Prognostic factors of T4 gastric cancer patients undergoing potentially curative resection.
AIM
To investigate the prognostic factors of T4 gastric cancer patients without distant metastasis who could undergo potentially curative resection.


METHODS
We retrospectively analyzed the clinical data of 71 consecutive patients diagnosed with T4 gastric cancer and who underwent curative gastrectomy at our institutions. The clinicopathological factors that could be associated with overall survival were evaluated. The cumulative survival was determined by the Kaplan-Meier method, and univariate comparisons between the groups were performed using the log-rank test. Multivariate analysis was performed using the Cox proportional hazard model and a step-wise procedure.


RESULTS
The study patients comprised 53 men (74.6%) and 18 women (25.4%) aged 39-89 years (mean, 68.9 years). Nineteen patients (26.8%) had postoperative morbidity: pancreatic fistula developed in 6 patients (8.5%) and was the most frequent complication, followed by anastomosis stricture in 5 patients (7.0%). During the follow-up period, 28 patients (39.4%) died because of gastric cancer recurrence, and 3 (4.2%) died because of another disease or accident. For all patients, the estimated overall survival was 34.1% at 5 years. Univariate analyses identified the following statistically significant prognostic factors in T4 gastric cancer patients who underwent potentially curative resection: peritoneal washing cytology (P < 0.01), number of metastatic lymph nodes (P < 0.05), and venous invasion (P < 0.05). In multivariate analyses, only peritoneal washing cytology was identified as an independent prognostic factor (HR = 3.62, 95% CI = 1.37-9.57) for long-term survival.


CONCLUSION
Positive peritoneal washing cytology was the only independent poor prognostic factor for T4 gastric cancer patients who could be treated with potentially curative resection.
['Fukuda|Naoto|N|', 'Sugiyama|Yasuyuki|Y|', 'Wada|Joji|J|']
D000328:Adult D000368:Aged D000369:Aged, 80 and over D005260:Female D005743:Gastrectomy D006801:Humans D053208:Kaplan-Meier Estimate D008297:Male D008875:Middle Aged D009367:Neoplasm Staging D010537:Peritoneum D011379:Prognosis D012189:Retrospective Studies D013274:Stomach Neoplasms D016896:Treatment Outcome
Prognostic factors T4 Gastric cancer Venous invasion Peritoneal cytology