Results after a Gastrectomy of 2,603 Patients with Gastric Cancer: Analysis of Survival Rate and Prognostic Factor.
- Author:
Sung Hoon NOH
1
;
Chang Hak YOO
;
Yong Il KIM
;
Choong Bai KIM
;
Jin Sik MIN
;
Kyong Sik LEE
Author Information
1. Department of Surgery, Yonsei University College of Medicine, Seoul, Korea.
- Publication Type:Original Article
- Keywords:
Gastric cancer;
Survival rate;
Prognostic factor;
Multivariate analysis
- MeSH:
Adenocarcinoma;
Classification;
Early Diagnosis;
Female;
Gastrectomy*;
Humans;
Lymph Nodes;
Male;
Mortality;
Multivariate Analysis;
Neoplasm Metastasis;
Prognosis;
Quality of Life;
Retrospective Studies;
Stomach;
Stomach Neoplasms*;
Survival Rate*
- From:Journal of the Korean Surgical Society
1998;55(2):206-213
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
A retrospective study of 2,603 patients with gastric cancer who underwent a gastric resection at Yonsei University Hospital from 1987 to 1994 was performed to evaluate the clinicopathological characteristics and survival rates of patients with gastric cancer. There were 1721 males and 882 females (ratio=2:1) with a mean age of 54 years (range=22~85 years). All patients underwent gastric resection with curative intent, but 199 patients (7.6%) had a palliative resection. The types of operations were a subtotal gastrectomy in 1,917 patients (73.6%) and a total gastrectomy in 686 patients (26.4%). A D2 or a more extended lymph-node dissection was performed in 2530 patients (97.2%), and only 73 patients (2.8%) had less extensive surgery. The postoperative mortality was 0.9%. The mean diameter of a tumor was 5.6 cm. The most common location of a tumor was the lower third of the stomach (49.4%). Borrmann type III (64.7%) was the most common gross type. The major histologic type was a tubular adenocarcinoma (76.3%). The overall 5-year survival rate was 66.5%. The 5-year survival rates according to the stage were 94.3% in IA, 90.5% in IB, 76.6% in II, 60.1% in IIIA, 38.7% in IIIB, and 12.9% in IV. In the univariate analysis, poor survival was closely related to increasing age, tumor location in the upper one third, larger tumor size, Borrmann type IV tumors, increasing pT and pN classifications, an advanced tumor stage, and perforance of a total gastrectomy. The multivariate analysis revealed that distant metastasis, lymph-node metastasis, depth of invasion, gross type, age, and type of resection were significant prognostic factors. In conclusion, the prognosis for gastric cancer after a gastrectomy has remarkably improved, and the most significant prognostic factors were distant metastasis, lymph node metastasis, and depth of invasion. Therefore, early diagnosis of gastric cancer and aggressive multimodal therapy, especially in patients with stage IIIB and IV tumors might improve the quality of life and the survival of the patients with gastric cancer.
