Clinicopathological Features and Prognostic Factors for Patients with Clinical T4 Gastric Cancer that Underwent Combined Resection of Invaded Organs

Byun, Gun Young; Park, Joong Min; Kim, Ho Il; Kim, Jong Han; Park, Sung Soo; Kim, Seong Ju; Mok, Young Jae; Kim, Chong Suk

Abstract

PURPOSE: The surgical treatment of gastric cancer that invades adjacent organs is a radical gastrectomy with combined resection including the adjacent organs or a palliative operation by performing either a gastrojejunostomy or gastrectomy. However, since it is impossible to determine the exact stage of the cancer, either T or N, in the case of palliative surgery, it is inappropriate to predict patient prognosis. This study analyzes the prognoses for patients whose final TNM stages are determined by a combined resection performed due to macroscopical infiltration into the adjacent organs.
MATERIALS AND METHODS
Of 2,452 patients that underwent surgery for gastric cancer at our hospital from 1983 to 2002, we evaluated 102 patients where a combined resection was performed because direct infiltration into the adjacent organs was discovered.
RESULTS
Univariate analysis showed that the survival rate differed by the depth of invasion into the gastric walls, the degree of lymph node metastasis, distant metastasis, pathological TNM stage, surgical curability, the location of tumor, and histological differentiation. By multivariate analysis, it was found that the surgical curability, the location of the tumor and the degree of lymph node metastasis were independent prognostic factors.
CONCLUSION
It is suggested that even when infiltration into adjacent organs is suspected, radical surgery should be performed as to allow a prediction of prognosis through an exact determination of disease stage, and to improve the survival rate.