Clinicopathological Factors and Gastric Cancer Prognosis in the Iranian Population: a Meta-analysis


Background: Gastric cancer is the most common cancer in the Iranian population. The aim of this study wasto determine the effect of clinicopathological factors on prognosis by meta-analysis. Materials and
Methods:A literature search was conducted using MEDLINE, EMBASE and Cochrane library and extensive literaturesearch using the Persian databases until February 2011. Prospective follow up studies with multivariate analysisof overall survival of the patients with gastric cancer were included in this review. The data were analyzed byCMA.2. Publication bias are checked by funnel plot and data are shown as Forest plots.
Results: From a totalof 63 articles, 14 retrospective studies which examined 5 prognostic factors and involving 10,500 patients wereincluded. Tumor size (>35mm) was the main significant factor predicting an unfavorable prognosis for the patientswith gastric cancer (RR=1.829 , p<0.001) followed by presence of distant metastases (RR=1.607 , p<0.001), poordifferentiation (RR=1.408 , p<0.001) and male sex (RR=1.194, p<0.001). Lymph node metastases (RR=1.058,p=0.698) and moderate differentiation (RR=0.836, p=0.043) were not statistically significant as prognosticfactors.
Conclusions: This meta-analysis suggests that tumor size>35mm, poor differentiation, presence of distantmetastasis and male gender are strongly associated with a poor prognosis in Iranian patients with gastric cancer.