It is the cache of ${baseHref}. It is a snapshot of the page. The current page could have changed in the meantime.
Tip: To quickly find your search term on this page, press Ctrl+F or ⌘-F (Mac) and use the find bar.

Comparison of colorectal and gastric cancer: Survival and prognostic factors Moghimi-Dehkordi B, Safaee A, Zali MR - Saudi J Gastroenterol
Saudi Journal of Gastroenterology
Home About us Instructions Ahead of print Submission Subscribe Advertise Contact Login    Print this page  Email this page Small font sizeDefault font sizeIncrease font size 
Users Online: 562 


 
ORIGINAL ARTICLE Table of Contents   
Year : 2009  |  Volume : 15  |  Issue : 1  |  Page : 18-23
Comparison of colorectal and gastric cancer: Survival and prognostic factors


Research Center of Gastroenterology and Liver Diseases, Shahid Beheshti University of Medical Sciences, Tehran, Taleghani Hospital, Tabnak St., Yaman Ave., Velenjak, Tehran, Iran

Click here for correspondence address and email

Date of Submission 29-Sep-2007
Date of Acceptance 07-Jul-2008
 

   Abstract  

Background/Aims: Gastric and colorectal cancers are the most common gastrointestinal malignancies in Iran. We aim to compare the survival rates and prognostic factors between these two cancers. Methods: We studied 1873 patients with either gastric or colorectal cancer who were registered in one referral cancer registry center in Tehran, Iran. All patients were followed from their time of diagnosis until December 2006 (as failure time). Survival curves were calculated according to the Kaplan-Meier Method and compared by the Log-rank test. Multivariate analysis of prognostic factors was carried out using the Cox proportional hazard model. Results: Of 1873 patients, there were 746 with gastric cancer and 1138 with colorectal cancer. According to the Kaplan-Meier method 1, 3, 5, and 7-year survival rates were 71.2, 37.8, 25.3, and 19.5%, respectively, in gastric cancer patients and 91.1, 73.1, 61, and 54.9%, respectively, in patients with colorectal cancer. Also, univariate analysis showed that age at diagnosis, sex, grade of tumor, and distant metastasis were of prognostic significance in both cancers ( P < 0.0001). However, in multivariate analysis, only distant metastasis in colorectal cancer and age at diagnosis, grade of tumor, and distant metastasis in colorectal cancer were identified as independent prognostic factors influencing survival. Conclusions: According to our findings, survival is significantly related to histological differentiation of tumor and distant metastasis in colorectal cancer patients and only to distant metastasis in gastric cancer patients.

Keywords: Colorectal cancer, gastric cancer, Iran, prognosis, survival rates

How to cite this article:
Moghimi-Dehkordi B, Safaee A, Zali MR. Comparison of colorectal and gastric cancer: Survival and prognostic factors. Saudi J Gastroenterol 2009;15:18-23

How to cite this URL:
Moghimi-Dehkordi B, Safaee A, Zali MR. Comparison of colorectal and gastric cancer: Survival and prognostic factors. Saudi J Gastroenterol [serial online] 2009 [cited 2014 Mar 2];15:18-23. Available from: http://www.saudijgastro.com/text.asp?2009/15/1/18/43284


Malignancy is a major health problem in many countries throughout the world. [1] Nowadays, gastrointestinal-related cancers especially gastric cancer (GC) and colorectal cancer (CRC), form a vast bulk of overall malignant conditions. GC is one of the major causes of cancer-related death in the world, even though its incidence has decreased over the past decade. [2] The prognosis of GC is generally poor, especially in Western countries, [3],[4] where the overall survival rate at 5 years has not changed, oscillating between 8 and 26%, even though the resectability rate has increased (currently 60-80%). [5],[6],[7],[8],[9]

In recent years, cancer morbidity and mortality has increased in Iran, with GC becoming the second most common among all cancers. [10],[11] Similarly, CRC is the fourth commonest form of cancer occurring worldwide, with an estimated 783,000 new cases diagnosed in 1990, the most recent year for which international estimates are available. [12] CRC is the third most common cause of cancer-related death in the world. [13] The incidence of CRC in Iran is lower than that in Western countries, being the fifth and third most common cancer in men and women, respectively. However, its incidence in Iran is rising and has therefore become a significant public health issue. [14] Several variables representing pathological, clinical, and therapeutic characteristics have already been studied in numerous retrospective reports in an attempt to identify prognostic indicators in patients with GC [15],[16],[17],[18],[19],[20],[21] and CRC. [22],[23],[24],[25],[26],[27],[28],[29],[30],[31],[32],[33],[34] The aim of the present study is to compare the survival rates and prognostic factors in GC and CRC in one referral cancer registry in Iran.


   Patients and Methods   Top


Between December 21, 2001 and December 21, 2006, 1873 patients with GC or CRC were registered in the cancer registry center of Research Center of Gastroenterology and Liver Disease (RCGLD), Shahid Beheshti Medical University; Tehran, Iran. Data on both cancers were collected using cancer registry forms and medical records of the patients. Two types of variables were analyzed in the survival analysis: (1) demographic variables including sex, age, family history of cancer and (2) clinical variables including histologic grade (degree of tumor differentiation) and presence of metastasis.

All patients were followed from their diagnosis until December 21, 2007 (as failure time) by telephone, and survival times were calculated in months. The survival curves were calculated according to the Kaplan-Meier Method and compared by the Log-rank test. Multivariate analysis of prognostic factors was carried out using the Cox proportional hazard model. SPSS.V.13 was used for all statistical calculations, and P < 0.05 was considered as statistically significant.


   Results   Top


Of the 1873 patients identified, 746 (39.8%) were with GC and 1127 (60.2%) were with CRC; 1220 were male (71% GC vs 61.2% CRC) and 653 were female (29.0% GC vs 38.8% CRC). Survival information was not available in 11 patients, and they were excluded from the study. The mean patient age at diagnosis was 55.9 ± 14.8 (range 14 - 94) years. The mean age of patients with GC was 59.63 ± 12.89 years compared with 53.59 ± 14.35 years in patients with CRC (P < 0.0001).

The mean age of male patients with GC (60.50 ± 12.55 years) and CRC (54.33 ± 14.57 years) was significantly different (P < 0.001). Similarly, the mean age of female patients with GC (57.45 ± 15.50 years) and CRC (52.42 ± 13.91 years) was significantly different (P < 0.001).

In GC patients, most (216 or 46.2%) were diagnosed with poorly differentiated grade of tumor, but in CRC patients, most tumors were well-differentiated (443 or 55.5%). Also, 179 (25.5%) of GC and 394 (36.7%) of CRC cases reported a positive family history of cancer. Distant metastasis was seen in 184 (36.4%) of GC and 171 (22.3%) of CRC patients [Table 1]. Mean of survival time of patients were 42.46 (CI, 35.74-49.17) for GC and 104.99 (CI, 94.96-115.02) for CRC cases, respectively.

Survival of patients with GC was less than those with CRC (P < 0.0001) [Figure 1]. Univariate analysis showed that the factors influencing overall survival rate in both GC and CRC patients were age at diagnosis, sex, grade of tumor, and pathologic distant metastasis (P < 0.0001). In relation to the age at diagnosis, CRC patients have better survival than GC patients in all age groups (P<0.001). Also, male patients with CRC have a longer life when compared with those with GC (P < 0.001).

Univariate analysis showed that CRC patients have higher survival rates than GC patients, regardless of the degree of tumor differentiation (well-differentiated, moderately-differentiated, poorly differentiated). Also, a better survival was seen in CRC cases with distant metastasis when compared with GC cases of the same status.

Multivariate analysis showed that grading of tumor and distant metastasis of tumor in CRC patients, and only distant metastasis in GC patients, were the most important prognostic factors determining survival. Poorly and moderately-differentiated tumors exhibited an increased risk of death of 2.18 and 1.71-fold than well-differentiated tumors in CRC patients. Likewise, patients with distant metastasis in GC and CRC have hazard rates of 2.25 and 1.92, respectively [Table 2] and [Figure 2], and [Figure 3].


   Discussion   Top


GC and CRC are two of the most commonly prevalent malignancies in Iran. If these cancers were diagnosed at an early stage, patients could have a highly favorable prognosis and avoid extended surgery, which may produce complications, especially in the elderly people. [35]

The data used in this study were collected in a cancer registry belonging to the Research Center of Gastroenterology and Liver Diseases of Shahid Beheshti University of Medical Sciences, Tehran, Iran. This cancer registry serves as a major referral registry for the region.

Prognostic factors in GC [36],[37],[38],[39],[40],[41] and CRC [42],[43],[44],[45],[46],[47],[48],[49],[50],[51] are a source of controversy in many series. This study, based upon a prospective database, indicates that several patient- and tumor-related factors affect survival but are not independent prognostic factors. Compared with CRC, GC has a dismal prognosis and a low 5-year survival rate.

It is generally believed that young patients with CRC have a worse survival rate. Reports from Europe demonstrate that the 5-year survival rate for patients (30 years old or younger) is only 25-30%. [52],[53] Young patients are more likely to present with late-stage disease. The young patients also have higher-grade tumors [54] About 60-67% of young patients with CRC have a later stage (III/IV) disease, [53],[55] most of which are poorly differentiated or mucinous tumors [53],[54],[55],[56],[57] indicating a very poor prognosis. Other reports demonstrate that the 5-year survival rate of patients 30 years old or younger is around 40%. [58]

Also, some authors [59],[60],[61],[62] consider that age has prognostic value because young patients with GC have a poorer prognosis than older patients. Perhaps they present with more advanced disease because the index of suspicion for malignant disease is low and so the symptoms are allowed to progress for a longer period before investigation is considered, or there may be a greater biological activity of the tumor, which is more likely to be of the Laur´en diffuse type.

In the present study, in the evaluation of demographic features, age at diagnosis was strongly associated with prognosis in the univariate analysis for both CRC and GC, but was not a significant prognostic factor in multivariate method for both cancers. In all age groups (≤ or > 50 yrs), CRC patients have a longer life than GC patients. Our results are in agreement with most other reports on GC [63],[64],[65],[66] and CRC [67],[68] which suggest that age at diagnosis significantly affects patient outcome.

Survival analysis indicated that gender is a prognostic factor for GC and CRC patients in the present study. Others have reported that, female patients with CRC compared with males showed a better outcome in the univariate analysis, but the overall survival was not significantly affected by these factors in the multivariate analysis. Our findings are in agreement with most series, [69],[70],[71],[72] though some controversies exist. [24],[73]

A study conducted in USA stated that GC females had better survival rates and that this was more apparent for early-stage tumors. [74] Curtis et al [75] reported that prognosis was better in females in their study, depending on the age and stage of diagnosis. However, no difference with respect to gender was observed in the survival rates for early-stage patients. Male patients had higher mortality rates in a study carried out on patients with GC in Canada [76] when the results were assessed regarding the gender for patients at the same stage (early stage). Another study reported no differences in survival rates regarding gender in patients at early or advanced stages. A study on 2773 patients with GC by the Rotterdam Cancer Registry reported similar resection rates for male and female patients. However, the same study demonstrated significantly lower postoperative mortality rates in female patients. [77] Jin-Pok Kim et al [78] stated that female patients had better prognosis in their study carried out on GC patients. Also a study stated no statistical differences in survival of patient on the basis of gender. [79]

With respect to the degree of cellular differentiation, the best prognosis has been found in well-differentiated groups in both tumors. [8],[9],[21],[25],[59] Patients with low-grade tumors had a greater survival rate than those with high-grade tumors, the difference being statistically significant.

Another important factor of prognosis was this study is distant metastasis. In univariate and multivariate analysis of both cancers, as expected, patients with metastasis to other organs have a poorer outcome. On the other hand, patients with distant metastasis had a risk of death about 2.25 and 1.92-fold of those without metastasis in GC and CRC, respectively. There are many reports that confirm our finding on GC [80],[81],[82] and CRC. [42],[44],[49],[50],[51],[83]

This study has some limitations as imposed by the retrospective nature of registry obtained data. For instance, we did not have access to important patient data such as macroscopic tumor type, depth of tumor invasion, and frequency of lymph node involvement. Also, no information was available on the rates of curative resection for the reason that patients under study were operated upon in different hospitals.

Although this study has highlighted the pertinent epidemiological and clinicopathological features of GC and CRC in Iran, further studies are needed to evaluate the environmental risk factors, incidence, the treatment outcomes, and long-term survival outcomes.


   Conclusion   Top


According to our findings, survival rates in GC patients were lower than those in CRC patients. High prevalence of GC in Iran and its poor prognosis suggests that health care policy makers should be privy to such data for implementation of screening programs and resource allocation. Also, prognosis of disease is significantly related to histological differentiation of tumor and distant metastasis in CRC patients and only to distant metastasis in GC patients. It appears that these factors are associated with late diagnosis of disease, and therefore, planning and enforcement of screening programs is necessary for an early detection of these cancers.


   Acknowledgements   Top


We thank Cancer registry center of Taleghani hospital for data gathering and Research Center of Gastroenterology and Liver Diseases for their valuable collaboration in this study.

 
   References   Top

1. Parkin DM, Pisani P, Ferlay J. Estimates of the worldwide incidence of 25 major cancers in 1990. Int J Cancer 1999;80:827-41.  Back to cited text no. 1  [PUBMED]  [FULLTEXT]
2. Boring CC, Squires TS, Tong T, Montgomery S. Cancer statistics, 1994. CA Cancer J Clin 1994;44:7-26.  Back to cited text no. 2  [PUBMED]  [FULLTEXT]
3. Akoh JA, Macintyre IM. Improving survival in gastric cancer: Review of 5-year survival rates in English language publications from 1970. Br J Surg 1992;79:293-9.  Back to cited text no. 3    
4. Wanebo HJ, Kennedy BJ, Chmiel J, Steele G Jr, Winchester D, Osteen R. Cancer of the stomach: A patient care study by the American College of Surgeons. Ann Surg 1993;218:583-92.  Back to cited text no. 4  [PUBMED]  [FULLTEXT]
5. Hangstvedt T, Viste A, Eide GE, Real C, Soreide O. The survival benefit of resection in patients with advanced stomach cancer: the Norwegian multicenter experience. World J Surg 1989;13:617-21.  Back to cited text no. 5    
6. Gouzi HL, Huguier M, Fagniez PL, Lannois B, Flamant Y, Lacaine F, et al . Total versus subtotal gastrectomy for adenocarcinoma of the gastric antrum: A French prospective controlled study. Ann Surg 1989;209:162-6.  Back to cited text no. 6    
7. Bozzetti F, Regalia E, Bonfanti G, Doci R, Ballarini D, Gennari L. Early and late results of extended surgery for cancer of the stomach. Br J Surg 1990;77:53-6.  Back to cited text no. 7  [PUBMED]  
8. Salvon-Harman JC, Cady B, Nikulasson S, Khettry U, Stone MD, Lavin P. Shifting proportions of gastric adenocarcinomas. Arch Surg 1994;129:381-8.  Back to cited text no. 8  [PUBMED]  
9. Stipa S, Di Giorgio A, Ferri M, Botti C. Results of curative gastrectomy for carcinoma. J Am Coll Surg 1994;179:567-72.  Back to cited text no. 9  [PUBMED]  
10. Eskandar H, Hossein SS, Rahim M, Jalal H, Mehrdad A, Rajabi T. Clinical profile of gastric cancer in Khuzestan, southwest of Iran. World J Gastroenterol 2006;12:4832-5.  Back to cited text no. 10    
11. Sadighi S, Raafat J, Mohagheghi M, Meemary F. Gastric cancer: 5 years experience of a single institute. Asian Pac J Cancer Prev 2005;6:195-6.  Back to cited text no. 11  [PUBMED]  
12. Boyle P, Langman JS. ABC of colorectal cancer: Epidemiology. BMJ 2000;321:805-8.  Back to cited text no. 12  [PUBMED]  [FULLTEXT]
13. Parkin DM. Global cancer statistics in the year 2000. Lancet Oncol 2001;2:533-43.  Back to cited text no. 13  [PUBMED]  [FULLTEXT]
14. Islamic Republic of Iran, Ministry of Health and Medical Education, Office of Deputy Minister for Health Center for disease control, cancer office. Iranian annual National Cancer Registration Report. 2005-2006. March 2007.  Back to cited text no. 14    
15. Cady B, Rossi RL, Silverman ML, Piccione W, Heck TA. Gastric adenocarcinoma: A disease in transition. Arch Surg 1989;124:303-8.  Back to cited text no. 15  [PUBMED]  
16. Shiu MH, Perrotti M, Brennan MF. Adenocarcinoma of the stomach: A multivariate analysis of clinical, pathologic and treatment factors. Hepatogastroenterology 1989;36:7-12.  Back to cited text no. 16  [PUBMED]  
17. Rohde H, Gebbensleben B, Bauer P, Stutzer H, Zieschang J; Findings from the German Gastric Cancer TNM Study Group. Has there been any improvement in the staging of gastric cancer? Cancer 1989;64:2465-81.  Back to cited text no. 17    
18. Arveux P, Faivre J, Boutron MC, Piard F, Dusserre-Guion L, Monnet E, et al . Prognosis of gastric carcinoma after curative surgery: A population based study using multivariate crude and relative survival analysis. Dig Dis Sci 1992;37:757-63.  Back to cited text no. 18  [PUBMED]  
19. Brems-Dalgaard E, Clausen HV. Survival following microscopically confirmed radical resection of N0 gastric cancer. Br J Surg 1993;80:1150-2.  Back to cited text no. 19  [PUBMED]  
20. Bollschweiler E, Boettcher K, Hoelscher AH, Sasako M, Kinoshita T, Maruyama K, et al . Is the prognosis for Japanese and German patients with gastric cancer really different? Cancer 1993;71:2918-25.  Back to cited text no. 20    
21. Michelassi F, Takanishi DM Jr, Pantalone D, Hart J, Chappell R, Block GE. Analysis of clinicopathologic prognostic features in patients with gastric adenocarcinoma. Surgery 1994;116:804-9.  Back to cited text no. 21  [PUBMED]  
22. Mitry E, Douillard JY, Van Cutsem E, Cunningham D, Magherini E, Mery-Mignard D, et al . Predictive factors of survival in patients with advanced colorectal cancer: An individual data analysis of 602 patients included in irinotecan phase III trials. Ann Oncol 2004;15:1013-7.  Back to cited text no. 22  [PUBMED]  [FULLTEXT]
23. Newland RC, Dent OF, Lyttle MN, Chapuis PH, Bokey EL. Pathologic determinants of survival associated with colorectal cancer with lymph node metastases: A multivariate analysis of 579 patients. Cancer 1994;73:2076-82.  Back to cited text no. 23  [PUBMED]  
24. Stower MJ, Hardcastle JD. The results of 1115 patients with colorectal cancer treated over 8-year period in a single hospital. Eur J Surg Oncol 1985;11:119-23.   Back to cited text no. 24  [PUBMED]  
25. Park YJ, Park KJ, Park JG, Lee KU, Choe KJ, Kim JP. Prognostic factors in 2230 Korean colorectal cancer patients: Analysis of consecutively operated cases. World J Surg 1999;23:721-6.  Back to cited text no. 25  [PUBMED]  [FULLTEXT]
26. Mitry E, Bouvier AM, Esteve J, Faivre J. How to explain the improvement in survival for colorectal cancer? A French population-based study. Eur J Cancer 2003;1:S326.  Back to cited text no. 26    
27. Martijn H, Voogd AC, van de Poll-Franse LV, Repelaer van Driel OJ, Rutten HJ, Coebergh JW, et al . Improved survival of patients with rectal cancer since 1980: A population-based study. Eur J Cancer 2003;39:2073-9.  Back to cited text no. 27    
28. Scott NA, Wieand HS, Moertel CG, Cha SS, Beart RW, Lieber MM. Colorectal cancer: Dukes stage, tumor site, preoperative plasma CEA level and patient prognosis related to tumor DNA ploidy pattern. Arch Surg 1987;122:1375-9.  Back to cited text no. 28  [PUBMED]  
29. Harrison LE, Guillem JG, Paty P, Cohen AM. Preoperative carcinoembryonic antigen predicts outcomes in node-negative colon cancer patients: A multivariate analysis of 572 patients. J Am Coll Surg 1997;185:55-9.  Back to cited text no. 29  [PUBMED]  [FULLTEXT]
30. Lee TL, Kim HD, Han WK, Pae WK, Kim KY. A clinical study of 1,037 Cases of colorectal cancer. J Korean Coloproctol Soc 1996;12:77.  Back to cited text no. 30    
31. Yang HK, Kim SW, Park JG, Hong SC, Kim JP. Multivariate analysis of prognostic factors in colorectal cancer patients: Significance of lymph node metastasis as a prognostic factor in colorectal cancer. Korean J Gastroenterol 1991;23:440.  Back to cited text no. 31    
32. Gardner B, Feldman J, Spivak Y, Panetta T, Fleischer J, Kasamblides E, et al . Investigations of factors influencing the prognosis of colon cancer. Am J Surg 1987;153:541-4.  Back to cited text no. 32  [PUBMED]  
33. Takahashi K, Mori T, Yasuno M. Histologic grade of metastatic lymph node and prognosis of rectal cancer. Dis Colon Rectum 2000;43:S40-6.  Back to cited text no. 33  [PUBMED]  
34. Cusack JC, Giacco GG, Cleary K, Davidson BS, Izzo F, Skibber J, et al . Survival factors in 186 patients younger than 40 years old with colorectal adenocarcinoma. J Am Coll Surg 1996;183:105-12.   Back to cited text no. 34  [PUBMED]  
35. Ramos-De la Medina A, Salgado-Nesme N, Torres-Villalobos G, Medina-Franco H. Clinicopathologic characteristics of gastric cancer in a young patient population. J Gastrointest Surg 2004;8:240-4.  Back to cited text no. 35    
36. Conti A, Tonini V. Factors influencing prognosis of gastric cancer after curative resection. G Chir 1989;10:303-7.  Back to cited text no. 36  [PUBMED]  
37. Stipa S, Di Giorgio A, Ferri M, Botti C. Results of curative gastrectomy for carcinoma. J Am Coll Surg 1994;179:567-72.  Back to cited text no. 37  [PUBMED]  
38. Shiu MH, Perrotti M, Brennan MF. Adenocarcinoma of the stomach: A multivariate analysis of clinical, pathologic and treatment factors. Hepatogastroenterology 1989;36:7-12.  Back to cited text no. 38  [PUBMED]  
39. Bozzetti F, Bonfanti G, Morabito A, Bufalino R, Menotti V, Andreola S, et al . A multifactorial approach for the prognosis of patients with carcinoma of the stomach after curative resection. Surg Gynecol Obstet 1986;162:229-34.  Back to cited text no. 39  [PUBMED]  
40. Adachi Y, Shiraishi N, Suematsu T, Shiromizu A, Yamaguchi K, Kitano S. Most important lymph node information in gastric cancer: Multivariate prognostic study. Ann Surg Oncol 2000;7:503-7.  Back to cited text no. 40  [PUBMED]  [FULLTEXT]
41. Haugstvedt TK, Viste A, Eide GE, Soreide O. Norwegian multicentre study of survival and prognostic factors in patients undergoing curative resection for gastric carcinoma: The Norwegian Stomach Cancer Trial. Br J Surg 1993;80:475-8.  Back to cited text no. 41    
42. Liang JL, Wan DS, Pan ZZ, Zhou ZW, Chen G, Li LR, et al . Multivariate regression analysis of recurrence following curative surgery for colorectal cancer. Ai Zheng 2004;23:564-7.   Back to cited text no. 42  [PUBMED]  [FULLTEXT]
43. Yamamoto Y, Takahashi K, Yasuno M, Sakoma T, Mori T. Clinicopathological characteristics of skipping lymph node metastases in patients with colorectal cancer. Jpn J Clin Oncol 1998;28:378-82.   Back to cited text no. 43  [PUBMED]  [FULLTEXT]
44. Hojo K, Koyama Y. Postoperative follow-up studies on cancer of the colon and rectum. Am J Surg 1982;143:293-3.   Back to cited text no. 44  [PUBMED]  [FULLTEXT]
45. Xu FY, Di MJ, Dong JK, Wang FJ, Jin YS, Zhu YM, et al . Influence of clinical and pathomorphological parameters on prognosis in colon carcinoma and rectal carcinoma. Zhejiang Da Xue Xue Bao Yi Xue Ban 2006;35:303-10.   Back to cited text no. 45    
46. Compton CC, Fielding LP, Burgart LJ, Conley B, Cooper HS, Hamilton SR, et al . Prognostic factors in colorectal cancer: College of American Pathologists Consensus Statement 1999. Arch Pathol Lab Med 2000;124:979-94.   Back to cited text no. 46  [PUBMED]  [FULLTEXT]
47. Berti Riboli E, Secco GB, Lapertosa G, Di Somma C, Santi F, Percivale PL. Colorectal cancer: Relationship of histologic grading to disease prognosis. Tumori 1983;69:581-4.   Back to cited text no. 47  [PUBMED]  
48. Nilsson KR, Berenholtz SM, Dorman T, Garrett P, Kaufman HS, Pronovost PJ. Preoperative predictors of blood transfusion in colorectal cancer surgery. J Gastrointest Surg 2002;6:753-62.  Back to cited text no. 48    
49. Liang H, Wang XN, Wang BG, Pan Y, Liu N, Wang DC, et al . Prognostic factors of young patients with colon cancer after surgery. World J Gastroenterol 2006;12:1458-62.  Back to cited text no. 49  [PUBMED]  [FULLTEXT]
50. He WJ, Wang L, Hu H, Kang SY, Qian HX, Xu FM. Correlation of invasion, metastasis, and prognosis in low and middle rectal cancer. Ai Zheng 2002;21:1222-5.   Back to cited text no. 50  [PUBMED]  
51. Enderlin F, Gloor F. Colorectal cancer: The relationship of staging to survival: A cancer registry study of 800 cases in St Gallen-Appenzell. Soz Praventivmed 1986;31:85-8.   Back to cited text no. 51  [PUBMED]  
52. Miyake Y, Mishima H, Nishisho I, Kikkawa N, Monden M. Use of microsatellite analysis in young patients with colorectal cancer to identify those with hereditary nonpolyposis colorectal cancer. J Surg Oncol 2002;79:157-65.  Back to cited text no. 52  [PUBMED]  [FULLTEXT]
53. Bedikian AY, Kantarjian H, Nelson RS, Stroehlein JR, Bodey GP. Colorectal cancer in young adults. South Med J 1981;74:920-4.  Back to cited text no. 53  [PUBMED]  [FULLTEXT]
54. O'Connell JB, Maggard MA, Liu JH, Etzioni DA, Ko CY. Are survival rates different for young and older patients with rectal cancer? Dis Colon Rectum 2004;47:2064-9.  Back to cited text no. 54  [PUBMED]  [FULLTEXT]
55. Minardi AJ Jr, Sittig KM, Zibari GB, McDonald JC. Colorectal cancer in the young patient. Am Surg 1998;64:849-53.   Back to cited text no. 55  [PUBMED]  
56. Taylor MC, Pounder D, Ali-Ridha NH, Bodurtha A, MacMullin EC. Prognostic factors in colorectal carcinoma of young adults. Can J Surg 1988;31:150-3.  Back to cited text no. 56  [PUBMED]  
57. Shahrudin MD, Noori SM. Cancer of the colon and rectum in the first three decades of life. Hepatogastroenterology 1997;44:441-4.  Back to cited text no. 57  [PUBMED]  
58. Liang Han. Prognosis factors for patients with colorectal cancer. In: Xishan H, Dianchang W, editors. Abdominal Oncology. Beijing: People's Health Press; 2003. p. 519-27.  Back to cited text no. 58    
59. Matley PJ, Dent DM, Madden MV, Price SK. Gastric carcinoma in young adults. Ann Surg 1988;208:593-6.  Back to cited text no. 59  [PUBMED]  [FULLTEXT]
60. Mitsudomi T, Matsusaka T, Wakasugi K, Takenaka M, Kume K, Fujinaga Y, et al . A clinicopathological study of gastric cancer with special reference to age of the patients: An analysis of 1630 cases. World J Surg 1989;13:225-30.  Back to cited text no. 60  [PUBMED]  
61. Maehara Y, Oshiro T, Oiwa H, Oda S, Baba H, Akazawa K, et al . Gastric carcinoma in patients over 70 years of age. Br J Surg 1995;82:102-5.  Back to cited text no. 61  [PUBMED]  
62. Maehara Y, Watanabe A, Kakeji Y, Emi Y, Moriguchi S, Anai H, et al . Prognosis for surgically treated gastric cancer patients is poorer for women than men in all patients under age 50. Br J Cancer 1992;65:417-20.  Back to cited text no. 62  [PUBMED]  
63. Lo SS, Wu CW, Chen JH, Li AF, Hsieh MC, Shen KH, et al . Surgical results of early gastric cancer and proposing a treatment strategy. Ann Surg Oncol 2007;14:340-7.  Back to cited text no. 63  [PUBMED]  [FULLTEXT]
64. Borie F, Rigau V, Fingerhut A, Millat B. French Association for Surgical Research. Prognostic factors for early gastric cancer in France: Cox regression analysis of 332 cases. World J Surg 2004;28:686-91.  Back to cited text no. 64    
65. Mitsudomi T, Matsusaka T, Wakasugi K, Takenaka M, Kume K, Fujinaga Y, et al . A clinicopathological study of gastric cancer with special reference to age of the patients: An analysis of 1630 cases. World J Surg 1989;13:225-30.  Back to cited text no. 65  [PUBMED]  
66. Faivre J, Forman D, Esteve J, Gatta G. Survival of patients with oesophageal and gastric cancers in Europe. Eur J Cancer 1998;34:2167-75.  Back to cited text no. 66    
67. Kosmidis PA, Tsavaris N, Skarlos D, Theocharis D, Samantas E, Pavlidis N, et al . Fluorouracil and leucovorin with or without interferon a-2b in advanced colorectal cancer: Analysis of a prospective randomized phase III trial. J Clin Oncol 1996;14:2682-7.  Back to cited text no. 67  [PUBMED]  [FULLTEXT]
68. Newland RC, Dent OF, Lyttle MN, Chapuis PH, Bokey EL. Pathologic determinants of survival associated with colorectal cancer with lymph node metastases: A multivariate analysis of 579 patients. Cancer 1994;73:2076-82.  Back to cited text no. 68  [PUBMED]  
69. Wiggers T, Arends JW, Volovics A. Regression analysis of prognostic factors in colorectal cancer after curative resections. Dis Colon Rectum 1987;51:33.   Back to cited text no. 69    
70. Hannisdal E, Thorsen G. Regression analyses of prognostic factors in colorectal cancer. J Surg Oncol 1988;37:109-12.   Back to cited text no. 70  [PUBMED]  
71. Roncucci L, Fante R, Losi L, Di Gregorio C, Micheli A, Benatti P, et al . Survival for colon and rectal cancer in a population based cancer registry. Eur J Cancer 1995;32A:295.  Back to cited text no. 71    
72. Wolmark N, Weinard HS, Rockette HE, Fisher B, Glass A, Lawrence W, et al . The prognostic significance of tumor location and bowel obstruction in Dukes B and C colorectal cancer. Ann Surg 1987;198:743.  Back to cited text no. 72    
73. Griffin MR, Bergstralh EJ, Coffey RJ, Beart RW Jr, Melton LJ 3rd. Predictors of survival after curative resection of carcinoma of the colon and rectum. Cancer 1987;60:2318-24.  Back to cited text no. 73    
74. Miller BA, Ries LA, Hankey BF, Kosary CL, Edwards BK, editors. Cancer statistics Review: 1973-1989. NIH Pub. No. 92-2789 Bethesda, National Cancer Institute 1992;23:1-9.  Back to cited text no. 74    
75. Curtis RE, Kennedy BJ, Myers MH, Hankley BF. Evaluation of AJC gastric cancer staging using the SEER population. Semin Oncol 1985;12:21-31.  Back to cited text no. 75    
76. Bako G, Ferenczi L, Hanson J, Hill GH, Dewar R. Factors influencing the survival of patients with cancer of the gastric. Clin Invest Med 1985;8:22-8.  Back to cited text no. 76  [PUBMED]  
77. Damhuis RA, Tilanus HW. The influence of age on resection rates and postoperative mortality in 2773 patients with gastric cancer. Eur J Cancer 1995;31:928-33.  Back to cited text no. 77    
78. Kim JP, Lee JH, Kim SJ, Yu HJ, Yang HK. Clinicopathologic characteristics and prognostic factors in 10783 patients with gastric cancer. Gastric Cancer 1998;1:125-33.  Back to cited text no. 78  [PUBMED]  
79. Yokota T, Kunii Y, Saito T, Teshima S, Yamada Y, Iwamoto K, et al . Prognostic factors of gastric cancer tumors of less than 2 cm in diameter: Rationale for limited surgery. Eur J Surg Oncol 2002;28:209-13.  Back to cited text no. 79  [PUBMED]  [FULLTEXT]
80. Zhang XF, Huang CM, Lu HS, Wu XY, Wang C, Guang GX, et al . Surgical treatment and prognosis of gastric cancer in 2,613 patients. World J Gastroenterol 2004;10:3405-8.  Back to cited text no. 80  [PUBMED]  [FULLTEXT]
81. Koga H, Ochiai A, Nakanishi Y, Sasako M, Mizuno S, Kinoshita T, et al . Reevaluation of prognostic factors in gastric leiomyosarcoma. Am J Gastroenterol 1995;90:1307-12.  Back to cited text no. 81    
82. Moriguchi S, Kamakura T, Odaka T, Nose Y, Maehara Y, Korenaga D, et al . Clinical features of the differentiated and undifferentiated types of advanced gastric carcinoma: Univariate and multivariate analyses. J Surg Oncol 1991;48:202-6.  Back to cited text no. 82    
83. Oya M, Takahashi S, Okuyama T, Yamaguchi M, Ueda Y. Synchronous colorectal carcinoma: clinicopathological features and prognosis. Jpn J Clin Oncol 2003;33:38-43.  Back to cited text no. 83  [PUBMED]  [FULLTEXT]

Top
Correspondence Address:
Bijan Moghimi-Dehkordi
Taleghani Hospital, Tabnak St., Yaman Ave., Velenjak, Tehran
Iran
Login to access the Email id


DOI: 10.4103/1319-3767.43284

PMID: 19568550

Get Permissions



    Figures

  [Figure 1], [Figure 2], [Figure 3]
 
 
    Tables

  [Table 1], [Table 2]

This article has been cited by
1 Predictors of Colorectal Cancer Survival in Golestan, Iran: A Population-based Study
Mohammad Aryaie,Gholamreza Roshandel,Shahryar Semnani,Mohsen Asadi-Lari,Mohsen Aarabi,Mohammad Ali Vakili,Vahideh Kazemnejhad,Seyed Mehdi Sedaghat,Masoud Solaymani-Dodaran
Epidemiology and Health. 2013; 35
[Pubmed]
2 Log-normal censored regression model detecting prognostic factors in gastric cancer: A study of 3018 cases
Wang, B.-B., Liu, C.-G., Lu, P., Latengbaolide, A., Lu, Y.
World Journal of Gastroenterology. 2011; 17(23): 2867-2872
[Pubmed]
3 Trend analysis of gastric cancer and colorectal cancer mortality in Iran, 1995-2003
Pourhoseingholi, M.A., Faghihzadeh, S., Hajizadeh, E., Gatta, G., Zali, M.R., Abadi, A.R.
Iranian Journal of Cancer Prevention. 2011; 4(1): 38-43
[Pubmed]
4 Epidemiological differences between colon cancer and rectum cancer
Safaee, A., Moghimi Dehkordi, B., Fatemi, S.R., Zali, M.R.
Iranian Journal of Cancer Prevention. 2010; 3(4): 185-192
[Pubmed]
5 Suppression of TSPAN1 by RNA interference inhibits proliferation and invasion of colon cancer cells in vitro
Chen, L., Yuan, D., Zhao, R., Li, H., Zhu, J.
Tumori. 2010; 96(5): 744-750
[Pubmed]
6 Genetic variant in PSCA predicts survival of diffuse-type gastric cancer in a Chinese population
Meilin Wang, Jin Bai, Yongfei Tan, Shizhi Wang, Yuanyuan Tian, Weida Gong, Yan Zhou, Yan Gao, Jianwei Zhou, Zhengdong Zhang
International Journal of Cancer. 2010; : n/a
[VIEW]
7 Gastric cancer: Correlation between clinicopathological factors and survival of patients (II)
Lazǎr, D., Tǎban, S., Sporea, I., Dema, A., Cornianu, M., Lazǎr, E., Goldiş, A., Vernic, C.
Romanian Journal of Morphology and Embryology. 2008; 50(2): 185-194
[Pubmed]



 

Top
 
  Search
 
  
  
    Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
    Email Alert *
    Add to My List *
* Registration required (free)  


    Abstract
    Patients and Methods
    Results
    Discussion
    Conclusion
    Acknowledgements
    References
    Article Figures
    Article Tables

 Article Access Statistics
    Viewed 3573    
    Printed 152    
    Emailed 1    
    PDF Downloaded 526    
    Comments  [Add]    
    Cited by others  7    

Recommend this journal