University of Oulu

Maharjan, U., Kauppila, J.H. Survival trends in gastric cancer patients between 1987 and 2016: a population-based cohort study in Finland. Gastric Cancer 25, 989–1001 (2022).

Survival trends in gastric cancer patients between 1987 and 2016 : a population-based cohort study in Finland

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Author: Maharjan, Urgena1; Kauppila, Joonas H.1,2
Organizations: 1Surgery Research Unit, Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
2Upper Gastrointestinal Surgery, Department of Molecular Medicine and Surgery, Karolinska Institutet and Karolinska University Hospital, Stockholm, Sweden
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 1.2 MB)
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Language: English
Published: Springer Nature, 2022
Publish Date: 2023-07-04


Background: Gastric cancer is the fourth leading cause of cancer-related deaths globally. There is a paucity of national studies examining gastric cancer mortality in relation to treatment status. This study evaluated the survival trends in gastric adenocarcinoma and all gastric cancers stratified by treatment in Finland during 1987–2016.

Methods: This population-based, nationwide, retrospective cohort study included all gastric cancer patients registered in the Finnish Cancer Registry and Patient Registry. The survival rates were calculated for 1, 3, and 5 years, stratified by treatment. Prognostic factors were determined using Cox regression.

Results: A total of 18,713 non-cardia gastric adenocarcinoma, and 3617 cardia adenocarcinoma patients were included. Surgical treatment decreased for non-cardia adenocarcinoma and remained constant for cardia adenocarcinoma. In non-cardia adenocarcinoma, the 5-year survival declined from 17% to 16% from 1987–1991 to 2012–2016. In surgically treated patients, survival increased from 29% to 38%, while an increase from 4% to 7% in those undergoing chemotherapy and decrease from 6% to 3% in those not receiving any treatment were observed. In cardia adenocarcinoma, the 5-year survival increased from 10% to 18% in all patients, 16% to 40% in surgical patients, 0% to 5% in patients receiving chemotherapy, and from 5% to 9% in patients receiving no treatment. Earlier calendar periods, older age, male sex, and higher comorbidity were risk factors for poor prognosis.

Conclusions: Gastric non-cardia adenocarcinoma survival declined, limited to advanced stage patients not receiving any treatment. Gastric cardia cancer survival seems to have improved over time in Finland.

Mini abstract: This study evaluated survival trends of gastric cancer in Finland during 1987–2016 and established that the 5-year survival is declining in non-cardia adenocarcinoma but improving in all gastric cancers.

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Series: Gastric cancer
ISSN: 1436-3291
ISSN-E: 1436-3305
ISSN-L: 1436-3291
Volume: 25
Issue: 6
Pages: 989 - 1001
DOI: 10.1007/s10120-022-01326-5
Type of Publication: A1 Journal article – refereed
Field of Science: 3122 Cancers
3126 Surgery, anesthesiology, intensive care, radiology
Funding: We thank the Sigrid Jusélius Foundation (Sigrid Juséliuksen Säätiö), The Finnish Cancer Foundation (Syöpäsäätiö), and Päivikki and Sakari Sohlberg Foundation for financially supporting this work. Open Access funding provided by University of Oulu including Oulu University Hospital.
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