Survival Rate of Patients with Gastric Cancer and effective factors in two referral hospitals of Mashhad, Iran: A Multiple Regression Analysis
Keywords:
Mashhad, Proportional Hazards Models, Stomach Neoplasms, Survival RateAbstract
Background: Gastric cancer (GC) is among the most prevalent cancers in both genders, and the survival rate constitutes a measure to evaluate the diagnosis and treatment of GC. Mashhad is a city located in the northern part of Iran where has been identified as a high incidence region for GC. Objective: To determine survival rate of GC patients diagnosed in Mashhad and identify whether underling factors including demographic factors, family history, education, addiction and co-morbidities can affect survival rate. Methods: This cross-sectional study was conducted in two tertiary referral hospitals (Ghaem Hospital and Imamreza Hospital) in Mashhad. Patients were all diagnosed with GC from 2012 to 2016, and their status in 2019 was determined by data collected from the patients’ records in the hospitals and also by phone calls. Kaplan- Meier, Log-Rank test, and Cox Proportional Hazards Model, were used for data analysis using STATA 14.1 software. Results: Among 308 patients, 230 (74.7%) were male, and 78 (25.3%) were female. The mean of patients’ age and age at diagnosis time were 65.49 and 64.72 years, respectively. Survival proportion at first, third, and fifth year after diagnosis in both sexes using Kaplan-Meier were 0.63, 0.20, and 0.16. Univariate analysis showed that ethnicity (HR=1.58, p=0.034), addiction (HR=0.53, p=0.016), positive family history (HR=1.56, p=0.023), past medical history (HR=7.93, p=0.002) and education level (HR=0.44, p=0.045) had significant effect on survival rate. Multivariate analysis was somehow consistent with those results except for education level. (HR=9.33, p=0.013). Conclusion: Older age at diagnosis time, male sex, positive family history, coronary artery disease, diabetes mellitus, and hypertension can negatively influence the survival rate of gastric cancer patients, and these could be applied for improving the GC screening and treatment guidelines.References
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