The relationship of prognosis to surgery and pathologic characteristics of stage IV (M0) gastric cancer patients.

BACKGROUND AND OBJECTIVE The proportion of stage IV gastric cancer in the whole gastric cancer population in China is still high. This study was to investigate the surgery and pathologic characteristic and prognostic factors of stage IV (M0) gastric cancer. METHODS Clinical data of 630 patients with pathologically confirmed stage IV (M0) gastric cancer treated at the affiliated Tumor Hospital of Harbin Medical University between January 1993 and August 2004 were analyzed using Cox proportional hazard model. Of the 630 patients, 338 received radical excision and 292 received palliative resection. RESULTS The overall 1-, 3-, 5-year survival rates were 63.8%, 31.4% and 14.3%, respectively. Univariate analysis showed that Borrmann type, lymphatic metastasis, organ involvement, tumor location, tumor size, pathologic type, radical excision and other organ excision were significant prognostic factors affecting 1-year survival rate (P < 0.05); Borrmann type, lymphatic metastasis, organ involvement, pathologic type and radical excision affected 3-year survival rate (P < 0.05); only organ involvement and pathologic type affected 5-year survival rate (P < 0.05). Multivariate analysis showed that pathologic type was independent prognostic factor for poor survival. CONCLUSIONS Radical resection and combined organ resection could prolong the survival of stage IV (M0) gastric cancer patients. Chemotherapy, radiotherapy and targeted therapy should be considered for individual therapeutic regimen.