J Korean Surg Soc.  2009 Sep;77(3):170-176. 10.4174/jkss.2009.77.3.170.

Different Clinical Outcomes of Stage IV Gastric Cancer according to the Curability of Surgery

• Seo YJ
• Bae JM
• Kim SW
• Kim SW
• Song SK

• KMID: 2004215
• DOI: http://doi.org/10.4174/jkss.2009.77.3.170

Abstract

PURPOSE
This study was conducted to evaluate the survival differences between curative stage IV and non-curative stage IV gastric cancers after gastrectomy. METHODS: Stage IV gastric cancer patients who received gastrectomy were selected from our surgical data-base from 1995 to 2004. These patients were separated into two groups according to the curability by surgery. We analyzed the survival differences between curative stage IV patients and non-curative stage IV patients. Survival analysis was performed by Kaplan-Meier survival analysis. RESULTS: During a 10-year period, gastrectomy was performed in 2,214 patients. 224 patients were diagnosed as stage IV. 144 patients were male and 80 patients were female. 97 patients received total gastrectomy. 127 patients received subtotal gastrectomy. 173 patients were diagnosed with curative stage IV and 51 patients were non-curative stage IV. Overall 3-year and 5-year survival rates of stage IV gastric cancer patients in this study were 31.5% and 18.4%. 3-YSR of curative and non-curative stage IV were 36.0% and 16.7% respectively (P-value=0.0204). 5-YSR of curative and non-curative stage IV was 21.9% and 4.2% (P-value=0.0169). CONCLUSION: Significant survival differences were found between curative and non-curative stage IV. Although direct tumor extension or distant metastasis exists, gastrectomy with combined resection was important to improve prognosis if it is possible to resect. When it comes to the matter of survival rate, the subclassification of stage IV gastric cancer should be considered for further management.

Keyword

Gastric cancer; Stage IV; Curability; Survival rate

MeSH Terms

Female
Gastrectomy
Humans
Male
Neoplasm Metastasis
Prognosis
Stomach Neoplasms
Survival Rate

Figure

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  Fig. 1 Survival curves of patients according to curability.

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