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Yoo and Lee: Factors Affecting Long Term Survival after Gastrectomy for Stage IV Gastric Cancer
Original Article
Journal of the Korean Surgical Society

Journal of the Korean Surgical Society 2010; 78(1): 17-22.

Published online: 8 January 2010

DOI: https://doi.org/10.4174/jkss.2010.78.1.17

Factors Affecting Long Term Survival after Gastrectomy for Stage IV Gastric Cancer

Joong-Jae Yoo, M.D, Sang-Ho Lee, M.D

Department of Surgery, Kosin University College of Medicine, Busan, Korea.

Corresponding author (gslsh@ns.kosinmed.or.kr)

Received 27 August 2009       Accepted 14 October 2009

Copyright © 2010 The Korean Surgical Society

Abstract

Purpose

The prognosis of stage IV gastric cancer is poor, but some patients with stage IV gastric cancer survive for more than 5 years. We investigated the prognostic factors of the stage IV gastric cancer in the patients with survival for more than 5 years after resection of the primary lesion.

Methods

We retrospectively analyzed 194 patients that underwent resection of stage IV gastric cancer from January 1997 to June 2000 in our hospital. We investigated clinicopathological characteristics between patients surviving 5 years or more group (n=17) and less than 5 years group (n=177) with chi-square and T-test. We used univariate analysis with Kaplan-Meier method and Log-rank test, and multivariate analysis with Cox proportional hazard model to investigate prognositic factors for survival rate about each characteristic.

Results

In clinicopathological characteristics between the two groups, we observed statistical significance in regard to macroscopic findings (P=0.035), but not in the others. Curative resection (P=0.001) and intravenous chemotherapy (P=0.012) had statistically significant influence on 5-year survival curve. Multivariate analysis showed that curative resection was a significant factor for long-term survival rates (P=0.005), but chemotherapy and macroscopic type had no effect on survival rate.

Conclusion

Although this study has the limitation of a retrospective study and total patient number in the 5-year survival group, curative resection may be important, as a prognostic factor, and active treatments should be performed for stage IV gastric cancer.

Keywords: Gastric cancer, Stage IV, Long term survival, Prognostic factor

Figures and Tables

Fig. 1
Survival of patients with stage IV gastric cancer based on radicality.
jkss-78-17-g001
Fig. 2
Survival of patients with stage IV gastric cancer based on lymph node metastasis.
jkss-78-17-g002
Fig. 3
Survival of patients with stage IV gastric cancer based on lymph node dissection.
jkss-78-17-g003
Fig. 4
Survival of patients with stage IV gastric cancer based on distant metastasis.
jkss-78-17-g004
Fig. 5
Survival of patients with stage IV gastric cancer based on chemotherapy.
jkss-78-17-g005
Fig. 6
Survival of patients with stage IV gastric cancer metastatic lymph node metastasis without distant metastasis.
jkss-78-17-g006
Fig. 7
Survival of patients with stage IV gastric cancer based on TNM stage.
jkss-78-17-g007
Table 1
Clinicopathological characteristics
jkss-78-17-i001

*NS = not significant; †Distant metastatic lymph node = portal, retropancreatic, mesenteric, para-aortic, retroperitoneal.

Table 2
Stage IV factor (P=0.910)
jkss-78-17-i002

*Distant metastatic lymph node = portal, retropancreatic, mesenteric, para-aortic, retroperitoneal.

Table 3
Distant metastatic node without distant metastasis (P= 0.870)
jkss-78-17-i003
Table 4
Multivariative analysis of prognostic factors by Cox's proportional harzard model
jkss-78-17-i004

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