title: Surgical outcomes and prognostic factors of T4 gastric cancer patients without distant metastasis.
abstract: OBJECTIVE
  To evaluate surgical outcomes and prognostic factors for T4 gastric cancer treated with curative resection.
  
  
  METHODS
  Between January 1994 and December 2008, 94 patients diagnosed with histological T4 gastric carcinoma and treated with curative resection were recruited. Patient characteristics, surgical complications, survival, and prognostic factors were analyzed.
  
  
  RESULTS
  Postoperative morbidity and mortality were 18.1% and 2.1%, respectively. Multivariate analysis indicated lymph node metastasis (hazard ratio, 2.496; 95% confidence interval, 1.218-5.115; p = 0.012) was independent prognostic factor.
  
  
  CONCLUSIONS
  For patients with T4 gastric cancer, lymph node metastasis was associated with poorer survival. Neoadjuvant chemotherapy or aggressive adjuvant chemotherapy after radical resection was strongly recommended for these patients.
authors.affiliation: Department of Gastrointestinal and Pancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Ming-zhe
authors.initials: MZ
authors.lastname: Li
authors.affiliation: Department of General Surgery I, the Eastern Hospital of the First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Liang
authors.initials: L
authors.lastname: Deng
authors.affiliation: Department of laboratory, Hexian Memory Hospital of Panyu District, Guangzhou, China.
authors.forename: Jing-jing
authors.initials: JJ
authors.lastname: Wang
authors.affiliation: Department of Gastrointestinal and Pancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Long-bin
authors.initials: LB
authors.lastname: Xiao
authors.affiliation: Department of Gastrointestinal and Pancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Wen-hui
authors.initials: WH
authors.lastname: Wu
authors.affiliation: Department of Gastrointestinal and Pancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Shi-bin
authors.initials: SB
authors.lastname: Yang
authors.affiliation: Department of Gastrointestinal and Pancreatic Surgery, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China.
authors.forename: Wen-feng
authors.initials: WF
authors.lastname: Li
mesh_terms: D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D005260:Female; D005743:Gastrectomy / Q000009:adverse effects / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D011183:Postoperative Complications / Q000145:classification / Q000473:pathology*; D011379:Prognosis; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome