Influence of the extent of resection on survival after curative treatment of gastric carcinoma. A retrospective multivariate analysis

Arch Surg. 1987 Nov;122(11):1347-51. doi: 10.1001/archsurg.1987.01400230135024.

Abstract

The therapeutic value of extensive gastric resection and regional lymphadenectomy in the curative treatment of gastric adenocarcinoma is controversial. We undertook a retrospective study of 210 patients treated with curative intent from 1960 to 1980. A multivariate survival analysis using the Cox model revealed five significant variables predictive of death from gastric cancer--two inherent pathologic factors: (1) nonpyloric site and (2) metastases in more than three lymph nodes, and three treatment factors that could often be controlled by the surgeon: (3) microscopic positive gastric resection margin, (4) inadequate lymphadenectomy, and (5) total gastrectomy. These observations reaffirm the value of wide gastric resection and adequate lymphadenectomy but argue against a general policy of elective total gastrectomy in the curative treatment of gastric carcinoma.

MeSH terms

  • Adenocarcinoma / pathology
  • Adenocarcinoma / surgery*
  • Gastrectomy / methods*
  • Humans
  • Lymph Node Excision
  • Prognosis
  • Retrospective Studies
  • Statistics as Topic
  • Stomach Neoplasms / pathology
  • Stomach Neoplasms / surgery*