J Korean Surg Soc.  2010 Jan;78(1):17-22. 10.4174/jkss.2010.78.1.17.

Factors Affecting Long Term Survival after Gastrectomy for Stage IV Gastric Cancer

• Yoo JJ
• Lee SH

• KMID: 1775440
• DOI: http://doi.org/10.4174/jkss.2010.78.1.17

Abstract

PURPOSE: The prognosis of stage IV gastric cancer is poor, but some patients with stage IV gastric cancer survive for more than 5 years. We investigated the prognostic factors of the stage IV gastric cancer in the patients with survival for more than 5 years after resection of the primary lesion.
METHODS
We retrospectively analyzed 194 patients that underwent resection of stage IV gastric cancer from January 1997 to June 2000 in our hospital. We investigated clinicopathological characteristics between patients surviving 5 years or more group (n=17) and less than 5 years group (n=177) with chi-square and T-test. We used univariate analysis with Kaplan-Meier method and Log-rank test, and multivariate analysis with Cox proportional hazard model to investigate prognositic factors for survival rate about each characteristic.
RESULTS
In clinicopathological characteristics between the two groups, we observed statistical significance in regard to macroscopic findings (P=0.035), but not in the others. Curative resection (P=0.001) and intravenous chemotherapy (P=0.012) had statistically significant influence on 5-year survival curve. Multivariate analysis showed that curative resection was a significant factor for long-term survival rates (P=0.005), but chemotherapy and macroscopic type had no effect on survival rate.
CONCLUSION
Although this study has the limitation of a retrospective study and total patient number in the 5-year survival group, curative resection may be important, as a prognostic factor, and active treatments should be performed for stage IV gastric cancer.

Keyword

Gastric cancer; Stage IV; Long term survival; Prognostic factor

MeSH Terms

Gastrectomy
Humans
Multivariate Analysis
Prognosis
Proportional Hazards Models
Retrospective Studies
Stomach Neoplasms
Survival Rate

Figure

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  Fig. 1 Survival of patients with stage IV gastric cancer based on radicality.

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  Fig. 2 Survival of patients with stage IV gastric cancer based on lymph node metastasis.

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  Fig. 3 Survival of patients with stage IV gastric cancer based on lymph node dissection.

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  Fig. 4 Survival of patients with stage IV gastric cancer based on distant metastasis.

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  Fig. 5 Survival of patients with stage IV gastric cancer based on chemotherapy.

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  Fig. 6 Survival of patients with stage IV gastric cancer metastatic lymph node metastasis without distant metastasis.

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  Fig. 7 Survival of patients with stage IV gastric cancer based on TNM stage.

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