Surgical outcome of serosa-negative advanced gastric carcinoma.
The purpose of the present study was to clarify prognostic factors and to investigate appropriate therapeutic strategies for T2 gastric carcinoma. A total of 297 consecutive patients with T2 gastric carcinoma (T2a; 130, T2b; 167) were enrolled in this study. The overall 5-year survival rate was 75.3%. There was a significant difference in survival between T2a and T2b tumor. Multivariate analysis showed that age, depth of invasion and lymph node metastasis independently influenced prognosis. Peritoneal recurrence was frequently observed in 37 patients. Multivariate analysis revealed that lymph node metastasis was an independent predictive factor for peritoneal recurrence. Furthermore, the quantity of the stroma was an independent prognostic factor for hematogenous metastasis, and lymph node metastasis for lmphatic metastasis. Prophylactic therapeutic strategy should be advised for patients with many metastatic lymph nodes, for peritoneal or lymphatic recurrence and in patients with "medullary" stroma for hematogenous recurrence.
Kunisaki
Chikara
C
Department of Gastroenterological Surgery, Yokohama City University, Graduate School of Medicine, Yokohama, Japan. s0714@med.yokohama-cu.ac.jp
Shimada
Hiroshi
H
Nomura
Masato
M
Matsuda
Goro
G
Otsuka
Yuichi
Y
Ono
Hidetaka
H
Akiyama
Hirotoshi
H
D017024:Chemotherapy, Adjuvant; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D012704:Serous Membrane / Q000473:pathology; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome