There are several prognostic factors in stomach cancer that can affect the outcome of your illness. I will outline these and why they are significant to you.
Prognosis means ‘the likely outcome of your illness. For a lot of people this isn't something they wish to know, so If that’s the case with you, please leave the page now.
For those of you who do want to know more about what actually affects the outcome of your illness, I will explain each individual factor that may have an influence.
It is true that age is one of the prognostic factors in stomach cancer survival, the older you are, the worse the outcome is likely to be (1). Why is this? Well there are a lot of factors with age.
The only way of curing gastric malignancies at present is through surgery and this is a major stress on your body
Usually, although not always, age is linked with other illnesses such as heart disease, lung complaints etc so you may not be in the best of health. .
The risk of heart attack, strokes and other post-operative complications increase with age, particularly if over the age of 65 years.
Immunity is poorer as well as wound healing when you are older.
It may be that your risk is just too high for your surgeon to contemplate surgery, but this will need careful discussion with them.
The studies that have been done to date have shown mixed results with this, although on balance there probably isn't any difference in outcomes between men and women (2).
The larger your tumor and the higher the stage, the worse the prognosis is (3).
Catching it in the early stages, preferably stage one, is associated with much better outcomes.
The more lymph nodes that are found to be affected at surgery, the worse the outcome too.
Proximal tumors (in the upper stomach) are associated with a worse outcome compared with distal ones (lower stomach) (4).
It is true that the surgeon you have can affect the outcome (5). Whilst all surgeons should have the same outcomes, it is important for you to ask your surgeon about his/her specific outcomes and complications.
There may be a specific reason such as one surgeon taking on more complex or risky surgeries in comparison to another.
This might not be a bad thing though – for example surgeon A may have lower complications and deaths versus surgeon B. The reason for this is that surgeon A only operates on people under the age of 50 whereas surgeon B operates on those over 65 years.
This particular prognostic factor is less important than it used to be.
The reason for this is that surgeries are often occurring now in centers of excellence as well as each surgeon having to go through revalidation (UK) i.e. being assessed by their peers to ensure quality.
It’s a lot to take in to account, but you have to balance your benefit versus the risk with any treatment you are offered.
1) Application of Smoothing Methods For Determining of The Effecting Factors On The Survival Rate of Gastric Cancer Patients
Hoda Noorkojuri et al. Iran Red Crescent Med J. 2013 February; 15(2): 166-172
2) Clinicopathological Features and Outcomes of Patients With Gastric Cancer: A Single-Center Experience.
Selcukbiricik F et al. World J Gastroenterol 2013 April 14: 19(14):2154-61. doi 10.3748/wjg.v19.i14.2154.
3) Prognostic Value of Tumor Size In Gastric Cancer: An Analysis of 2,379 Patients
Guo P et al Tumor Biol 2013 Apr 34(2): 1027-35. doi: 10.1007/s13277-012-0642-6. Epub 2013 Jan 15.
4) Surgical Treatment And Prognosis Of Gastric Cancer In 2,613 Patients
Zhang XF et al World J Gastroenterol 2004 Dec 1: 10(23):3405-8
5) Surgeon Subspeciality As A Factor In Improving Long-Term Outcomes For Gastric Cancer: Twenty Years Of Experience In Korea
Jang YJ et al Arch Surg 2010 Nov:145(11):1091-6. doi: 10.001/archsurg. 2010.232