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Prognostic factors for patients after curative resection for proximal gastric cancer

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Summary

The factors influencing the long-term survival of patients with proximal gastric cancer (PGC) after curative resection were investigated. Data from 171 patients who underwent curative resection for PGC were retrospectively analyzed. The patients were grouped according to the clinicopathological factors and operative procedures. The tumor depth (T stage) and lymph node metastasis (pN stage) were graded according to the fifth edition of TNM Staging System published by UICC in 1997. The metastatic lymph node ratio (MLR) was divided into four levels: 0%, <10%, 10%–30% and >30%. The data of survival rate were analyzed by Kaplan-Meier method (log-rank test) and Cox regression model. The 5-year overall survival rate of 171 patients was 37.32%. The univariate analysis demonstrated that the survival time of the postoperative patients with PGC was related to tumor size (χ 2=4.57, P=0.0325), gross type (χ 2=21.38, P<0.001), T stage (χ 2=27.91, P<0.001), pN stage (χ 2=44.72, P<0.001), MLR (χ 2=61.12, P<0.001), TNM stage (χ 2=44.91, P<0.001), and range of gastrectomy (χ 2=4.36, P=0.0368). Multivariate analysis showed that MLR (χ 2=10.972, P=0.001), pN stage (χ 2=6.640, P=0.010), TNM stage (χ 2=7.081, P=0.007), T stage (χ 2=7.687, P=0.006) and gross type (χ 2=6.252, P=0.012) were the independent prognostic factors. In addition, the prognosis of patients who underwent total gastrectomy (TG) was superior to that of patients who underwent proximal gastrectomy (PG) for the cases of tumor ≥5 cm (χ 2=6.31, P=0.0120), Borrmann III/IV (χ 2=7.96, P=0.0050), T4 (χ 2=4.57, P=0.0325), pN2 (χ 2=5.52, P=0.0188), MLR 10%–30% (χ 2=4.46, P=0.0347), MLR >30% (χ 2=13.34, P=0.0003), TNM III (χ 2=14.05, P=0.0002) or TNM IV stage (χ 2=4.37, P=0.0366); and combining splenectomy was beneficial to the cases of T3 (χ 2=5.68, P=0.0171) or MLR >30% (χ 2=6.11, P=0.0134). It was concluded that MLR, pN stage, TNM stage, T stage, and gross type had advantages in providing a precise prognostic evaluation for patients undergoing curative resection for PGC, in which MLR was the most valuable index. TG and combining splenectomy were useful to improve the prognosis to patients with PGC of TNM III/IV stage, serosa invasion, or extensive regional lymph node metastasis.

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Authors and Affiliations

  1. Department of Surgical Oncology, Research Unit of General Surgery, Department of Gastrointestinal Oncosurgery, First Affiliated Hospital of China Medical University, Shenyang, 110001, China

    Donghui Zhao  (赵东晖), Huimian Xu  (徐惠绵), Kai Li  (李 凯) & Zhe Sun  (孙 哲)

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  1. Donghui Zhao  (赵东晖)
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  2. Huimian Xu  (徐惠绵)
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  3. Kai Li  (李 凯)
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  4. Zhe Sun  (孙 哲)
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Correspondence to Huimian Xu  (徐惠绵).

Additional information

This project was supported by National Natural Sciences Foundation of China (No. 30672050) and the Science and Technology Project of Liaoning Province (No. 2005225007-3).

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Zhao, D., Xu, H., Li, K. et al. Prognostic factors for patients after curative resection for proximal gastric cancer. J. Huazhong Univ. Sci. Technol. [Med. Sci.] 30, 530–535 (2010). https://doi.org/10.1007/s11596-010-0463-z

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  • DOI: https://doi.org/10.1007/s11596-010-0463-z

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