Journal List > J Korean Surg Soc > v.77(3) > 1011002

Seo, Bae, Kim, Kim, and Song: Different Clinical Outcomes of Stage IV Gastric Cancer according to the Curability of Surgery

Abstract

Purpose

This study was conducted to evaluate the survival differences between curative stage IV and non-curative stage IV gastric cancers after gastrectomy.

Methods

Stage IV gastric cancer patients who received gastrectomy were selected from our surgical data-base from 1995 to 2004. These patients were separated into two groups according to the curability by surgery. We analyzed the survival differences between curative stage IV patients and non-curative stage IV patients. Survival analysis was performed by Kaplan-Meier survival analysis.

Results

During a 10-year period, gastrectomy was performed in 2,214 patients. 224 patients were diagnosed as stage IV. 144 patients were male and 80 patients were female. 97 patients received total gastrectomy. 127 patients received subtotal gastrectomy. 173 patients were diagnosed with curative stage IV and 51 patients were non-curative stage IV. Overall 3-year and 5-year survival rates of stage IV gastric cancer patients in this study were 31.5% and 18.4%. 3-YSR of curative and non-curative stage IV were 36.0% and 16.7% respectively (P-value=0.0204). 5-YSR of curative and non-curative stage IV was 21.9% and 4.2% (P-value=0.0169).

Conclusion

Significant survival differences were found between curative and non-curative stage IV. Although direct tumor extension or distant metastasis exists, gastrectomy with combined resection was important to improve prognosis if it is possible to resect. When it comes to the matter of survival rate, the subclassification of stage IV gastric cancer should be considered for further management.

Figures and Tables

Fig. 1
Survival curves of patients according to curability.
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Table 1
Clinicopathological characteristics
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Table 2
5-year survival rate according to clinicopathological features
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Table 3
Multivariate analysis according to Cox proportional hazard model
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*Exp (B) = relative risk.

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