Clinicopathologic Characteristics of and Prognosis for Patients with a Borrmann Type IV Gastric Carcinoma.
10.5230/jkgca.2006.6.2.97
- Author:
Taeg Hyun KIM
1
;
Kyo Young SONG
;
Seung Nam KIM
;
Cho Hyun PARK
Author Information
1. Department of Surgery, College of Medicine, The Catholic University of Korea, Seoul, Korea. chpark@catholic.ac.kr
- Publication Type:Original Article
- Keywords:
Borrmann type IV;
Gastric carcinoma;
Prognosis
- MeSH:
Diagnosis;
Drug Therapy;
Female;
Humans;
Laparoscopy;
Lymph Nodes;
Multivariate Analysis;
Neoplasm Metastasis;
Prognosis*;
Recurrence;
Stomach Neoplasms;
Survival Rate
- From:Journal of the Korean Gastric Cancer Association
2006;6(2):97-102
- CountryRepublic of Korea
- Language:Korean
-
Abstract:
PURPOSE: The prognosis for patients with a Borrmann type IV gastric cancer is extremely poor despite an aggressive surgical approach. We evaluated the clinicopathological features for Borrmann type IV cancers to find treatment strategy. MATERIALS AND METHODS: The 1098 patients with advanced gastric cancer who underwent surgical resection between 1990 and 2001 were analyzed. These patients were divided into two groups: 81 patients with a Borrmann type IV carcinoma, and 1017 patients with all other types of gastric carcinomas. RESULTS: Patients with a Borrmann type IV carcinoma were younger than those with other types, and female was prevalent (p=0.000). Of the patients with a Borrmann type IV gastric carcinoma, 68 patients (84%) were classified as stage III or IV at the initial diagnosis. The histologic type was commonly undifferentiated and serosal infiltration; nodal involvement and lymphatic invasion were more frequent in patients with a Borrmann type IV than in those with other types of cancer. Multivariate analysis confirmed that the extent of lymph node metastasis was a negative prognostic factor for Borrmann type IV gastric carcinomas. The curability for a Borrmann type IV carcinoma was only 53.1%, and peritoneal dissemination rate was 25.9%. The predominant pattern of recurrence for a Borrmann type IV gastric carcinoma was peritoneal dissemination, and it was significantly different with other types (93.1% vs 55.8%, P<0.05). The 5-year survival rate of patients with a Borrmann type IV gastric carcinoma was significantly lower than those of patients with other types of cancer, even though a curative resection had been accomplished (26% vs 63%, p<0.005). The 5-year survival rates of patients with a Borrmann type IV carcinoma following a curative resection were 44.9%, 24%, and 0% for stages II, III and IV, respectively (p<0.05). CONCLUSION: Because the prognosis for patients of a Borrmann type IV gastric cancer is extremely poor despite a curative resection, preoperative and/or intraperitoneal chemotherapy should be considered. And diagnostic laparoscopy and peritoneal cytology may be used to play an important role in accurate staging workup.
