Background: Upper gastrointestinal cancer is the most common cancer in Ardabil Province, North-West of Iran, accounting for more than 50% of all cancer deaths in this area. We conducted this study to determine the present survival rate of patients with esophageal and gastric cancers before launching interventional studies.
Methods: A prospective follow-up study of 420 biopsy-proven patients (127 females, mean age: 64) with upper gastrointestinal cancer (141 esophageal and 279 stomach cancers) who were initially diagnosed in Aras Clinic, the main gastrointestinal referral center of Ardabil Province, from 2000 through 2004, was performed with collection of data on demographics, tumor characteristics, pathologic stage, treatment methods, complications, survival time, etc. Data were gathered through direct interview with patients or their families in 303 cases and evaluation of death certificates in 55 patients. Follow-up was from cancer diagnosis until death, or immigration. Survival according to stage of disease, Lauren tumor type, tumor location, surgery, and adjuvant chemotherapy was analyzed, and results were compared with those of western series.
Results: Sixty-two cases were lost to follow-up. The one- and five-year survival rates in the patients with upper gastrointestinal cancer in Ardabil Province were 40.5%, and 0.8%, respectively. In the univariate analysis, men had a slightly lower survival rate than women (P = 0.21) and patients with esophageal cancer had a longer survival rate compared to stomach cancer patients (P = 0.15). Patients who had undergone surgery (P < 0.001) and/or chemotherapy (P < 0.001) survived longer than those without such treatments. Tumor morphology, age at diagnosis, radiotherapy, alcohol, and opium consumption did not show any significant effects on the survival rate of patients. In multivariate analysis, only smoking was remained as an independent factor for stomach cancer (P = 0.04) while in esophageal cancer, surgery and grade of differentiation were significant predictors of survival.
Conclusion: Survival rate of stomach and esophagus cancer cases in Ardabil is relatively low. Intervention for early detection and therapy is necessary to increase survival.