Influence of the extent of resection on survival after curative treatment of gastric carcinoma. A retrospective multivariate analysis.
The therapeutic value of extensive gastric resection and regional lymphadenectomy in the curative treatment of gastric adenocarcinoma is controversial. We undertook a retrospective study of 210 patients treated with curative intent from 1960 to 1980. A multivariate survival analysis using the Cox model revealed five significant variables predictive of death from gastric cancer--two inherent pathologic factors: (1) nonpyloric site and (2) metastases in more than three lymph nodes, and three treatment factors that could often be controlled by the surgeon: (3) microscopic positive gastric resection margin, (4) inadequate lymphadenectomy, and (5) total gastrectomy. These observations reaffirm the value of wide gastric resection and adequate lymphadenectomy but argue against a general policy of elective total gastrectomy in the curative treatment of gastric carcinoma.
Shiu
M H
MH
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY 10021.
Moore
E
E
Sanders
M
M
Huvos
A
A
Freedman
B
B
Goodbold
J
J
Chaiyaphruk
S
S
Wesdorp
R
R
Brennan
M F
MF
D000230:Adenocarcinoma / Q000473:pathology / Q000601:surgery*; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D008197:Lymph Node Excision; D011379:Prognosis; D012189:Retrospective Studies; D013223:Statistics as Topic; D013274:Stomach Neoplasms / Q000473:pathology / Q000601:surgery*