title: Prognostic factors of T4 gastric cancer patients undergoing potentially curative resection.
abstract: OBJECTIVE
  To investigate the prognostic factors of T4 gastric cancer patients without distant metastasis who could undergo potentially curative resection.
  
  
  METHODS
  We retrospectively analyzed the clinical data of 71 consecutive patients diagnosed with T4 gastric cancer and who underwent curative gastrectomy at our institutions. The clinicopathological factors that could be associated with overall survival were evaluated. The cumulative survival was determined by the Kaplan-Meier method, and univariate comparisons between the groups were performed using the log-rank test. Multivariate analysis was performed using the Cox proportional hazard model and a step-wise procedure.
  
  
  RESULTS
  The study patients comprised 53 men (74.6%) and 18 women (25.4%) aged 39-89 years (mean, 68.9 years). Nineteen patients (26.8%) had postoperative morbidity: pancreatic fistula developed in 6 patients (8.5%) and was the most frequent complication, followed by anastomosis stricture in 5 patients (7.0%). During the follow-up period, 28 patients (39.4%) died because of gastric cancer recurrence, and 3 (4.2%) died because of another disease or accident. For all patients, the estimated overall survival was 34.1% at 5 years. Univariate analyses identified the following statistically significant prognostic factors in T4 gastric cancer patients who underwent potentially curative resection: peritoneal washing cytology (P < 0.01), number of metastatic lymph nodes (P < 0.05), and venous invasion (P < 0.05). In multivariate analyses, only peritoneal washing cytology was identified as an independent prognostic factor (HR = 3.62, 95% CI = 1.37-9.57) for long-term survival.
  
  
  CONCLUSIONS
  Positive peritoneal washing cytology was the only independent poor prognostic factor for T4 gastric cancer patients who could be treated with potentially curative resection.
authors: Department of Surgery, Teikyo University School of Medicine University Hospital, Mizonokuchi, Kawsaki 213-8507, Japan. nf341206@hotmail.co.jp
authors: Naoto
authors: N
authors: Fukuda
authors: Yasuyuki
authors: Y
authors: Sugiyama
authors: Joji
authors: J
authors: Wada
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D010537:Peritoneum / Q000473:pathology; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016896:Treatment Outcome