual tumors survived 6 months respectively. Overall average survival was of 20.61 sd 17.52 months with a median of 12. No statistical difference was detected in terms of survival among M0 and M1 sub-groups.Based on the findings of the present study, T4 gastric cancer has a poor prognosis. Survival rate was decreased over time after diagnosis. Tumoral stage at the time of diagnosis is the most important factor affecting the survival of surveyed patients. This shows that there is a crucial need to diagnose the gastric cancer in early stages.Advanced gastric cancer, Surgical techniques, Therapy.Il cancro gastrico (CG) è la quarta causa principale di morte per cancro in tutto il mondo, anche se negli ultimi decenni è stato osservato un calo della sua incidenza e del tasso di mortalità. I casi di tumore avanzato sono difficilmente gestibili in elezione per la presenza di complicanze che impongono spesso un trattamento in urgenza. Lo studio si propone di esaminare 26 casi di cancro gastrico avanzato, trattati tra il 2008 e il 2018 presso il dipartimento di chirurgia generale “Federico II” e sottoposti a follow up fino alla fine del 2019. Le curve di sopravvivenza sono state costruite usando il metodo di Kaplan-Meier. Inoltre il test di Log-rank è stato utilizzato per valutare se le relative curve di sopravvivenza per pazienti con residuo tumorale e non, fossero statisticamente equivalenti. Si è registrata una sopravvivenza media di circa 20.61 sd 17.52 mesi con una mediana di 12. Non sono state evidenziate differenze significative tra pazienti M0 ed M1, in termini di sopravvivenza. Pertanto, alla luce dei dati raccolti, si evidenzia come la diagnosi precoce di tumore gastrico, rappresenti uno dei principali fattori per migliorare la prognosi e la sopravvivenza dei pazienti.