Prognostic factors in the surgical treatment of gastric cancer--10 years experience.
BACKGROUND
In spite of the increase in radicality and extended resections, the prognosis of gastric cancer is very poor. Surgical resection is the only effective therapy. The morbidity and mortality of surgical interventions decreased during the last years.


METHODS
The aim of this study was to evaluate the prognostic effect of different factors on survival of gastric cancer. A retrospective study of 483 patients with gastric cancer was performed. Data were collected from January 1993 to December 2002. There were 380 resections, 267 (70,2%) total gastrectomies, 93 (24.8%) distal resections and 20 (5.2%) proximal resections. Epidemiological factors, tumour and treatment related parameters were analysed. Kaplan-Meier method was used to assess survival and Cox regression analysis to evaluate the effect of prognostic factors on survival.


RESULTS
The rate of R0 resections was 73.4% for total gastrectomy, and 73% for distal gastrectomy. The five-year overall survival of the entire population was 26.08%, 36.2% of the resected patients and 69.05% of curative resections. In concordance with literature findings, radicality of resection, depth of tumour invasion and lymph node metastases proved to be the most powerful independent prognostic factors.


CONCLUSIONS
Prognosis of gastric cancer can be remarkably improved by a complete resection of the tumour and its lymphatic drainage, even if extension of the resection is needed.
Káposztás
Zsolt
Z
Pécsi Tudományegyetem, Orvostudományi és Egészségtudományi Centrum, Altálnos Orvostudományi Kar, Sebészeti Klinika.
Kalmár
Katalin
K
Cseke
László
L
Illényi
László
L
Kelemen
Dezso
D
Horváth
Ors Péter
OP
D000230:Adenocarcinoma / Q000401:mortality / Q000601:surgery; D000368:Aged; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D006814:Hungary / Q000453:epidemiology; D053208:Kaplan-Meier Estimate; D008297:Male; D008499:Medical Records; D008875:Middle Aged; D009367:Neoplasm Staging; D010166:Palliative Care / Q000379:methods; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012307:Risk Factors; D013274:Stomach Neoplasms / Q000145:classification / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome