Asian Journal of Surgery
Volume 32, Issue 4 , Pages 198-204, October 2009

Surgical Outcomes and Prognostic Factors for T4 Gastric Cancers

Department of Surgery, Korea University College of Medicine, Ansan City, South Korea

Accepted 29 August 2009.

Article Outline

Purpose

In locally advanced gastric carcinomas that have invaded adjacent organs, the prognosis is poor. When combined resections are performed in T4 gastric cancers, a high morbidity rate is reported and it is inconclusive as to whether or not there is an improvement in the survival rate. We investigated surgical outcomes and analysed the prognostic factors for T4 gastric cancers.

Patients and Methods

Between January 1992 and December 2000, 132 patients underwent surgery for T4 gastric cancer; they were divided into three groups: combined resections in group I, gastrectomy alone in group II, and resections not performed but palliative gastrojejunostomy or intraperitoneal chemotherapy in group III. Surgical outcomes and clinicopathologic factors were compared and prognostic factors were evaluated.

Results

Among the three groups, statistically significantly different factors were tumour location, Borrmann type, tumour size, distant metastasis and peritoneal metastasis. The most commonly resected organ was the transverse colon, and 14 post-operative morbidities developed. In the multivariate analysis, the treatment group and curability were proved to be independent prognostic factors.

Conclusion

In patients with T4 gastric carcinoma, an aggressive surgical approach can be beneficial when curative resection is performed. If curative resection is not possible, palliative resection can be performed for a better quality of life.

Key Words:  prognostic factors , surgical resection , T4 gastric cancer

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PII: S1015-9584(09)60395-X

doi:10.1016/S1015-9584(09)60395-X

Asian Journal of Surgery
Volume 32, Issue 4 , Pages 198-204, October 2009

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