title: Type IV Borrmann gastric adenocarcinoma: analysis of curative resection results.
abstract: OBJECTIVE
  To evaluate the results obtained with curative resection of Borrmann IV gastric adenocarcinoma (B IV) through the analysis of clinical, surgical and pathological data, identifying which of these prognostic factors were associated with survival.
  
  
  METHODS
  We retrospectively analyzed 123 patients with B IV gastric adenocarcinoma undergoing surgical treatment at the Department of the pelvic-abdominal surgeries of the National Cancer Institute (INCA) from January 1997 to December 2005. The group undergoing curative resection was examined for various prognostic factors regarding overall survival.
  
  
  RESULTS
  Of the 123 patients studied, 68 underwent gastrectomy, 52 (42.3%) with curative intent and 16 (13%) palliative resection, while 55 (44.7%) had disease not subject to resection. Three postoperative deaths followed the curative resection, constituting a mortality rate of 5.76%. In nine (17.3%) patients there were technical complications, and esophagojejunal fistula seven cases, the most frequent. All technical complications and deaths occurred after total gastrectomy, which was the most commonly performed curative resection type in this series. The most common pattern of recurrence was peritoneal carcinomatosis. The location of the tumor, lymph node metastasis, lymphatic invasion and pathological staging were considered significant prognostic factors. The median survival time was 29 months, with a rate of five-year survival of 33% in patients undergoing curative resection.
  
  
  CONCLUSIONS
  The curative resection of B IV gastric adenocarcinoma had a positive impact on survival of patients with the disease in stages IB, II and III, with up to 15 lymph nodes (pN2) and localized type.
authors.affiliation: Instituto Nacional do Câncer, Rio de Janeiro, Brazil. antonioaccetta@globo.com
authors.forename: Antonio Carlos
authors.initials: AC
authors.lastname: Accetta
authors.forename: José Eduardo Ferreira
authors.initials: JE
authors.lastname: Manso
authors.forename: Eduardo Linhares Riello de
authors.initials: EL
authors.lastname: Mello
authors.forename: Rubens Kesley Siqueira de
authors.initials: RK
authors.lastname: Paiva
authors.forename: Leonaldson dos Santos
authors.initials: Ldos S
authors.lastname: Castro
authors.forename: Pietro
authors.initials: P
authors.lastname: Accetta
mesh_terms: D000230:Adenocarcinoma / Q000145:classification / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D000328:Adult; D000368:Aged; D015331:Cohort Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000145:classification / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate