Selection of surgical procedures and analysis of prognostic factors in patients with primary gastric tumour based on Cox regression: a SEER database analysis based on data mining

Introduction
There are numerous types of surgery for patients with primary gastric tumour, which can be summarized as radical surgery or palliative surgery. Different surgical procedures will have further effects for different stage of patients. Aim: We will use the resources of the SEER database (2010–2015) to explore the therapeutic value of surgery and prognostic factors.

Material and methods
Kaplan-Meier analysis/log-rank testing for data analysis and multivariate analysis was conducted through a Cox proportional model.

Results
Fourteen thousand five hundred and seven cases of primary gastric tumours identified in the period from 2010 to 2015. In a multivariate cox regression analysis, the following factors were associated with better primary gastric patients survival (Surgical method, Age at diagnosis, histological grade). Through Kaplan-Meier analysis (p < 0.005) we also found that for the patient group the survival rate of using gastrectomy (partial, subtotal, hemi-) surgery is the lowest.

Conclusions
Among patients with multivariate Cox regression model, type of surgery, age at diagnosis, and histological grade were the top 3 factors affecting patient survival. In palliative surgery, laser excision is the best surgical method of local tumour excision, and the survival of patients of this group is obviously better than in other groups. In radical surgery, near-total gastrectomy and radical gastrectomy, in continuity with the resection of other organs, are better surgical methods, while gastrectomy (partial, subtotal, hemi-) is the worst type of surgery in terms of prognosis, and even the survival rate in the later stage (after 3 years) is worse than in the group without surgery.