Progressive improvement of prognosis for patients with gastric cancer (dynamic stage grouping) with increasing survival interval from initial staging: how much longer can a given survivor expect to live?

Abstract

The prognosis in gastric cancer is usually defined at the time of presentation. Prognosis, however, is a variable that alters with time. Once a patient has survived for 1 year, the prognosis will change. This study examines this variable in patients who have survived from 1 to 5 years after operation. Of 1468 patients with gastric cancer, the next 5-year survival (5YS) of patients who already survived for 1, 2, 3, 4, and 5 years after the initial operation was examined, ie, for patients who have survived 1 year, the 5YS (the 6-year survival from operation) was calculated. Similar survival was determined for patients who had survived more than 2, 3, 4, or 5 years and reported according to stage. In patients who survived 2 years, the next 5YS from that time of patients in stage III a stage was similar to that in stage II, and was similar to the 5YS of patients in stage II at the time of diagnosis. In patients who survived 3, 4, or 5 years, the next 5YS from that time of patients in stage III b and stage III a was similar to that of stage II, and subsequently improved. Similarly, the relationship between stage and survival was disordered subsequently with the passage of time. Similar improvement in survival such that 5YS from the 3rd, 4th, and 5th postoperative year approximated that of the survival of patients at an earlier stage at the time of diagnosis. Survival is not only stage-dependent at the time of diagnosis but dependent on the length of survival from the initial operation. Progressive improvement in subsequent 5YS appears to approximate survival of lower-stage disease with the passage of time.