Results of Surgical Treatment and Analysis of Prognostic Factors in Primary Gastric Adenocarcinoma

Chung, Cheol Hun; Mok, Young Jae; Son, Gil Soo; Kim, Seung Joo; Kim, Sae Min

Abstract

PURPOSE: Despite gsstric cancer is one of the most common ma1ignancies, its prognosis has not been improved significantly. Therefore, it is important to know what clinical and pathological factors relate to survival in gastric carcinoma in order to improve survival rate. The aim of this retrospective study was to evaluate treatment results and to analyze the factors that affect the survival of patients with gastric carcinoma.
MATERIALS AND METHODS
A total of 1,580 patients with primary gastric adenocarcinoma who had been treated surgically during the period 1983-1996 at the Department of Surgery, Korea University College of Medicine was studied to evaluate the treatment outcome. Prognostic factors were investigated by univariate and multivariate analyses in 1,407 resected patients.
RESULTS
The 5-year survival rate was 57.1% in all case, 62.4% in resected cases, and there was no survivor at 2.5 year in unresectable cases. In univariate analysis, gross type, maximum tumor diameter, depth of invasion, lymph node involvement, distant metastasis, histologic type and type of operation were found to correlate significantly with survival. Multivariate analysis indicated that lymph node involvement, depth of invasion and type of cancer were independently conelated with survival. The stage-related survival rates (UICC, 1987) were 95.8% (stage Ia), 87.6% (stage Ib), 76.7% (stage II), 51.3% (stage 1IIa), 25.5% (stage IIlb), 9.4% (stage IV) and the stage-related survival rates (UICC, 1997) 95.8% (stage Ia), 87.6% (stage Ib), 76.4% (stage II), 55.2% (stage IIla), 24.0% (stage IIIb), 13.4% (stage IV). There was no difference between two staging systems.
CONCLUSIONS
These results suggest that lymph node involvement, depth of invasion, and gross type were the most important prognostic factors, indicating that they may be helpful as predictors of long-term survival and in planning the treatment.