Analysis of Prognostic Factors in 448 Gastric Cancer Patients Treated with a Gastric Resection

ABSTRACT

BACKGROUND: Among malignant diseases, gastric cancer remains a major cause of death in Korea. Many variables are considered to be important to the prognosis of patients with gastric carcinomas. METHODS: The authors evaluated the 5-year survival rates and analyzed the prognostic factors in 448 patients with gastric cancer who had under gone a gastric resection during the period between Dec. 1984 and Dec. 1992. RESULTS: The overall 5-year survival rate was 50.5%, and the survival rates according to the stage were stage Ia, 97.4%; Ib, 56.5%; II, 48.4%; IIIa, 41.6%; IIIb, 7.1%; and stage IV, 14.3%. Univariate analysis was used to relate prognostic factors, such as tumor size, gross type, depth of invasion, lymph node involvement, positive lymph node ratio, distant metastasis, complications, the surgical curability, and the TNM stage, with the survival of the patients. In a multivariate analysis using 11 variables, the TNM stage was the most significant prognostic factor. Besides the TNM stage, the depth of invasion, a lymph node involvement, a positive lymph node ratio, and complications were considered as independent prognostic factors influencing survival. CONCLUSIONS: The current TNM staging system appears to be a reasonable one, and the TMN stage of the tumor at the time of surgery is the most important prognostic factor.