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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.

Different Clinical Outcomes of Stage IV Gastric Cancer according to the Curability of Surgery