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©The Author(s) 2015. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastroenterol. Jun 7, 2015; 21(21): 6434-6443
Published online Jun 7, 2015. doi: 10.3748/wjg.v21.i21.6434
Published online Jun 7, 2015. doi: 10.3748/wjg.v21.i21.6434
Short-term and long-term risk factors in gastric cancer
Giuseppe Verlato, Simone Accordini, Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, 37134 Verona, Italy
Daniele Marrelli, Franco Roviello, Department of Medicine, Surgery and Neurosciences, Section of General Surgery and Surgical Oncology, Translational Research Laboratory, University of Siena, 53100 Siena, Italy
Maria Bencivenga, Giovanni de Manzoni, Upper Gastrointestinal Surgery, University of Verona, 37126 Verona, Italy
Alberto Di Leo, General Surgery, Hospital “Santa Maria del Carmine”, 38068 Rovereto, Italy
Alberto Marchet, Department of Surgery, Oncology and Gastroenterology, University of Padua, 35121 Padua, Italy
Roberto Petrioli, Department of Medicine, Surgery and Neurosciences, Medical Oncology Unit, University of Siena, 53100 Siena, Italy
Giacomo Zoppini, Michele Muggeo, Section of Endocrinology, Diabetes and Metabolism, Department of Medicine, Azienda Ospedaliera Universitaria Integrata, University of Verona, 37126 Verona, Italy
Author contributions: Verlato G devised the study and prepared the draft of the manuscript; Verlato G did the statistical analysis; Marrelli D, Di Leo A, Roviello F and de Manzoni G founded the GIRCG with other colleagues and contributed to the GIRCG database; Bencivenga M, Marchet A and Petrioli R contributed to the GIRCG database; Muggeo M organized and coordinated the Verona Diabetes Study, with the help of Zoppini G; all the authors contributed to the interpretation of results and to the revision of the manuscript; all the authors read and approved the final manuscript.
Conflict-of-interest: Giuseppe Verlato has received financial support from BioMed Central to participate to the 2014 Congress of the ERS (European Respiratory Society). The other Authors declare no conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Giuseppe Verlato, MD, PhD, Unit of Epidemiology and Medical Statistics, Department of Public Health and Community Medicine, University of Verona, Sezione di Epidemiologia e Statistica Medica, Istituti Biologici 2 B, Strada Le Grazie 8, 37134 Verona, Italy. giuseppe.verlato@univr.it
Telephone: +39-45-8027628 Fax: +39-45-8027154
Received: December 15, 2014
Peer-review started: December 16, 2014
First decision: January 22, 2015
Revised: February 28, 2015
Accepted: March 31, 2015
Article in press: March 31, 2015
Published online: June 7, 2015
Processing time: 178 Days and 1.3 Hours
Peer-review started: December 16, 2014
First decision: January 22, 2015
Revised: February 28, 2015
Accepted: March 31, 2015
Article in press: March 31, 2015
Published online: June 7, 2015
Processing time: 178 Days and 1.3 Hours
Core Tip
Core tip: In gastric cancer patients mortality from recurrence peaked in the first two years after curative gastrectomy and then declined. The prognostic significance of risk factors was not stable, as the effect of T and N decreased with time, while the effect of histology became apparent after two years. Advancing age was associated with increased post-operative mortality. Hence, the proportional hazards assumption of the Cox model was violated. A possible solution was to split survival analysis in the first two years of follow-up and subsequent years. By comparison, overall mortality and prognostic significance of risk factors was rather stable in a cohort of type 2 diabetic patients.