A Five-Year Survival Analysis of Patients with Gastric Cancer in Kerman Province
,
Abstract
Background. Gastric adenocarcinoma (GAC) is the second most frequent cause of cancer-related deaths worldwide. Determining survival and its associated prognostic factors provides a basis for further interventions to prolong survival among patients with GAC. In this study, we aimed to perform a 5-year survival analysis among GAC patients in Kerman, Iran.
Methods. This retrospective multi-centric study was conducted on all patients with GAC who were referred to Afzalipour, Bahonar, and Shafa Hospitals in Kerman, Iran in 2009-2019. The 5-year survival rates were calculated based on prognostic factors, including age, histopathology, stage/grade of the tumor, metastatic status, and surgical procedures using the Kaplan-Meier analysis and log-rank test.
Results: The 5-year survival rate of GAC patients with total gastrectomy was higher than those with subtotal gastrectomy (P=0.03). Also, the 5-year survival rate was substantially improved after lymph node dissection (P<0.001). Overall survival has not been significantly different in terms of age, sex, grade, histological type, clinical T stage, lymphovascular invasion, and perineural invasion.
Conclusion: Overall survival was different for the two surgical procedures and lymph node dissection. Therefore, total gastrectomy and lymph node dissection are significant independent prognostic factors for overall survival in patients with GAC.
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2- Eric Van Cutsem, Xavier Sagaert, Baki Topal, Karin Haustermans, and Hans Prenen, "Gastric cancer." The Lancet, Vol. 388 (No. 10060), pp. 2654-64, (2016).
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6- Jaffer A Ajani, Jeeyun Lee, Takeshi Sano, Yelena Y Janjigian, Daiming Fan, and Shumei Song, "Gastric adenocarcinoma." Nature reviews Disease primers, Vol. 3 (No. 1), pp. 1-19, (2017).
7- Johannes Asplund, Joonas H Kauppila, Fredrik Mattsson, and Jesper Lagergren, "Survival trends in gastric adenocarcinoma: a population-based study in Sweden." Annals of surgical oncology, Vol. 25pp. 2693-702, (2018).
8- Salman Khazaei, Shahab Rezaeian, Mokhtar Soheylizad, Somayeh Khazaei, and Azam Biderafsh, "Global incidence and mortality rates of stomach cancer and the human development index: an ecological study." Asian Pacific Journal of Cancer Prevention, Vol. 17 (No. 4), pp. 1701-04, (2016).
9- Jun Tian, Xiao-Dong Wang, and Zhen-Chun Chen, "Survival of patients with stomach cancer in Changle city of China." World journal of gastroenterology: WJG, Vol. 10 (No. 11), p. 1543, (2004).
10- Xinxing Li et al., "Age-specific impact on the survival of gastric cancer patients with distant metastasis: an analysis of SEER database." Oncotarget, Vol. 8 (No. 57), p. 97090, (2017).
11- Najib Allah Baeradeh, Mohammad Hassan Lotfi, Hossein Fallahzadeh, Saeed Kargar, and ROGHANI HASSAN SALMAN, "Survival rate of patients with stomach cancer and its effective factors in Yazd Province." (2015).
12- H Jamali, N Khanjani, M Fararouei, Z Parisae, and M Chorami, "Estimation of the survival rate of patients with gastric cancer and its risk factors based on pathological and demographic data during 2005 to 2011 in Kohgiloyeh and Boyerahmad." Iranian Journal of Epidemiology, Vol. 11 (No. 1), pp. 42-55, (2015).
13- E. C. Halperin, L. W. Brady, C. A. Perez and D. E. "Perez & Brady's principles and practice of radiation oncology." Wazer Lippincott Williams & Wilkins, (2013)
14- B Moghimi Dehkordi, AR Rajaeefard, HR Tabatabaee, B Zeighami, A Safaee, and Z Tabeie, "Estimation of survival rates and related factors in patients with stomach cancer using life-table method." Internal Medicine Today, Vol. 14 (No. 2), pp. 24-31, (2008).
15- Qingguo Li, Lu Gan, Lei Liang, Xinxiang Li, and Sanjun Cai, "The influence of marital status on stage at diagnosis and survival of patients with colorectal cancer." Oncotarget, Vol. 6 (No. 9), p. 7339, (2015).
16- Jie Chen et al., "Impact of age on the prognosis of operable gastric cancer patients: an analysis based on SEER database." Medicine, Vol. 95 (No. 24), (2016).
17- Offir Ben-Ishay, Eran Brauner, Zvi Peled, Amira Othman, Benjamin Person, and Yoram Kluger, "Diagnosis of colon cancer differs in younger versus older patients despite similar complaints." The Israel Medical Association journal: IMAJ, Vol. 15 (No. 6), pp. 284-87, (2013).
18- Brian R Smith and Bruce E Stabile, "Extreme aggressiveness and lethality of gastric adenocarcinoma in the very young." Archives of surgery, Vol. 144 (No. 6), pp. 506-10, (2009).
19- A Biglarian, EBRAHIM Hajizadeh, and MR Gohari, "Survival analysis of patients with gastric adenocarcinomas and factors related." Trauma Monthly, Vol. 2007 (No. 4, Winter), pp. 337-47, (2007).
20- Mahmoodreza Ghadimi, Mahmood Mahmoodi, Kazem Mohammad, Hojjat Zeraati, Mahboobeh Rasouli, and Mahmood Sheikhfathollahi, "Family history of the cancer on the survival of the patients with gastrointestinal cancer in northern Iran, using frailty models." BMC gastroenterology, Vol. 11pp. 1-9, (2011).
21- H Zeraati, M Mahmoudi, and M Mohammad, "Postrative survival in gustric cancer patient and Iits related factors." J Sch Public Health Inst Public Health Res, Vol. 3 (No. 4), pp. 21-30, (2004).
22- Fatemeh Atoof, Mahmood Mahmoudi, Hojat Zeraati, Abbas Rahimi Foroushani, and AR Moravveji, "Survival analysis of gastric cancer patients refering to Emam-Khomeini hospital using Weibull cure model." Feyz Journal of Kashan University of Medical Sciences, Vol. 14 (No. 4), (2010).
23- Roja Nikaeen, Alireza Khalilian, and Abbas Bahrampour, "Determining the effective factors on gastric cancer using frailty model in South-East and North of Iran." (2017).
24- Trond Haugstvedt, Asgaut Viste, Geir Egil Eide, Odd Söreide, and Norwegian Stomach Cancer Trial, "The survival benefit of resection in patients with advanced stomach cancer: the Norwegian multicenter experience." World journal of surgery, Vol. 13pp. 617-21, (1989).
25- Giovanni Battista Doglietto, Fabio Pacelli, Paola Caprino, Antonio Sgadari, and Francesco Crucitti, "Surgery: independent prognostic factor in curable and far advanced gastric cancer." World journal of surgery, Vol. 24pp. 459-64, (2000).
26- Chia-Siu Wang, Tzu-Chieh Chao, Yi-Yin Jan, Long-Bin Jeng, Tsann-Long Hwang, and Miin-Fu Chen, "Benefits of palliative surgery for far-advanced gastric cancer." Chang Gung medical journal, Vol. 25 (No. 12), pp. 792-802, (2002).
27- YL Wan et al., "Clinical analysis of combined resection for T4 gastric cancer: report of 69 cases." Zhonghua wai ke za zhi [Chinese Journal of Surgery], Vol. 41 (No. 8), pp. 594-96, (2003).
28- Federico Bozzetti et al., "Total versus subtotal gastrectomy: surgical morbidity and mortality rates in a multicenter Italian randomized trial. The Italian Gastrointestinal Tumor Study Group." Annals of surgery, Vol. 226 (No. 5), p. 613, (1997).
29- F Meriggi and E Forni, "Terapia chirurgica radicale del cancro gastrico. Esperienza personale." Giornale di Chirurgia, Vol. 23 (No. 10), pp. 361-67, (2002).
30- Mitsuru Sasako et al., "Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer." J clin oncol, Vol. 29 (No. 33), pp. 4387-93, (2011).
31- John S Macdonald et al., "Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction." New England Journal of Medicine, Vol. 345 (No. 10), pp. 725-30, (2001).
32- JJ Bonenkamp et al., "Extended lymph-node dissection for gastric cancer." New England Journal of Medicine, Vol. 340 (No. 12), pp. 908-14, (1999).
33- David Cunningham et al., "Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer." New England Journal of Medicine, Vol. 355 (No. 1), pp. 11-20, (2006).
34- D Cunningham, WH Allum, SP Stenning, and S ft Weeden, "Perioperative chemotherapy in operable gastric and lower oesophageal cancer: final results of a randomised, controlled trial (the MAGIC trial, ISRCTN 93793971)." Journal of Clinical Oncology, Vol. 23 (No. 16_suppl), pp. 4001-01, (2005).
35- Jaffer A Ajani et al., "Paclitaxel-based chemoradiotherapy in localized gastric carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome." Journal of Clinical Oncology, Vol. 23 (No. 6), pp. 1237-44, (2005).
36- JAMES T Diehl, ROBERT E Hermann, AVRAM M Cooperman, and STANLEY O Hoerr, "Gastric carcinoma. A ten-year review." Annals of surgery, Vol. 198 (No. 1), p. 9, (1983).
37- WH Allum, DJ Powell, CC McConkey, and JWL Fielding, "Gastric cancer: a 25‐year review." British journal of surgery, Vol. 76 (No. 6), pp. 535-40, (1989).
38- H Rohde, P Bauer, H Stützer, K Heitmann, and B Gebbensleben, "Proximal compared with distal adenocarcinoma of the stomach: differences and consequences." Journal of British Surgery, Vol. 78 (No. 10), pp. 1242-48, (1991).
39- G Heidl, P Langhans, V Krieg, W Mellin, R Schilke, and H Bünte, "Comparative studies of cardia carcinoma and infracardial gastric carcinoma." Journal of cancer research and clinical oncology, Vol. 120pp. 91-94, (1993).
40- Elfriede Bollschweiler et al., "Is the prognosis for Japanese and German patients with gastric cancer really different?" Cancer, Vol. 71 (No. 10), pp. 2918-25, (1993).
41- Fatih Selçukbiricik, Deniz Tural, Evin Buyukunal, and Suheyla Serdengecti, "Perineural invasion independent prognostic factors in patients with gastric cancer undergoing curative resection." Asian Pacific Journal of Cancer Prevention, Vol. 13 (No. 7), pp. 3149-52, (2012).
42- Frédéric Borie et al., "Lymphatic involvement in early gastric cancer: prevalence and prognosis in France." Archives of surgery, Vol. 135 (No. 10), pp. 1218-23, (2000).
43- Caigang Liu et al., "Prognostic role of lymphatic vessel invasion in early gastric cancer: a retrospective study of 188 cases." Surgical oncology, Vol. 19 (No. 1), pp. 4-10, (2010).
44- Zhaode Bu et al., "Lymphatic vascular invasion is an independent correlated factor for lymph node metastasis and the prognosis of resectable T2 gastric cancer patients." Tumor Biology, Vol. 34pp. 1005-12, (2013).
45- Ju-Hee Lee, Min Gyu Kim, Min-Sung Jung, and Sung Joon Kwon, "Prognostic significance of lymphovascular invasion in node-negative gastric cancer." World journal of surgery, Vol. 39pp. 732-39, (2015).
46- Hamid Reza Raziee et al., "Systematic review of the predictors of positive margins in gastric cancer surgery and the effect on survival." Gastric Cancer, Vol. 15pp. 116-24, (2012).
47- Massimiliano Bissolati et al., "Risk factor analysis for involvement of resection margins in gastric and esophagogastric junction cancer: an Italian multicenter study." Gastric Cancer, Vol. 20pp. 70-82, (2017).
48- Lauren M Postlewait et al., "The importance of the proximal resection margin distance for proximal gastric adenocarcinoma: A multi‐institutional study of the US Gastric Cancer Collaborative." Journal of surgical oncology, Vol. 112 (No. 2), pp. 203-07, (2015).
49- Steven L Chen and Anton J Bilchik, "More extensive nodal dissection improves survival for stages I to III of colon cancer: a population-based study." Annals of surgery, Vol. 244 (No. 4), p. 602, (2006).
2- Eric Van Cutsem, Xavier Sagaert, Baki Topal, Karin Haustermans, and Hans Prenen, "Gastric cancer." The Lancet, Vol. 388 (No. 10060), pp. 2654-64, (2016).
3- Kazuto Harada, Anthony Lopez, Namita Shanbhag, Brian Badgwell, Hideo Baba, and Jaffer Ajani, "Recent advances in the management of gastric adenocarcinoma patients." F1000Research, Vol. 7(2018).
4- Ashley E Russo and Vivian E Strong, "Gastric cancer etiology and management in Asia and the West." Annual review of medicine, Vol. 70pp. 353-67, (2019).
5- Prashanth Rawla and Adam Barsouk, "Epidemiology of gastric cancer: global trends, risk factors and prevention." Gastroenterology Review/Przegląd Gastroenterologiczny, Vol. 14 (No. 1), pp. 26-38, (2019).
6- Jaffer A Ajani, Jeeyun Lee, Takeshi Sano, Yelena Y Janjigian, Daiming Fan, and Shumei Song, "Gastric adenocarcinoma." Nature reviews Disease primers, Vol. 3 (No. 1), pp. 1-19, (2017).
7- Johannes Asplund, Joonas H Kauppila, Fredrik Mattsson, and Jesper Lagergren, "Survival trends in gastric adenocarcinoma: a population-based study in Sweden." Annals of surgical oncology, Vol. 25pp. 2693-702, (2018).
8- Salman Khazaei, Shahab Rezaeian, Mokhtar Soheylizad, Somayeh Khazaei, and Azam Biderafsh, "Global incidence and mortality rates of stomach cancer and the human development index: an ecological study." Asian Pacific Journal of Cancer Prevention, Vol. 17 (No. 4), pp. 1701-04, (2016).
9- Jun Tian, Xiao-Dong Wang, and Zhen-Chun Chen, "Survival of patients with stomach cancer in Changle city of China." World journal of gastroenterology: WJG, Vol. 10 (No. 11), p. 1543, (2004).
10- Xinxing Li et al., "Age-specific impact on the survival of gastric cancer patients with distant metastasis: an analysis of SEER database." Oncotarget, Vol. 8 (No. 57), p. 97090, (2017).
11- Najib Allah Baeradeh, Mohammad Hassan Lotfi, Hossein Fallahzadeh, Saeed Kargar, and ROGHANI HASSAN SALMAN, "Survival rate of patients with stomach cancer and its effective factors in Yazd Province." (2015).
12- H Jamali, N Khanjani, M Fararouei, Z Parisae, and M Chorami, "Estimation of the survival rate of patients with gastric cancer and its risk factors based on pathological and demographic data during 2005 to 2011 in Kohgiloyeh and Boyerahmad." Iranian Journal of Epidemiology, Vol. 11 (No. 1), pp. 42-55, (2015).
13- E. C. Halperin, L. W. Brady, C. A. Perez and D. E. "Perez & Brady's principles and practice of radiation oncology." Wazer Lippincott Williams & Wilkins, (2013)
14- B Moghimi Dehkordi, AR Rajaeefard, HR Tabatabaee, B Zeighami, A Safaee, and Z Tabeie, "Estimation of survival rates and related factors in patients with stomach cancer using life-table method." Internal Medicine Today, Vol. 14 (No. 2), pp. 24-31, (2008).
15- Qingguo Li, Lu Gan, Lei Liang, Xinxiang Li, and Sanjun Cai, "The influence of marital status on stage at diagnosis and survival of patients with colorectal cancer." Oncotarget, Vol. 6 (No. 9), p. 7339, (2015).
16- Jie Chen et al., "Impact of age on the prognosis of operable gastric cancer patients: an analysis based on SEER database." Medicine, Vol. 95 (No. 24), (2016).
17- Offir Ben-Ishay, Eran Brauner, Zvi Peled, Amira Othman, Benjamin Person, and Yoram Kluger, "Diagnosis of colon cancer differs in younger versus older patients despite similar complaints." The Israel Medical Association journal: IMAJ, Vol. 15 (No. 6), pp. 284-87, (2013).
18- Brian R Smith and Bruce E Stabile, "Extreme aggressiveness and lethality of gastric adenocarcinoma in the very young." Archives of surgery, Vol. 144 (No. 6), pp. 506-10, (2009).
19- A Biglarian, EBRAHIM Hajizadeh, and MR Gohari, "Survival analysis of patients with gastric adenocarcinomas and factors related." Trauma Monthly, Vol. 2007 (No. 4, Winter), pp. 337-47, (2007).
20- Mahmoodreza Ghadimi, Mahmood Mahmoodi, Kazem Mohammad, Hojjat Zeraati, Mahboobeh Rasouli, and Mahmood Sheikhfathollahi, "Family history of the cancer on the survival of the patients with gastrointestinal cancer in northern Iran, using frailty models." BMC gastroenterology, Vol. 11pp. 1-9, (2011).
21- H Zeraati, M Mahmoudi, and M Mohammad, "Postrative survival in gustric cancer patient and Iits related factors." J Sch Public Health Inst Public Health Res, Vol. 3 (No. 4), pp. 21-30, (2004).
22- Fatemeh Atoof, Mahmood Mahmoudi, Hojat Zeraati, Abbas Rahimi Foroushani, and AR Moravveji, "Survival analysis of gastric cancer patients refering to Emam-Khomeini hospital using Weibull cure model." Feyz Journal of Kashan University of Medical Sciences, Vol. 14 (No. 4), (2010).
23- Roja Nikaeen, Alireza Khalilian, and Abbas Bahrampour, "Determining the effective factors on gastric cancer using frailty model in South-East and North of Iran." (2017).
24- Trond Haugstvedt, Asgaut Viste, Geir Egil Eide, Odd Söreide, and Norwegian Stomach Cancer Trial, "The survival benefit of resection in patients with advanced stomach cancer: the Norwegian multicenter experience." World journal of surgery, Vol. 13pp. 617-21, (1989).
25- Giovanni Battista Doglietto, Fabio Pacelli, Paola Caprino, Antonio Sgadari, and Francesco Crucitti, "Surgery: independent prognostic factor in curable and far advanced gastric cancer." World journal of surgery, Vol. 24pp. 459-64, (2000).
26- Chia-Siu Wang, Tzu-Chieh Chao, Yi-Yin Jan, Long-Bin Jeng, Tsann-Long Hwang, and Miin-Fu Chen, "Benefits of palliative surgery for far-advanced gastric cancer." Chang Gung medical journal, Vol. 25 (No. 12), pp. 792-802, (2002).
27- YL Wan et al., "Clinical analysis of combined resection for T4 gastric cancer: report of 69 cases." Zhonghua wai ke za zhi [Chinese Journal of Surgery], Vol. 41 (No. 8), pp. 594-96, (2003).
28- Federico Bozzetti et al., "Total versus subtotal gastrectomy: surgical morbidity and mortality rates in a multicenter Italian randomized trial. The Italian Gastrointestinal Tumor Study Group." Annals of surgery, Vol. 226 (No. 5), p. 613, (1997).
29- F Meriggi and E Forni, "Terapia chirurgica radicale del cancro gastrico. Esperienza personale." Giornale di Chirurgia, Vol. 23 (No. 10), pp. 361-67, (2002).
30- Mitsuru Sasako et al., "Five-year outcomes of a randomized phase III trial comparing adjuvant chemotherapy with S-1 versus surgery alone in stage II or III gastric cancer." J clin oncol, Vol. 29 (No. 33), pp. 4387-93, (2011).
31- John S Macdonald et al., "Chemoradiotherapy after surgery compared with surgery alone for adenocarcinoma of the stomach or gastroesophageal junction." New England Journal of Medicine, Vol. 345 (No. 10), pp. 725-30, (2001).
32- JJ Bonenkamp et al., "Extended lymph-node dissection for gastric cancer." New England Journal of Medicine, Vol. 340 (No. 12), pp. 908-14, (1999).
33- David Cunningham et al., "Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer." New England Journal of Medicine, Vol. 355 (No. 1), pp. 11-20, (2006).
34- D Cunningham, WH Allum, SP Stenning, and S ft Weeden, "Perioperative chemotherapy in operable gastric and lower oesophageal cancer: final results of a randomised, controlled trial (the MAGIC trial, ISRCTN 93793971)." Journal of Clinical Oncology, Vol. 23 (No. 16_suppl), pp. 4001-01, (2005).
35- Jaffer A Ajani et al., "Paclitaxel-based chemoradiotherapy in localized gastric carcinoma: degree of pathologic response and not clinical parameters dictated patient outcome." Journal of Clinical Oncology, Vol. 23 (No. 6), pp. 1237-44, (2005).
36- JAMES T Diehl, ROBERT E Hermann, AVRAM M Cooperman, and STANLEY O Hoerr, "Gastric carcinoma. A ten-year review." Annals of surgery, Vol. 198 (No. 1), p. 9, (1983).
37- WH Allum, DJ Powell, CC McConkey, and JWL Fielding, "Gastric cancer: a 25‐year review." British journal of surgery, Vol. 76 (No. 6), pp. 535-40, (1989).
38- H Rohde, P Bauer, H Stützer, K Heitmann, and B Gebbensleben, "Proximal compared with distal adenocarcinoma of the stomach: differences and consequences." Journal of British Surgery, Vol. 78 (No. 10), pp. 1242-48, (1991).
39- G Heidl, P Langhans, V Krieg, W Mellin, R Schilke, and H Bünte, "Comparative studies of cardia carcinoma and infracardial gastric carcinoma." Journal of cancer research and clinical oncology, Vol. 120pp. 91-94, (1993).
40- Elfriede Bollschweiler et al., "Is the prognosis for Japanese and German patients with gastric cancer really different?" Cancer, Vol. 71 (No. 10), pp. 2918-25, (1993).
41- Fatih Selçukbiricik, Deniz Tural, Evin Buyukunal, and Suheyla Serdengecti, "Perineural invasion independent prognostic factors in patients with gastric cancer undergoing curative resection." Asian Pacific Journal of Cancer Prevention, Vol. 13 (No. 7), pp. 3149-52, (2012).
42- Frédéric Borie et al., "Lymphatic involvement in early gastric cancer: prevalence and prognosis in France." Archives of surgery, Vol. 135 (No. 10), pp. 1218-23, (2000).
43- Caigang Liu et al., "Prognostic role of lymphatic vessel invasion in early gastric cancer: a retrospective study of 188 cases." Surgical oncology, Vol. 19 (No. 1), pp. 4-10, (2010).
44- Zhaode Bu et al., "Lymphatic vascular invasion is an independent correlated factor for lymph node metastasis and the prognosis of resectable T2 gastric cancer patients." Tumor Biology, Vol. 34pp. 1005-12, (2013).
45- Ju-Hee Lee, Min Gyu Kim, Min-Sung Jung, and Sung Joon Kwon, "Prognostic significance of lymphovascular invasion in node-negative gastric cancer." World journal of surgery, Vol. 39pp. 732-39, (2015).
46- Hamid Reza Raziee et al., "Systematic review of the predictors of positive margins in gastric cancer surgery and the effect on survival." Gastric Cancer, Vol. 15pp. 116-24, (2012).
47- Massimiliano Bissolati et al., "Risk factor analysis for involvement of resection margins in gastric and esophagogastric junction cancer: an Italian multicenter study." Gastric Cancer, Vol. 20pp. 70-82, (2017).
48- Lauren M Postlewait et al., "The importance of the proximal resection margin distance for proximal gastric adenocarcinoma: A multi‐institutional study of the US Gastric Cancer Collaborative." Journal of surgical oncology, Vol. 112 (No. 2), pp. 203-07, (2015).
49- Steven L Chen and Anton J Bilchik, "More extensive nodal dissection improves survival for stages I to III of colon cancer: a population-based study." Annals of surgery, Vol. 244 (No. 4), p. 602, (2006).
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| Issue | Vol 11 No 4 (2024) | |
| Section | Original Article(s) | |
| DOI | https://doi.org/10.18502/fbt.v11i4.16509 | |
| Keywords | ||
| Gastric Neoplasm Survival Prognosis | ||
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How to Cite
1.
Shamsi S, Bahador M, Larizade MH, Nouri M. A Five-Year Survival Analysis of Patients with Gastric Cancer in Kerman Province. Frontiers Biomed Technol. 2023;11(4):607-615.
