Qun An1, Xuan Song, Yan Li, Xing-Ye Shi. 1. Department of Pediatric Surgery, First Affiliated Hospital of Harbin Medical University, Harbin 150040, China.
Abstract
BACKGROUND/AIMS: 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. METHODOLOGY: 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.
BACKGROUND/AIMS: 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. METHODOLOGY: 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.