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

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 mo...

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Bibliographic Details
Published inArchives of surgery (Chicago. 1960) Vol. 122; no. 11; p. 1347
Main Authors Shiu, M H, Moore, E, Sanders, M, Huvos, A, Freedman, B, Goodbold, J, Chaiyaphruk, S, Wesdorp, R, Brennan, M F
Format Journal Article
LanguageEnglish
Published United States 01.11.1987
Subjects
Adenocarcinoma - pathology
Adenocarcinoma - surgery
Gastrectomy - methods
Humans
Lymph Node Excision
Prognosis
Retrospective Studies
Statistics as Topic
Stomach Neoplasms - pathology
Stomach Neoplasms - surgery
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Summary: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.
ISSN:0004-0010
DOI:10.1001/archsurg.1987.01400230135024