[Problems of surgical management of Borrmann's type IV stomach cancer--with special reference to subdivision of Borrmann's type IV].
Type IV of Borrmann's classification was subdivided into IVa and IVb according to the gross aspect of the mucosal surface of surgical specimens. Type IVa indicates the presence of slight elevation or depression, type IVb includes the rest of type IV. Of 2682 gastrectomized patients, 151 (5.6%) were classified as type IVa and 253 (9.4%) as type IVb. The 5-year survival rate of patients with type IVa who underwent curative gastrectomy was 36.0%; of patients with type IVb it was 17.5%. The difference in these survival rates was statistically significant. Between types IVa and IVb, there were no significant differences with respect to serosal invasion, lymph node metastasis, tumor size, and age and sex distribution. Therefore, other clinical and/or biological factors should be considered as reasons for the difference in the survival rates between these two groups. From this point of view, subdivision Borrmann's type IV is useful in evaluating the postoperative prognosis.
D005743:Gastrectomy / Q000401:mortality; D006801:Humans; D013274:Stomach Neoplasms / Q000145:classification* / Q000473:pathology / Q000601:surgery