Prognostic Factors and Survival Rates of Stage III Gastric Cancer Patients after a Gastrectomy

Jang, Seok Won; Kim, Chi Ho; Kim, Sang Woon; Song, Sun Kyo

Abstract

PURPOSE
There have been some controversies over the therapeutic principles of advanced gastric cancer, and the results of treatment have been variable, especially for stage III disease. This study was conducted to define the prognostic factors of stage III gastric cancer.
MATERIALS AND METHODS
This retrospective study was based on the medical records of 179 patients with stage III disease who received a gastrectomy from January 1990 to December 1994. The 5-year survival rate was analyzed according to the age, sex, tumor location, tumor size, Borrmann's type, depth of invasion, lymph-node metastasis, ratio of metastatic lymph nodes, type of surgical resection, extent of lymph- node dissection, curability of resection, postoperative chemotherapy, and pathological stage. The statistical analysis was done by using the Kaplan-Meier method, the log-rank test, and the Cox proportional hazards model.
RESULTS
The overall 5-year survival rate was 61.6%. the 5-year survival rates according to subgroup were 69.7% for stage IIIa (100% for T2N2, 70.0% for T3N1, 68.6% for T4N0), and 54.1% for stage IIIb (T3N2) (P<0.05). Among various clinicopathologic factors of stage III gastric cancer, the age of the patient, the tumor location, the gross type of tumor, the type of gastric resection, the extent of lymph-node dissection, the curability of resection, and the subgroups of stage III were statistically significant in the univariate survival analysis. The multivariate analysis defined the curability of resection, the extent of lymph-node dissection, the type of operation, the stage of disease, and the age of the patient as independent prognostic factors.
CONCLUSION
A curative surgical resection and an extended lymph-node dissection are thought to be most important for improving the survival rate in stage III gastric cancer patients.