Introduction
Materials and methods
Study design
Data sources
Data analysis
Results
Patients
Variable | Gastric non-cardia adenocarcinoma n (%) | Gastric cardia adenocarcinoma n (%) | Total n (%) |
---|---|---|---|
Total | 18,713 (83.8) | 3617 (16.2) | 22,330 (100) |
Calendar period | |||
1987–1991 | 4486 (24.0) | 677 (18.7) | 5163 (23.1) |
1992–1996 | 3720 (19.9) | 676 (18.7) | 4396 (19.7) |
1997–2001 | 3135 (16.8) | 657 (18.2) | 3792 (17.0) |
2002–2006 | 2928 (15.6) | 551 (15.2) | 3479 (15.6) |
2007–2011 | 2552 (13.6) | 612 (16.9) | 3164 (14.2) |
2012–2016 | 1892 (10.1) | 444 (12.3) | 2336 (10.5) |
Age | |||
> 50 | 1325 (7.1) | 265 (7.3) | 1590 (7.1) |
50–59 | 2243 (12.0) | 523 (14.5) | 2766 (12.4) |
60–69 | 4197 (22.4) | 929 (25.7) | 5126 (23.0) |
70–79 | 5910 (31.6) | 1126 (31.1) | 7036 (31.5) |
80–89 | 4398 (23.5) | 678 (18.7) | 5076 (22.7) |
90 + | 640 (3.4) | 96 (2.7) | 736 (3.3) |
Sex | |||
Female | 8864 (47.4) | 1085 (30.0) | 9949 (44.6) |
Male | 9849 (52.6) | 2532 (70.0) | 12,381 (55.4) |
CCI | |||
0 | 12,007 (64.2) | 2222 (61.4) | 14,229 (63.7) |
1 | 4058 (21.7) | 817 (22.6) | 4875 (21.8) |
2 | 1717 (9.2) | 375 (10.4) | 2092 (9.4) |
3 + | 931 (5.0) | 203 (5.6) | 1134 (5.1) |
Surgery | |||
Yes | 8293 (44.3) | 1320 (36.5) | 9613 (43.0) |
No | 10,420 (55.7) | 2297 (63.5) | 12,717 (57.0) |
Chemotherapy | |||
No | 12,909 (69.0) | 2255 (62.3) | 15,164 (67.9) |
Yes | 2758 (14.7) | 694 (19.2) | 3452 (15.5) |
Missing | 3046 (16.3) | 668 (18.5) | 3714 (16.6) |
Stage | |||
Local | 3608 (19.3) | 599 (16.6) | 4207 (18.8) |
Locally advanced | 2226 (11.9) | 469 (13.0) | 2695 (12.1) |
Advanced | 7610 (40.7) | 1452 (40.1) | 9062 (40.6) |
Unclear or missing | 5269 (28.2) | 1097 (30.3) | 6366 (28.5) |
Surgery
Survival trends in gastric non-cardia cancer
All patients
Gastric non- cardia adenocarcinoma | Gastric cardia adenocarcinoma | |||||||
---|---|---|---|---|---|---|---|---|
Patients | Survival in % | Patients | Survival in % | |||||
Calendar period | Number (%) | 1 year | 3 years | 5 years | Number (%) | 1 year | 3 years | 5 years |
All patients | ||||||||
1987–1991 | 4486 (24.0) | 38 | 21 | 17 | 677 (18.7) | 34 | 14 | 10 |
1992–1996 | 3720 (19.9) | 40 | 20 | 18 | 676 (18.7) | 36 | 16 | 12 |
1997–2001 | 3135 (16.8) | 41 | 23 | 19 | 657 (18.2) | 40 | 18 | 13 |
2002–2006 | 2928 (15.6) | 41 | 22 | 17 | 551 (15.2) | 40 | 16 | 12 |
2007–2011 | 2552 (13.6) | 42 | 23 | 17 | 612 (16.9) | 44 | 20 | 14 |
2012–2016 | 1892 (10.1) | 40 | 23 | 16 | 444 (12.3) | 50 | 24 | 18 |
Surgery | ||||||||
1987–1991 | 2051 (24.7) | 62 | 37 | 29 | 270 (20.5) | 54 | 23 | 16 |
1992–1996 | 1817 (21.9) | 66 | 40 | 31 | 280 (21.2) | 58 | 31 | 24 |
1997–2001 | 1505 (18.1) | 69 | 43 | 35 | 271 (20.5) | 68 | 37 | 28 |
2002–2006 | 1293 (15.6) | 71 | 43 | 35 | 171 (13.0) | 76 | 44 | 36 |
2007–2011 | 995 (12.0) | 77 | 49 | 37 | 176 (13.3) | 90 | 57 | 43 |
2012–2016 | 632 (7.6) | 77 | 49 | 38 | 152 (11.5) | 86 | 52 | 40 |
No surgery | ||||||||
1987–1991 | 2435 (23.4) | 18 | 8 | 7 | 407 (17.7) | 20 | 7 | 5 |
1992–1996 | 1903 (18.3) | 16 | 7 | 6 | 396 (17.2) | 20 | 4 | 4 |
1997–2001 | 1630 (15.6) | 16 | 5 | 4 | 386 (16.8) | 20 | 4 | 2 |
2002–2006 | 1635 (15.7) | 17 | 5 | 3 | 380 (16.5) | 23 | 3 | 2 |
2007–2011 | 1557 (14.9) | 20 | 6 | 4 | 436 (19.0) | 26 | 5 | 3 |
2012–2016 | 1260 (12.1) | 22 | 6 | 4 | 292 (12.7) | 32 | 9 | 7 |
Surgical patients
Non-surgical patients
Cancer stage
Gastric non-cardia adenocarcinoma | Gastric cardia adenocarcinoma | |||||||
---|---|---|---|---|---|---|---|---|
Patients | Survival in % | Patients | Survival in % | |||||
Calendar period | Number (%) | 1 year | 3 years | 5 years | Number (%) | 1 year | 3 years | 5 years |
Local | ||||||||
1987–1991 | 1092 (30.3) | 74 | 55 | 45 | 147 (24.5) | 64 | 32 | 26 |
1992–1996 | 960 (26.6) | 79 | 59 | 48 | 150 (25.0) | 62 | 42 | 33 |
1997–2001 | 609 (16.9) | 78 | 60 | 52 | 107 (17.9) | 68 | 43 | 35 |
2002–2006 | 488 (13.5) | 78 | 60 | 50 | 85 (14.2) | 71 | 49 | 37 |
2007–2011 | 351 (9.7) | 74 | 58 | 50 | 88 (14.7) | 62 | 48 | 34 |
2012–2016 | 108 (3.0) | 79 | 62 | 57 | 22 (3.7) | 73 | 54 | 55 |
Locally advanced | ||||||||
1987–1991 | 505 (22.7) | 61 | 26 | 17 | 83 (17.7) | 46 | 11 | 5 |
1992–1996 | 447 (20.1) | 62 | 28 | 20 | 91 (19.4) | 57 | 19 | 12 |
1997–2001 | 459 (20.6) | 68 | 34 | 23 | 116 (24.7) | 68 | 32 | 23 |
2002–2006 | 350 (15.7) | 72 | 40 | 31 | 61 (13.0) | 74 | 33 | 26 |
2007–2011 | 267 (12.0) | 80 | 44 | 28 | 80 (17.1) | 82 | 46 | 28 |
2012–2016 | 198 (8.9) | 66 | 35 | 26 | 38 (8.1) | 76 | 37 | 24 |
Advanced | ||||||||
1987–1991 | 1892 (24.9) | 16 | 3 | 2 | 290 (20.0) | 14 | 2 | 1 |
1992–1996 | 1472 (19.3) | 15 | 2 | 2 | 278 (19.1) | 18 | 4 | 3 |
1997–2001 | 1203 (15.8) | 16 | 4 | 3 | 258 (17.8) | 18 | 3 | 1 |
2002–2006 | 1286 (16.9) | 23 | 6 | 3 | 263 (18.1) | 24 | 5 | 3 |
2007–2011 | 1243 (16.3) | 30 | 12 | 7 | 273 (18.8) | 34 | 8 | 6 |
2012–2016 | 514 (6.8) | 18 | 4 | 3 | 90 (6.2) | 20 | 6 | 4 |
Survival trends in gastric cardia cancer
All patients
Surgical patients
Non-surgical patients
Cancer stage
Risk factors for 5-year mortality in gastric non-cardia cancer
Covariate | Category | Gastric non- cardia adenocarcinoma | |
---|---|---|---|
Number of patients (%) | HR (95% CI) | ||
All patients | |||
Calendar period | 1987–1991 | 4486 (24.0) | 1.08 (1.02–1.15) |
1992–1996 | 3720 (19.9) | 1.02 (0.96–1.08) | |
1997–2001 | 3135 (16.8) | 0.97 (0.91–1.03) | |
2002–2006 | 2928 (15.6) | 1.02 (0.95–1.08) | |
2007–2011 | 2552 (13.6) | 0.97 (0.91–1.04) | |
2012–2016 | 1892 (10.1) | 1 (Reference) | |
Age | > 50 | 1325 (7.1) | 1 (Reference) |
50–59 | 2243 (12.0) | 1.03 (0.95–1.12) | |
60–69 | 4197 (22.4) | 1.14 (1.06–1.22) | |
70–79 | 5910 (31.6) | 1.37 (1.28–1.47) | |
80–89 | 4398 (23.5) | 1.90 (1.77–2.04) | |
90 + | 640 (3.4) | 2.92 (2.64–3.24) | |
Sex | Female | 8864 (47.4) | 1 (Reference) |
Male | 9849 (52.6) | 1.07 (1.03–1.10) | |
CCI | 0 | 12,007 (64.2) | 1 (Reference) |
1 | 4058 (21.7) | 1.01 (0.97–1.05) | |
2 | 1717 (9.2) | 1.12 (1.06–1.18) | |
3 + | 931 (5.0) | 1.22 (1.14–1.32) | |
Surgery | |||
Calendar period | 1987–1991 | 2051 (24.7) | 1.58 (1.41–1.77) |
1992–1996 | 1817 (21.9) | 1.40 (1.24–1.56) | |
1997–2001 | 1505 (18.1) | 1.21 (1.07–1.36) | |
2002–2006 | 1293 (15.6) | 1.19 (1.06–1.35) | |
2007–2011 | 995 (12.0) | 1.03 (0.90–1.16) | |
2012–2016 | 632 (7.6) | 1 (Reference) | |
Age | > 50 | 728 (8.8) | 1 (Reference) |
50–59 | 1186 (14.3) | 1.01 (0.89–1.14) | |
60–69 | 2129 (25.7)) | 1.11 (1.00–1.24) | |
70–79 | 2777 (33.5) | 1.37 (1.23–1.52) | |
80–89 | 1410 (17.0) | 1.83 (1.63–2.05) | |
90 + | 63 (0.8) | 2.94 (2.22–3.88) | |
Sex | Female | 3865 (46.6) | 1 (Reference) |
Male | 4428 (53.4) | 1.10 (1.05–1.16) | |
CCI | 0 | 5515 (66.5) | 1 (Reference) |
1 | 1805 (21.8) | 1.13 (1.06–1.21) | |
2 | 653 (7.9) | 1.25 (1.13–1.38) | |
3 + | 320 (3.9) | 1.55 (1.36–1.77) | |
No surgery | |||
Calendar period | 1987–1991 | 2435 (23.4) | 1.05 (0.98–1.13) |
1992–1996 | 1903 (18.3) | 1.13 (1.05–1.22) | |
1997- 2001 | 1630 (15.6) | 1.13 (1.05–1.22) | |
2002–2006 | 1635 (15.7) | 1.16 (1.08–1.25) | |
2007–2011 | 1557 (14.9) | 1.07 (0.99–1.15) | |
2012–2016 | 1260 (12.1) | 1 (Reference) | |
Age | > 50 | 597 (5.7) | 1 (Reference) |
50–59 | 1057 (10.1) | 1.03 (0.93–1.15) | |
60–69 | 2068 (19.8) | 1.13 (1.02 -1.24) | |
70–79 | 3133 (30.1) | 1.28 (1.17–1.40) | |
80–89 | 2988 (28.7) | 1.44 (1.33–1.58) | |
90 + | 577 (5.5) | 1.65 (1.47–1.86) | |
Sex | Female | 4999 (48.0) | 1 (Reference) |
Male | 5421 (52.0) | 1.03 (0.99–1.08) | |
CCI | 0 | 6492 (62.3) | 1 (Reference) |
1 | 2253 (21.6) | 0.95 (0.91–1.00) | |
2 | 1064 (10.2) | 0.99 (0.93–1.06) | |
3 + | 611 (5.9) | 0.97 (0.89–1.05) |
Risk factors for 5-year mortality in gastric cardia cancer
Covariate | Category | Gastric cardia adenocarcinoma | |
---|---|---|---|
Number of patients (%) | HR (95% CI) | ||
All patients | |||
Calendar period | 1987–1991 | 677 (18.7) | 1.49 (1.30–1.71) |
1992–1996 | 676 (18.7) | 1.36 (1.19–1.55) | |
1997–2001 | 657 (18.2) | 1.27 (1.11–1.45) | |
2002–2006 | 551 (15.2) | 1.24 (1.08–1.43) | |
2007–2011 | 612 (16.9) | 1.13 (0.98–1.29) | |
2012–2016 | 444 (12.3) | 1 (Reference) | |
Age | > 50 | 265 (7.3) | 1 (Reference) |
50–59 | 523 (14.5) | 0.91 (0.78–1.07) | |
60–69 | 929 (25.7) | 0.98 (0.84–1.14) | |
70–79 | 1126 (31.1) | 1.13 (0.97–1.30) | |
80–89 | 678 (18.7) | 1.59 (1.36–1.87) | |
90 + | 96 (2.7) | 2.03 (1.59–2.60) | |
Sex | Female | 1085 (30.0) | 1 (Reference) |
Male | 2532 (70.0) | 1.05 (0.97–1.14) | |
CCI | 0 | 2222 (61.4) | 1 (Reference) |
1 | 817 (22.6) | 1.07 (0.98–1.17) | |
2 | 375 (10.4) | 1.26 (1.12–1.42) | |
3 + | 203 (5.6) | 1.33 (1.14–1.55) | |
Surgery | |||
Calendar period | 1987–1991 | 270 (20.5) | 2.22 (1.72–2.86) |
1992–1996 | 280 (21.2) | 1.82 (1.42–2.35) | |
1997–2001 | 271 (20.5) | 1.48 (1.14–1.90) | |
2002–2006 | 171 (13.0) | 1.17 (0.88–1.54) | |
2007–2011 | 176 (13.3) | 0.86 (0.65–1.15) | |
2012–2016 | 152 (11.5) | 1 (Reference) | |
Age | > 50 | 117 (8.9) | 1 (Reference) |
50–59 | 225 (17.0) | 0.84 (0.63–1.10) | |
60–69 | 409 (31.0) | 1.00 (0.78–1.29) | |
70–79 | 445 (33.7) | 1.19 (0.92–1.52) | |
80–89 | 118 (8.9) | 1.45 (1.06–1.97) | |
90 + | 6 (0.5) | 2.50 (1.09–5.77) | |
Sex | Female | 361 (27.3) | 1 (Reference) |
Male | 959 (72.7) | 1.22 (1.05–1.42) | |
CCI | 0 | 905 (68.6) | 1 (Reference) |
1 | 283 (21.4) | 1.01 (0.85–1.19) | |
2 | 94 (7.1) | 1.13 (0.87–1.46) | |
3 + | 38 (2.9) | 1.30 (0.85–1.85) | |
No surgery | |||
Calendar period | 1987–1991 | 407 (17.7) | 1.34 (1.14–1.57) |
1992–1996 | 396 (17.2) | 1.36 (1.16–1.59) | |
1997–2001 | 386 (16.8) | 1.42 (1.21–1.66) | |
2002–2006 | 380 (16.5) | 1.28 (1.09–1.50) | |
2007–2011 | 436 (19.0) | 1.20 (1.03–1.40) | |
2012–2016 | 292 (12.7) | 1 (Reference) | |
Age | > 50 | 148 (6.4) | 1 (Reference) |
50–59 | 298 (13.0) | 0.90 (0.73–1.10) | |
60–69 | 520 (22.6) | 0.96 (0.80–1.16) | |
70–79 | 681 (29.6) | 1.02 (0.85–1.23) | |
80–89 | 560 (24.4) | 1.12 (0.93–1.36) | |
90 + | 90 (3.9) | 1.24 (0.95–1.64) | |
Sex | Female | 724 (31.5) | 1 (Reference) |
Male | 1573 (68.5) | 0.98 (0.90–1.08) | |
CCI | 0 | 1317 (57.3) | 1 (Reference) |
1 | 534 (23.2) | 1.07 (0.96–1.19) | |
2 | 281 (12.2) | 1.14 (1.00–1.31) | |
3 + | 165 (7.2) | 1.11 (0.94–1.32) |