The contributions of patient factors, physician delay, and tumor biology to the outcome of gastric cancer
Wile, A. G., Hourani, L., & Schell, M. J. (1993). The contributions of patient factors, physician delay, and tumor biology to the outcome of gastric cancer. American Surgeon, 59(12), 850-854.
Patients with gastric cancer were presenting at advanced stage to our hospital. We were concerned that patient or physician controlled factors might have been responsible. A retrospective review of 49 analytic gastric cancer cases presenting to UCIMC between 1984 and 1989 was conducted. Twenty-four patients were determined to have gastric cancer as outpatients, with a median duration of symptoms of 4 months. The other 25 patients had initial physician contact in the emergency room, with a median duration of symptoms of only 1.5 months (P = 0.007). Minority ethnic groups were urgently admitted more frequently than Caucasians (P = 0.004). Multivariate analysis revealed that the worst prognostic factors for gastric cancer were urgent admission of Caucasians and Asians (P = 0.0013) and distant metastases (P = 0.005). Age, gender, duration of symptoms, and physician delay, could not be shown to have any effect on survival. This study demonstrates that the aggressive nature of gastric cancer, particularly in certain minority ethnic groups, is the overriding prognostic feature