While in chronic diseases, such as diabetes, mortalityrates slowly increases with age, in oncological seriesmortality usually changes dramatically during thefollow-up, often in an unpredictable pattern. Forinstance, i...While in chronic diseases, such as diabetes, mortalityrates slowly increases with age, in oncological seriesmortality usually changes dramatically during thefollow-up, often in an unpredictable pattern. Forinstance, in gastric cancer mortality peaks in thefirst two years of follow-up and declines thereafter.Also several risk factors, such as TNM stage, largelyaffect mortality in the first years after surgery, whileafterward their effect tends to fade. Temporal trendsin mortality were compared between a gastric cancerseries and a cohort of type 2 diabetic patients. Forthis purpose, 937 patients, undergoing curativegastrectomy with D1/D2/D3 lymphadenectomy forgastric cancer in three GIRCG （Gruppo Italiano RicercaCancro Gastrico = Italian Research Group for GastricCancer） centers, were compared with 7148 type 2diabetic patients from the Verona Diabetes Study. Inthe early/advanced gastric cancer series, mortality fromrecurrence peaked to 200 deaths per 1000 personyears1 year after gastrectomy and then declined,becoming lower than 40 deaths per 1000 person-yearsafter 5 years and lower than 20 deaths after 8 years.Mortality peak occurred earlier in more advanced Tand N tiers. At variance, in the Verona diabetic cohort overall mortality slowly increased during a 10-yearfollow-up, with ageing of the type 2 diabetic patients.Seasonal oscillations were also recorded, mortalitybeing higher during winter than during summer. Alsothe most important prognostic factors presented adifferent temporal pattern in the two diseases： whilethe prognostic significance of T and N stage markedlydecrease over time, differences in survival amongpatients treated with diet, oral hypoglycemic drugsor insulin were consistent throughout the follow-up.Time variations in prognostic significance of main riskfactors, their impact on survival analysis and possiblesolutions were evaluated in another GIRCG series of568 patients with advanced gastric cancer, undergoingcurative gastrectomy with D2/D3 lymphadenectomy.Survival curves in the two differ展开更多
文摘While in chronic diseases, such as diabetes, mortalityrates slowly increases with age, in oncological seriesmortality usually changes dramatically during thefollow-up, often in an unpredictable pattern. Forinstance, in gastric cancer mortality peaks in thefirst two years of follow-up and declines thereafter.Also several risk factors, such as TNM stage, largelyaffect mortality in the first years after surgery, whileafterward their effect tends to fade. Temporal trendsin mortality were compared between a gastric cancerseries and a cohort of type 2 diabetic patients. Forthis purpose, 937 patients, undergoing curativegastrectomy with D1/D2/D3 lymphadenectomy forgastric cancer in three GIRCG （Gruppo Italiano RicercaCancro Gastrico = Italian Research Group for GastricCancer） centers, were compared with 7148 type 2diabetic patients from the Verona Diabetes Study. Inthe early/advanced gastric cancer series, mortality fromrecurrence peaked to 200 deaths per 1000 personyears1 year after gastrectomy and then declined,becoming lower than 40 deaths per 1000 person-yearsafter 5 years and lower than 20 deaths after 8 years.Mortality peak occurred earlier in more advanced Tand N tiers. At variance, in the Verona diabetic cohort overall mortality slowly increased during a 10-yearfollow-up, with ageing of the type 2 diabetic patients.Seasonal oscillations were also recorded, mortalitybeing higher during winter than during summer. Alsothe most important prognostic factors presented adifferent temporal pattern in the two diseases： whilethe prognostic significance of T and N stage markedlydecrease over time, differences in survival amongpatients treated with diet, oral hypoglycemic drugsor insulin were consistent throughout the follow-up.Time variations in prognostic significance of main riskfactors, their impact on survival analysis and possiblesolutions were evaluated in another GIRCG series of568 patients with advanced gastric cancer, undergoingcurative gastrectomy with D2/D3 lymphadenectomy.Survival curves in the two differ
