title: Prognostic significance of subclassification of stage IV gastric cancer according to pTNM categories.
abstract: OBJECTIVE
  The aim was to evaluate the surgical outcome and prognosis of patients with stage IV gastric cancer, and to investigate whether stage IV gastric cancer should be further subclassified for more accurate prediction of outcome.
  
  
  METHODS
  We analyzed 401 patients with stage IV gastric cancer who underwent gastric resection from 1998 to 2004. According to TNM categories, we separated them into T1-3N3M0, T4N1-2M0, T4N3M0, And TanyNanyM1 groups.
  
  
  RESULTS
  The survival rate of patients with subclassification IVa (T1-3N3M0 and T4N1-2M0) gastric cancers was significant higher than that of patients with sub-classification IVb (T4N3M0 and TanyNanyM1) ones (p < 0.001). Multivariate analysis showed that sub-classification, distant metastasis, and curability of operation were significant factors affecting survival.
  
  
  CONCLUSIONS
  Sub-classification of stage IV gastric cancer into a relatively favorable group (T4N1-2M0 and T1-3N3M0; stage IVa) and an unfavorable group (T4N3M0 and TanyNanyM1; stage IVb) may predict patients' prognosis more accurately.
authors.affiliation: Department of Pediatric Surgery, First Affiliated Hospital of Harbin Medical University, Harbin 150040, China.
authors.forename: Qun
authors.initials: Q
authors.lastname: An
authors.forename: Xuan
authors.initials: X
authors.lastname: Song
authors.forename: Yan
authors.initials: Y
authors.lastname: Li
authors.forename: Xing-Ye
authors.initials: XY
authors.lastname: Shi
mesh_terms: D000328:Adult; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000145:classification* / Q000401:mortality / Q000473:pathology