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Epidemiology and survival characteristics of patients with gastric cancer in Ege Unıversity database

Authors: Burçak, Şaziye Karaca; Haydaroğlu, Ayfer; Demir, Halit Batuhan; Sezer, Taylan Özgür; Yalman, Deniz; Ünal, Nalan Gülşen; Sezak, Murat;

Epidemiology and survival characteristics of patients with gastric cancer in Ege Unıversity database

Abstract

Amaç: Bu çalışmada mide kanserinin (MK) epidemiyolojik ve genel sağkalım (GSK) özelliklerinin araştırılması amaçlanmıştır. Gereç Yöntem: Ege Üniversitesi Kanserle Savaş Uygulama ve Araştırma Merkezine (EÜKAM) 1992- 2017 yıllarında kayıtlı Ege Üniversitesi Tıp Fakültesi Hastanesi kanser verileri retrospektif olarak taranmıştır. CAN-REG-4 bilgisayar programına kayıtlı veriler, Dünya Sağlık Örgütü ve Surveillance, Epidemiology, and End Results sistemlerinde gruplanarak analizler yapılmıştır. İstatistik analizlerde kikare, General Linear Model (GLM), Kaplan Meier sağkalım analizleri uygulanmıştır. Etik kurul onayı alınmıştır. Bulgular: EÜKAM veri tabanına kayıtlı toplam 117.139 kanserden 4.212’si (%3,6) MK’dir. Gastrointestinal sistem kanserler içinde kolorektal kanserlerden sonra ikinci sıklıkta MK (%21,6) yer almıştır. Olguların 2.692’si (%63,9) erkek, 1.520’si (%36,1) kadındır, arasındaki fark istatistiksel olarak anlamlıdır (p<0,0001). Erkek/kadın oranı 1,8’dir. MK en sık 60-69 yaşlarda (%28,9) görülmüştür. En sık tümör yerleşimi korpusdur (%31,2), bunu antrum ve kardia izlemektedir. Distal (kardia dışı) tümörler, proksimal (kardia) tümörlerine göre yaklaşık 2,5 kat daha fazladır. Adenokarsinom en sık (%73,6) görülen histolojik alt tiptir. MK, erkeklerde kadınlara göre daha geç evrelerde saptanmış olup, fark istatistiksel olarak anlamlı bulunmuştur (p<0,0001). Tanı anında olgularının çoğu lokal ileri evre ve metastatik evrede bulunmuştur. Veri toplanan son 25 yıl içinde MK olgularında sayısal olarak doğrusal artış saptanmıştır (GLM:F=15,9;p<0,0001). MK’de medyan sağkalım 16 aydır. Beş-yıllık sağkalım %28,1 saptanmıştır, erkeklerde %25,2 kadınlarda %32’dir, kadınlarda istatistiksel olarak anlamlı yüksektir (p<0,0001). Adenokarsinomlar 5-yıllık %22,1 GSK oranı ile en kötü prognozu göstermektedir. Diffüz tip adenokarsinomlarda prognoz, intestinal tipe göre daha kötüdür (p=0,020). En iyi sağkalım oranları beklendiği gibi erken evrededir. Lokalize dönemde tanı konanlarda 5-yıllık GSK %61,8 iken, lokal ileri evrede %32,4 e düşmektedir (p<0,0001). Sonuç: Son 25 yıldaki verilerimizin analizinde yıllar içindeki olgu sayısında doğrusal bir artış görülmüştür. MK erkeklerde ve 60-69 yaş arasında daha sıktır. 5-yıllık sağkalım kadınlarda erkeklere göre daha yüksektir. MK evresi prognozda en önemli parametredir.

Aim: The aim of this study was to determine the epidemiologic and survival characteristics of gastric cancer (GC) patients. Materials and Methods: Data of Ege University Cancer Control and Research Center (EÜKAM) between 1992-2017 were screened retrospectively. Data recorded in computer program CAN-REG-4 were categorized according to the World Health Organisation and Surveillance, Epidemiology, and End Results systems and analyzed. Chi-square test, General Linear Model, and Kaplan-Meier survival analysis were used for statistical analysis. Ethical approval was obtained. Results: Out of a total of 117,139 cancers registered in the EÜKAM database, 4,212 (3.6%) were GC. Among the gastrointestinal cancers, GC (21.6%) was the second most frequent after colorectal cancers. 2,692 (63.9%) of the patients were male, 1,520 (36.1%) were female, the difference was found significant (p<0.0001). The male/female ratio was 1.8. GC was most commonly seen between 60-69 years (28.9%). The most common location was corpus (31.2%), followed by antrum and cardia. Distal (non-cardia) tumors were approximately 2.5 times more frequent than proximal (cardia) tumors. Adenocarcinoma was the most common (73.6%) histological subtype. GC was detected at more advanced stages in men than in women (p<0.0001). Most of the patients were diagnosed at locally advanced or metastatic stages. Numerical linear increase was detected in GC cases in the last 25 years (GLM: F=15.9; p<0.0001). The median survival was 16 months. The 5-year survival rate was 28.1%; women had significantly higher 5-year survival rates (32%) than males (25.6%) (p<0.0001). Adenocarcinomas showed poorer prognosis with 22.1% of 5-year survival rate (p<0.0001). The prognosis of diffuse type adenocarcinomas was worse than intestinal type (p=0.020). The best survival rates were achieved in the early stage as expected. The 5-year survival rate was 61.8% at localized stage, while it decreases to 32.4% in the locally advanced stage (p <0.0001). Conclusion: The analysis of our 25 years-data revealed a linear increase in the number of cases over the years. GC was found more common in men and most often between the ages of 60-69. The 5-year survival was longer in women than in men. GC stage was the most important parameter in prognosis.

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citations
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
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