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The prognosis of stage IV gastric carcinoma patients after curative resection.

BACKGROUND/AIMS
In the UICC staging system, stage IV contains not only those patients with distant metastasis but also patients with far-advanced T and N status but without distant metastasis. We investigated the prognostic factors of stage IV gastric carcinoma patients, without distant metastasis after curative resection and the role of surgery.


METHODOLOGY
One hundred and ninety stage IV gastric carcinoma patients, without distant metastasis were reviewed after curative resection in our hospital from January 1987 to December 1996.


RESULTS
Male sex, distal third location, diffuse or infiltrative type and histologically undifferentiated type were common. Of the 190 patients, 52 (27.4%) patients lived more than 3 years. The lymph node ratio (positive lymph node/retrieved lymph node) and combined resection independently affected survival (P = 0.0013, 0.0061, respectively). The perigastric lymph node ratio was well correlated with overall lymph node ratio (r = 0.794, P < 0.001).


CONCLUSIONS
With the involvement of an adjacent organ and knowing the perigastric lymph node ratio, the surgeon can decide upon the extent of dissection and postoperative treatment. However, a prospective study is warranted.