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Prognostic influence of sub‐stages according to pTNM categories in patients with stage IV gastric cancer
Author(s) -
Li Chen,
Yan Min,
Chen Jun,
Xiang Min,
Zhu Zheng Gang,
Lin Yan Zheng
Publication year - 2009
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.21242
Subject(s) - medicine , stage (stratigraphy) , gastrectomy , cancer , lymphadenectomy , gastroenterology , multivariate analysis , oncology , surgery , paleontology , biology
Abstract Background and Objectives The prognosis for patients with stage IV gastric cancer is still very poor. The purpose of this study was to evaluate the surgical outcome and prognosis, and to determine the prognostic influence of sub‐stages of stage IV gastric cancer. Methods From 1992 to 2002, 287 patients histologically diagnosed with stage IV gastric cancer underwent gastrectomy at the Department of Surgery, Ruijin Hospital, China. Regarding TNM categories, we separated them into T1‐3N3M0, T4N1‐2M0, T4N3M0, and TanyNanyM1 groups. We compared the clinicopathological characteristics as well as the survival in these groups. Results There were largest proportions of patients who underwent extended lymphadenectomy and curative gastrectomy in T1‐3N3M0 group followed by T4N1‐2M0, T4N3M0, and TanyNanyM1 groups. The survival rate of patients with sub‐stage IVa (T1‐3N3M0 and T4N1‐2M0) tumors was significant higher than that of patients with sub‐stage IVb (T4N3M0 and TanyNanyM1) tumors ( P = 0.008). Multivariate analysis showed that sub‐stage with the highest risk ratio (1.454), and the surgical curability were independent prognostic factors in patients with stage IV gastric cancer. Conclusions Sub‐stages IVa (T1‐3N3M0 and T4N1‐2M0) and IVb (T4N3M0 and TanyNanyM1) may predict patients' prognosis more accurately. Curative resection should be performed whenever possible in patients with stage IV gastric cancer. J. Surg. Oncol. 2009;99:324–328. © 2009 Wiley‐Liss, Inc.