Impact of clinicopathological factors and treatment outcomes on gastric cancer survival: A tertiary care hospital-based study in Eastern India.

Objective: The late diagnosis of GC poses a significant health burden worldwide, particularly in Asia. Despite the declining incidence, the heterogeneous diversity of India exhibits pronounced regional disparity in survival rates among the patients. The study observed the clinicopathological factors and treatment outcomes influencing the survival of gastric cancer (GC) patients.

Methods: A total of 78 newly diagnosed GC patients were enrolled (from 2019 to 2023). Overall survival (OS) and hazard risk (HR) for sociodemographic, clinicopathological factors, and treatment outcomes of the patients were assessed by univariate Kaplan-Meier and multivariate Cox-Regression analysis.

Results: The frequency of GC was highly prevalent among males (69.2%), with a median age of 52 ± 11.35 years. The majority of them are associated with mixed diet (88.5%), grade-III tumors (57.7%) located in the antrum (60.3%) at ≥5 cm (56.4%) classified as pTNM stage-III (64.1%) exhibiting lymphovascular invasion (75.6%). Clinical features, including initial symptoms, treatment response, and pTNM-stage presented increased hazard risks in the patients (HR >1) but presented no significant difference. Nearly 63% of the patients operated upfront and 37% received neoadjuvant FLOT chemotherapy. The mean overall survival of the patients was 19.7 months [95% CI: 15.9-23.5]. The hazard of death was significantly allied with older age (P < 0.001), and neoadjuvant-FLOT-chemotherapy (P < 0.001); however, a higher number of cycles of adjuvant-CAPOX-chemotherapy associated with improved overall survival (P < 0.001) and relatively lower HR.

Conclusion: The clinicopathological attributes and treatment outcomes like older age, weight loss, tumor size, type of gastrectomy, FLOT regimen, number of cycles, and postoperative undernourishment demonstrated higher HR and compromised survival in GC patients of Eastern India.