Factors Affecting Long Term Survival for Metastatic Gastric Cancer Treated with Chemotherapy

ABSTRACT

BACKGROUND/AIMS: Systemic chemotherapy for patients with metastatic gastric cancer is generally for palliative purposes. However some patients achieve long term survival after chemotherapy. Here we investigated the prognostic factors affecting long term survival for metastatic gastric cancer after chemotherapy. MATERIALS AND METHODS: We retrospectively reviewed 176 metastatic gastric cancer patients who received chemotherapy at the Kosin University Gospel Hospital from 2005 to 2010. Univariate and multivariate analyses were performed to evaluate the prognostic factors of long term survival. RESULTS: Overall survival time was 9 months and 5-year survival rate was 2.6%. Multivariate analysis revealed distant lymph nodes metastasis (hazard ratio [HR], 0.53; P=0.008), initial low albumin level (<3 g/dL) (HR, 2.64; P=0.003), patients <40 years (HR, 2.12; P=0.032), and poor performance status (Eastern Cooperative Oncology Group [ECOG], 2) (HR, 1.66; P=0.008) as significant factors of poor survival. 12 patients with metastatic gastric cancer survived more than 36 months. All of them had ECOG performance status of 0 or 1 and no one was <40 years at the time of diagnosis. In addition, there were no lung metastasis and bone metastasis. CONCLUSIONS: These results suggest that better performance status and the presence of only distant lymph nodes metastasis are favorable factors for long term survival of metastatic gastric cancer. Macroscopically scirrhous type of tumors, lung, bone or peritoneal metastasis and age of <40 years are poor prognostic factors for long term survival of metastatic gastric cancer.