Prognosis of T4 gastric carcinoma patients: an appraisal of aggressive surgical treatment

Journal of Surgical Oncology
D K DharN Nagasue

Abstract

Despite precipitous drop in the incidence of gastric carcinoma in Japan, it is still one of the leading causes of death associated with malignant disease. Once the contiguous organs are involved the prognosis becomes dismal. Prognostic factors governing the survival of patients with T4 gastric carcinoma remain unclear. Between 1980 and 1998, 150 patients were treated for T4 gastric carcinoma. Results and prognostic factors were evaluated by univariate and multivariate analyses. With a 73% resectability, patients with tumor resection had a significantly (P < 0.0001) improved survival rate. Within an acceptable operative mortality (2.6%), apparently curative cases had survival benefit (P < 0.0001) over noncurative cases. In the multivariate analysis, the death risk increased by 2.18 (relative risk) when splenectomy was spared from the operative procedure (P < 0.0071). Presence of esophageal invasion was the other independent prognostic factor in T4 gastric carcinoma patients (relative risk 2.11). Conventional prognostic factors along with the type of organs invaded by the carcinoma had no impact on prognosis. Patients with T4 gastric carcinoma might be benefited from aggressive surgery with a curative intent. Whenever possible, s...Continue Reading

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Citations

Oct 9, 2007·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Masanori TokunagaToshiharu Yamaguchi
Jan 12, 2011·Annals of Surgical Oncology·Chi-Tung ChengYi-Yin Jan
Aug 13, 2011·Annals of Surgical Oncology·Jae-Seok MinJong-Inn Lee
Sep 2, 2011·World Journal of Surgery·Kuan-Kai LaiAnna Fen-Yau Li
Nov 7, 2009·Asian Journal of Surgery·Jong-Han KimChong-Suk Kim
Apr 9, 2011·American Journal of Surgery·Kazuhito MitaHiroyuki Kikuchi
Jun 14, 2006·ANZ Journal of Surgery·Dong Y KimShin K Kim
Oct 1, 2008·American Journal of Surgery·Ilter OzerMusa Akoglu
Jan 24, 2006·Journal of the American College of Surgeons·Chikara KunisakiHiroshi Shimada
Jul 26, 2007·Magyar sebészet·Zsolt KáposztásOrs Péter Horváth
Mar 13, 2015·Gastric Cancer : Official Journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association·Yinting ChenKaihong Huang
Dec 4, 2003·The British Journal of Surgery·D K DharN Nagasue
Sep 25, 2017·Journal of Gastrointestinal Surgery : Official Journal of the Society for Surgery of the Alimentary Tract·Kazuhito MitaKeiichi Fujino
Aug 10, 2004·International Journal of Cancer. Journal International Du Cancer·Dipok Kumar DharNaofumi Nagasue
Nov 29, 2007·Journal of Surgical Oncology·Jian-Hua LiuKai-Hong Huang
Apr 22, 2005·Journal of Surgical Oncology·Fabio CarboniEugenio Santoro
Mar 22, 2019·Journal of Gastrointestinal Cancer·Mushegh А SahakyanArthur M Sahakyan
Feb 1, 2020·Journal of Surgical Oncology·Andre R DiasIvan Cecconello
Feb 11, 2014·Arquivos Brasileiros De Cirurgia Digestiva : ABCD = Brazilian Archives of Digestive Surgery·Bernard Costa FavachoGeraldo Ishak
Oct 11, 2020·American Journal of Surgery·Yanpeng YangYucun Liu
May 10, 2021·Journal of Medical Case Reports·Naohiko NakamuraHiroyuki Takamura

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