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KMID : 0371320030640050383
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Journal of the Korean Surgical Society
2003 Volume.64 No. 5 p.383 ~ p.389
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Outcome of Potentially Curative Gastrectomy in Patients with Stage IV Stomach Cancer -Based on the 5th Edition of AJCC/UICC Classification (1997)-
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Jung In-Mok
Suh Jun-Suk
Kim Young-Cheol
Heo Seung-Chul
Ahn Young-Joon
Chung Jung-Kee
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Abstract
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Purpose :The prognosis after potentially curative resection for stage IV gastric cancer, according to the 5th edition of AJCC/UICC classification, is poorly understood. The aim of this study was to evaluate the feasibility of the curative resection in patients with stage IV gastric cancer, which were considered potentially curable cases.
Methods :From November 1991 to June 1996, 91 patients were confirmed as having stage IV gastric cancer at Seoul Boramae Municipal Hospital. Of these 91 patients, 30 who were potentially curative resected including at least D2 type lymph node dissections were reviewed retrospectively. The average numbers of totally dissected and positive lymph nodes were 43.0 (range: 26~74) and 23.1 (range: 2~47), respectively.
Results :The overall 1-, 2-, and 5-year survival rates of patients were 60.0%, 36.7%, 13.3%, respectively. In comparison with stage IIIb (N=20), no significant difference in survival rate was observed (P=0.1178). In univariate analysis, we found that the presence of a recurrence (P=0.0121) and a P (positive lymph nodes)/R (total dissected lymph nodes) ?¾0.6 were correlated with poor survival rates. Long- survivors (N=12, more than 24 months postoperatively) had a tendency to be younger, less recurrent (P=0.017) and less involvement of histological perineural invasion (P=0.028).
Conclusion :The results of the present study indicate that stage IV patients without distant metastasis may indeed be cured by potentially curative surgery.
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KEYWORD
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Stomach cancer, Stage IV, Potentially curative resection,
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