For gastric carcinoma, surgery remains the only method of treatment that offers the potential for cure. We undetook a retrospective study of 410 pateints treated with curative intent from 1980 to 1990. A multivartiate survival analysis using the
Cox
model revealed six significant variables-four inherent clinicopathological factors and two treatment factors.
@ES Their list and 5 year survivals were as follows;
1) Depth of invasion; T1 (87.1%), T2(80.6%), T3 (45.6%), T4 (0%) (P<0.0001).
2) Regional lymph node mtastasis; n0 (80.4%), n1(49.8%), n2(34.8%), n3(27.4%), n4(0%) (pp<0.0001)
3) Age; 30~49; (63.9%), less than 30, (51.1%), 50~69; (49.7%), more than 70; (38.7%) (p=0.043)
4) Location of primary tumor; middle (59.5%), lower; (55.1%), upper (51.7%), entire; (4.9%) (p<60.0001)
5) Microscopic positive resection margin; positive (18.7%), negative (57.3%) (p<0.0001)
6) Type of gastric resection; distal subtotal gastrectomy (55.4%), total gastrectomy (43.4%) (p=0.0055)
These observations reconfirm the importance of treatment at early stage as possible and negative resection margins, but argue against a general policy of a elective total gastrectomy. We also have to consider a more active surgical treatment
especially
the extent of resection for geriatric gastric cancer patients.
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