Open Access, Peer-reviewed
pISSN 2288-6575
eISSN 2288-6796
    J Korean Surg Soc. 2011 Jan;80(1):16-22. Korean.
    Published online Jan 27, 2011.
    https://doi.org/10.4174/jkss.2011.80.1.16
    Copyright © 2011 The Korean Surgical Society
    Original Article

    Prognostic Factors for Gastric Cancer Patients with Synchronous Metastasis

    Hyun Il Kim, M.D., Tae Kyung Ha, M.D. and Sung Joon Kwon, M.D.
      • Department of Surgery, College of Medicine, Hanyang University, Seoul, Korea.
    • Corresponding author (Email: sjkwon@hanyang.ac.kr )
    Received July 28, 2010; Accepted November 17, 2010.

    Abstract

    Purpose

    The prognosis for gastric cancer patients with distant metastasis is very poor. The purpose of this study was to evaluate the prognosis and survival for gastric cancer patients with synchronous metastasis.

    Methods

    Among 2,083 gastric cancer patients who received surgery at the Department of Surgery, Hanyang University Hospital from 1992 to 2009, 164 patients revealed distant metastasis. However, 3 patients who died of postoperative complications were excluded. For the remaining patients, various clinicopathological factors were analyzed using univariate and multivariate survival analyses.

    Results

    Systemic chemotherapy (SC), type of surgery, lymph node dissection, degree of peritoneal carcinomatosis (PC), presence of ascites and tumor location were significant prognostic factors. However, sex, age, number of metastatic sites and histologic classification were not significant prognostic factors. In multivariate analysis, the type of surgery, the SC and the degree of PC were independent prognostic factors. Survival benefit by SC was significant in single site metastasis. The significant survival difference between resection and non-resection groups was observed regardless of number of metastatic sites.

    Conclusion

    In gastric cancer patients with metastasis, the favorable prognostic factors were type of surgery and SC in single metastasis. The gastrectomy improves the prognosis regardless of number of metastatic sites. However, a prospective randomized clinical trial is mandatory to attain more accurate information.

    Keywords
    Gastric cancer; Metastasis; Prognostic factors

    Figures

    Fig. 1
    Cumulative survival curves according to the type of surgery.

    Fig. 2
    Cumulative survival curves according to the performance of chemotherapy; *CTx(+) = chemotherapy conducted group; †CTx(-) = chemotherapy not conducted group.

    Fig. 3
    Cumulative survival curves according to the degree of peritoneal carcinomatosis; *P0 = no peritoneal metastasis; †P1 = metastases to the adjacent peritoneum but not the distant peritoneum; ‡P2 = a few metastases to the distant peritoneum; §P3 = numerous metastases to the distant peritoneum.

    Tables

    Table 1
    Univariate survival analysis in synchronous distant metastasis of gastric cancer

    Table 2
    Multivariate survival analysis in synchronous metastasis of gastric cancer

    Table 3
    Survival rate in single and multiple metastasis group according to the performance of chemotherapy

    Table 4
    Survival rate in single and multiple metastasis group according to the type of surgery

    Table 5
    Survival rate according to the degree of peritoneal carcinomatosis (PC) in patients with single PC and PC with other site metastasis

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    MeSH Terms
    Ascites
    Carcinoma
    Gastrectomy
    Humans
    Lymph Node Excision
    Multivariate Analysis
    Neoplasm Metastasis
    Postoperative Complications
    Prognosis
    Stomach Neoplasms
    Metrics
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