Survival and adequate preoperative staging in patients undergoing gastric cancer surgery at a Peruvian Police Hospital

Abstract

Introduction: Gastric cancer is the fifth most common malignant neoplasm and the third leading cause of cancer-related death worldwide. In Peru, its incidence is 15.8 per 100,000 population, and it is associated with high mortality rates, especially in areas with low socioeconomic status. The aim of this study was to compare preoperative, postoperative, and anatomopathological staging results and their relation to disease recurrence and survival. Methods: We conducted a retrospective cohort study of patients undergoing surgery for gastric cancer with a definitive postoperative anatomopathological diagnosis from 2005 to 2014 at the Hospital Nacional Luis N. Sáenz. Statistical analyses included descriptive and correlation statistics using the κ index, determination of associations between preoperative and postoperative staging and surgical reintervention and recurrence using the χ2 test, as well as Kaplan Meier survival analysis. Results: There was little correlation between preoperative staging and final anatomopathological diagnosis, while there was a good correlation with postoperative staging. A significant association was found between preoperative staging and cancer recurrence. In the survival analysis, survival was lower among patients with underestimated staging. Conclusions: The survival of patients with gastric cancer can be affected by an overestimation of preoperative staging, therefore improvements in preoperative staging could lengthen the survival of patients undergoing gastric cancer surgery.