Zare Ali, Mahmoodi Mahmood, Mohammad Kazem, Zeraati Hojjat, Hosseini Mostafa, Naieni Kourosh Holakouie
Department of Epidemiology and Biostatistics, Tehran University of Medical Sciences, Iran E-mail :
Asian Pac J Cancer Prev. 2013;14(11):6369-73. doi: 10.7314/apjcp.2013.14.11.6369.
Gastric cancer is one of the most common causes of cancer deaths all over the world and the most important reason for its high rate of death is its belated diagnosis at advanced stages of the disease. Events occur in patients which are regarded not only as themselves factors affecting patients' survival but also which can be affected by other factors. This study was designed and implemented aiming to identify these events and to investigate factors affecting their occurrence.
Data from 330 patients with gastric cancer undergoing surgery at the Iran Cancer Institute from 1995-1999 were analyzed. The survival time of these patients was determined after surgery and the effects of various factors including demographic, diagnostic and clinical as well as medical, and post-surgical varuiables on the occurrence of death hazard without relapse, hazard of relapse, and death hazard with a relapse were assessed.
The median survival time for these patients was 16.3 months and the 5-year survival rate was 21.6%. Based on the results of multi-state model, age and distant metastases affected relapse whereas disease stage, type and extent of surgery, lymph nodes metastases, and number of renewed treatments affected death hazard without relapse. Moreover, age, type and extent of surgery, number of renewed treatments, and liver metastases were identified as factors affecting death hazard in patients with relapse.
Most cancer studies pay heed to factors which have effect on death occurrence, but some events occur which should be taken into consideration to better describe the natural process of the disease and provide researchers with more accurate data.
胃癌是全球癌症死亡的最常见原因之一，其高死亡率的最重要原因是在疾病晚期才被诊断出来。患者身上发生的事件不仅被视为影响患者生存的自身因素，而且还会受到其他因素的影响。本研究旨在识别这些事件并调查影响其发生的因素。
分析了1995年至1999年在伊朗癌症研究所接受手术的330例胃癌患者的数据。确定这些患者术后的生存时间，并评估包括人口统计学、诊断和临床以及医学和术后变量等各种因素对无复发死亡风险、复发风险和复发后死亡风险发生的影响。
这些患者的中位生存时间为16.3个月，5年生存率为21.6%。基于多状态模型的结果，年龄和远处转移影响复发，而疾病分期、手术类型和范围、淋巴结转移以及再次治疗次数影响无复发死亡风险。此外，年龄、手术类型和范围、再次治疗次数以及肝转移被确定为影响复发患者死亡风险的因素。
大多数癌症研究关注影响死亡发生的因素，但有些事件发生时应予以考虑，以便更好地描述疾病的自然进程并为研究人员提供更准确的数据。
