P-096 - Gastric Carcinoma and curative surgery predictive factors: Retrospective analysis of 60 Tunisian cases

Date 04 July 2015
Event WorldGI 2015
Session Posters
Topics Gastric Cancer
Surgery and/or Radiotherapy of Cancer
Presenter N. Chraiet
Citation Annals of Oncology (2015) 26 (suppl_4): 1-100. 10.1093/annonc/mdv233
Authors N. Chraiet1, Y. Ben Romdhane2, M. Serghini3, H. Raies4, M. Ayadi1, K. Meddeb1, A. Mokrani1, Y. Yahyaoui1, A. Filali5, A. Mezlini6
  • 1Salah Azaiz Institute, Tunis/TN
  • 2Alah Azaiez Institute, Tunis/TN
  • 3Rabta Hospital, Tunis/TN
  • 4Salah Azaiez Institute Medical Oncology Department, Tunis/TN
  • 5Salah Aziez Intitute, Tunis/TN
  • 6Institut Salah Azaiz, Tunis/TN

Abstract

Introduction

Gastric cancer is still known to have a poor prognosis. Despite a multimodal treatment including surgery that is the mainstay curative treatment, the 5 years overall survival (OS) does not exceed 30%. The identification of prognostic and predictive factors is mandatory for the choice of the most suitable therapeutic strategy. The aims of this study were to identify among the epidemiological, clinical, histological and therapeutic features those that are predictive of achieving a curative versus palliative surgery.

Methods

we conducted a retrospective analysis of 126 histologically proven gastric adeno-carcinoma. Surgery was indicated in 60 patients. Two groups were first defined: patients with curative (n = 44) or palliative surgery (n = 16), then two subgroups of patients with versus without metastasis, in the latter group (n = 5, n = 11 respectively).

Results

The median age was 60 years with a male predominance in the 3 groups (p = 0.8, p = 0.51 respectively). There was no significant difference in terms of comorbidities, alcohol and tobacco consumption or a cancer's familial history. Clinically, vomiting was often correlated with palliative treatment regardless of metastatic disease or not (p = 0.06). Patients with curative surgery had significantly higher levels of serum albumin (p = 0.02). Obstructing tumors, with distal antral location and locally advanced ones were significantly related to palliative treatment (p = 0.02; p = 0.04; p= 0.004, respectively). Neoadjuvant chemotherapy and adjuvant radiotherapy were significantly related to curative treatment (p = .0.02). Curative surgery improved significantly the OS (p <0.0001). However, palliative surgery, particularly in metastatic forms, was deleterious in term of OS.

Conclusion

Nutritional factors and multimodal treatment were significantly associated with the achievement of a curative surgery and therefore a better survival. In the contrary, palliative surgery, did not improve the OS.