Risk Factors for Surgical Treatment in Gastric and Colorectal Cancer Patients with Low Socioeconomic Status
Keywords:
Cancer stage; Colorectal cancer; Gastric cancer; Socioeconomic status; SurgeryAbstract
Surgery is the only potentially curative treatment option for gastric and colorectal cancer patients. Stage at diagnosis is the most important prognostic factor and closely related with socioeconomic status. Authors aimed to compare the risk factors influencing presentation and outcomes of surgical treatment of gastric and colorectal cancer patients with low socioeconomic status. Clinicopathologic characteristics of 112 consecutive patients in low socioeconomic area and outcomes of their surgical treatments were compared to identify the risk factors for each type of cancer. Clinicopathologic characteristics were similar in both groups. Elderly patients had comprised 30% of all patients. Advanced stage diseases were noted in 82% of gastric cancer patients and 78.6% of colorectal cancer patients. Curative resection rates were 19.6% for gastric cancers and 51.8% for colorectal cancers. Emergency surgical procedures were performed in 35% of patients with colorectal cancer. Postoperative morbidity rates were 18% and 23%, mortality rates were 5.4% and 10.7% in gastric and colorectal cancer patients, respectively.Advanced age and advanced stage at diagnosis significantly influence the results of surgical treatment of gastric and colorectal cancer patients. Morbidity and mortality rates are also significant correlated with high ASA scores, emergency procedures and curative resections in colorectal cancer patients. Optimal balance should be established between the goals of surgical treatment and acceptable risks of surgery for a good quality of life. Improvement of socioeconomic status may make considerable contribution to surgical treatment.
References
Abir, F., Alva, S., Longo, W.E., Audiso, R., Virgo, K.S., Johnson, F.E., 2006. The postoperative surveillance of patients with colon cancer and rectal cancer. Am. J. Surg., 192, 100-108.
Auvinen, A., Karjalainen, S., 1997. Possible explanations for social class differences in cancer patient survival. I.A.R.C. Sci. Publ., 138, 377-397.
Braga, M., Molinari, M., Zuliani, W., Foppa, L., Gianotti, L., Radaelli, G., Cristallo, M., Di Carlo, V.., 1996. Surgical treatment of gastric adenocarcinoma: impact on survival and quality of life. A prospective ten year study. Hepatogastroenterology, 43, 187-193.
Biondo, S,, Kreisler, E., Millan, M., Fraccalvieri, D., Goldai T., Martí Ragué, J., Salazar, R., 2008. Differences in patient postoperative and long-term outcomes between obstructive and perforated colonic cancer. Am. J. Surg., 195, 427-432.
Biondo, S., Martí-Ragué, J., Kreisler, E., Parés, D., Martín, A., Navarro, M., Pareja, L., Jaurrieta, E., 2005. A prospective study of outcomes of emergency and elective surgeries for complicated colonic cancer. Am. J. Surg., 189, 377-383.
Borch, K., Jönsson, B., Tarpila, E., Franzén, T., Berglund, J., Kullman, E., Franzén, L., 2000. Changing pattern of histological type, location, stage and outcome of surgical treatment of gastric carcinoma. Br. J. Surg., 87, 618-626.
Cappell, M.S., 2008. Pathophysiology, clinical presentation, and management of colon cancer. Gastroenterol. Clin. North. Am., 37, 1-24.
Crozier, J.E., Leitch, E.F., McKee ,R.F., Anderson, J.H., Horgan, P.G., Mc Millan, D.C., 2009. Relationship between emergency presentation, systemic inflammatory response, and cancer-specific survival in patients undergoing potentially curative surgery for colon cancer. Am. J. Surg., 197, 544-549.
Díaz De Liaño, A., Oteiza Martínez, F., Ciga, M.A., Aizcorbe, M., Cobo, F., Trujillo, R., 2003. Impact of surgical procedure for gastric cancer on quality of life. Br. J. Surg., 90, 91-94.
Dicken, B.J., Bigam, D.L., Cass, C., Mackey, J.R., Joy, A.A., Hamilton, S.M., 2005. Gastric adenocarcinoma: review and considerations for future directions. Ann. Surg., 241, 27-39.
Doglietto, G.B., Pacelli, F., Caprino, P., Sqadari, A., Crucitti, F., 2000. Surgery: independent prognostic factor in curable and far advanced gastric cancer. World J. Surg., 24, 459-464.
Emmons, K, Puleo, E., McNeill, L.H., Bennett, G., Chan, S., Syngal, S., 2008. Colorectal cancer screening awareness and intentions among low income, sociodemographically diverse adults under age 50. Cancer Causes Control, 19, 1031-1041.
Evans, M.D., Escofet, X., Karandikar, S.S., Stamatakis, J.D., 2009. Outcomes of resection and non-resection strategies in management of patients withadvanced colorectal cancer. World. J. Surg. Oncol., 7, 28.
Green, D., Ponce de Leon, S., Leon-Rodriguez, E., Sosa-Sanchez, R., 2002. Adenocarcinoma of the stomach: univariate and multivariate analysis of factors associated with survival. Am. J. Clin. Oncol., 25, 84-89.
Hartgrink, H.H., Putter, H., Klein Kranenbarg, E., Bonenkamp, J.J., van de Velde, C.J., 2002. Value of palliative resection in gastric cancer. Br. J. Surg., 89, 1438-1443.
Huerta, S., Goulet, E.J., Livingston, E.H., 2006. Colon cancer and apoptosis. Am. J. Surg., 191, 517-526.
Kawaguchi, Y., 2009. Improved Survival of Patients with Gastric Cancer or Colon Cancer when treated with Active Hexose Correlated Compound (AHCC): Effect of AHCC on digestive system cancer. Nat. Med., 1, 1-6.
Krieger, N., 2005. Defining and investigating social disparities in cancer: critical issues. Cancer Causes Control, 16, 5-14.
Kulig, J., Popiela, T., Kolodziejczyk, P., Sierzega, M., Szczepanik, A., 2007. Standard D2 versus extended D2 (D2+) lymphadenectomy for gastric cancer: an interim safety analysis of a multicenter, randomized, clinical trial. Am. J. Surg., 193, 10-15.
Kunisaki, C., Akiyama, H, Nomura, M., Matsuda, G., Otsuka, Y., Ono, H.A., Shimada, H., 2006. Comparison of surgical outcomes of gastric cancer in elderly and middle-aged patients. Am. J. Surg., 191, 216-224.
La Vecchia, C,, Negri, E., Franceschi, S., Gentile, A., 1992. Family history and the risk of stomach and colorectal cancer. Cancer, 70, 50-55.
Lee, L., Jannapureddy, M., Albo, D., Awad, S.S., Farrow, B., Bellows, C.C., Berger, D.H., 2007. Outcomes of Veterans Affairs patients older than age 80 after surgical procedures for colon malignancies. Am. J. Surg., 194, 646-651.
Lo, CH., Chen, J.H., Wu, C.W., Lo, S.S., Hsieh, M.C., Lui, W.Y., 2008. Risk factors and management of intra-abdominal infection after extended radical mastectomy. Am. J. Surg., 196, 741-745.
McArdle, C.S., McMillan, D.C., Hole, D.J., 2006. The impact of blood loss, obstruction and perforation on survival in patients undergoing curative resection for colon cancer. Br. J. Surg., 93, 483-488.
Msika, S., Benhamiche, A.M., Jouve, J.L., Rat, P., Faivre, J., 2000. Prognostic factors after curative resection for gastric cancer. A population-based study. Eur. J. Cancer, 36, 390-396.
Nakajima, T., 2002. Gastric cancer treatment guidelines in Japan. Gastric Cancer, 5, 1-5.
Nakamura, K., Ueyama, T., Yao, T., Xuan, Z.X., Ambe, K., Adachi, Y., Yakeishi, Y., Matsukuma, A., Enjoji, M., 1992. Pathology and prognosis of gastric carcinoma. Findings in 10,000 patients who underwent primary mastectomy. Cancer, 70, 1030-1037.
Ren, L., Upadhyay, A.M., Wang, L., Li, L., Lu, J., FU, W., 2009. Mortality rate prediction by Physiological and Operative Severity Score for the Enumeration of Mortality and Morbidity (POSSUM), Portsmouth POSSUM and Colorectal POSSUM and the development of new scoring systems in Chinese colorectal cancer patients. Am. J. Surg., 198, 31-38.
Repetto, L., Venturino, A., Fratino, L., Serraino, D., Troisi, G., Gianni, W., Pietropaolo, M., 2003. Geriatric oncology: a clinical approach to the older patient with cancer. Eur. J. Cancer, 39, 870-880.
Santoro, R., Carboni, F., Lepiane, P., Ettorre, G.M., Santoro, E., 2007. Clinicopathological features and prognosis of gastric cancer in young European adults. Br. J. Surg., 94, 737-742.
Serpell, J,W,, McDermott, F.T., Katrivessis, H., Hughes, E.S., 1989. Obstructing carcinomas of the colon. Br .J. Surg. 76, 965-969.
Sessa, A., Abbate, R., Di Giuseppe, G., Marinelli, P., Angelillo, IF., 2008. Knowledge, attitudes, and preventive practices about colorectal cancer among adults in an area of Southern Italy. B.M.C. Cancer, 8, 171.
Siewert, J.R., Böttcher, K., Stein, H.J., Roder, J.D., 1998. Relevant prognostic factors in gastric cancer: ten-year results of the German Gastric Cancer Study. Ann. Surg., 228, 449-461.
Sjövall, A., Holm, T., Singnomklao, T., Granath, F., Glimelius, B., Cedemark, B., 2007. Colon cancer management and outcome in relation to individual hospitals in a defined population. Br. J. Surg., 94, 491-499.
Sun, P,, Xiang, J.B., Chen, Z.Y., 2009. Meta-analysis of adjuvant chemotherapy after radical surgery for advanced gastric cancer. Br. J. Surg., 96, 26-33.
Thompson, A.M., Rapson, T., Gilbert, F.J., Park, K.G., 2007. Hospital volume does not influence long-term survival of patients undergoing surgery for oesophageal or gastric cancer. Br. J. Surg., 94, 578-584.
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Copyright (c) 2014 B. Kulah, Z. Ergul, M. Akinci, H. Kulacoglu
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