Relapse-Free Survival and Prognostic Factors in Gastric Cancer Patients in Albania: A Prospective Longitudinal Observational Cohort Study

ORIGINAL ARTICLE
Bledi Kreka, Ervin Toçi, Arvit Llazani, Drini Shehi, Albana Shahini, Dorina Canaku, Enkelejda Cuedari, Fatjona Kraja, Alba Agaraj, Martiola Kola, Dea Kreka, Meri Vasha, Arvin Dibra, Manika Face

 
For citation: Kreka B, Toçi E, Llazani A, Shehi D, Shahini A, Canaku D, Cuedari E, Kraja F, Agaraj A, Kola M, Kreka D, Vasha M, Dibra A, Face M. Relapse-Free Survival and Prognostic Factors in Gastric Cancer Patients in Albania: A Prospective Longitudinal Observational Cohort Study. International Journal of Biomedicine. 2026;16(2):169-177. doi:10.21103/Article16(2)_OA3
 
Originally published June 5, 2026

Abstract: 

Background: In Eastern Europe, where late cancer diagnoses are frequent and survival rates are low, gastric cancer continues to be a leading cause of cancer-related death. The data on relapse-free survival (RFS) and the factors that influence it in Albania are scarce.
Methods and Results: A total of 221 adult patients with histologically confirmed gastric cancer at the Oncology Service at the University Hospital Center "Mother Teresa" participated in this 60-month follow-up prospective longitudinal observational study. The Kaplan-Meier method was used to estimate relapse-free survival, and multivariate Cox proportional hazards regression was used to evaluate prognostic factors.
Relapses occurred in 37.1% of patients during follow-up. The median relapse-free survival was 28.0 months (95% CI: 25.04–30.96). When compared to diffuse gastric cancer, the intestinal type was independently linked to a lower risk of relapse (HR = 0.32; 95% CI: 0.19–0.53). Relapse risk was strongly correlated with increasing lymph node involvement (N1: HR = 5.31; N2: HR = 6.53; N3: HR = 9.59). Age, radiotherapy, adjuvant therapy, and tumor depth did not independently correlate with RFS. A higher risk of relapse was linked to a positive family history of gastric cancer (HR = 10.87).
Conclusion: The histopathological subtype and lymph node status at diagnosis were the main factors influencing relapse-free survival in this group of gastric cancer patients in Albania. These findings highlight the importance of early detection, accurate staging, and follow-up strategies adapted to the risk level in gastric cancer care.

Keywords: 
Albania • cohort study • gastric cancer • prognostic factors • relapse-free survival
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Received February 10, 2026.
Accepted March 23, 2026.
© 2026 The Author(s). International Journal of Biomedicine is published by IMRDC.
This is an open access article under the CC BY-NC-ND 4.0 license.