J Korean Surg Soc.  2010 Sep;79(3):196-201.

Resection A Surgery: An Exclusion Criterion of Adjuvant Treatment for Gastric Cancer

• Yu W
• Chung HY

Abstract

PURPOSE
We evaluated the clinical implication of Resection A surgery retrospectively to identify whether quality of surgery can be used as a selection factor for adjuvant therapy in patients with gastric cancer.
METHODS
Prognosis of 902 patients with gastric cancer who underwent Resection A surgery was evaluated.
RESULTS
Among all discharged patients, 77 patients (8.5%) died of recurrent disease, 55 patients (6.1%) died without recurrent disease. Five-year survival rate of all discharged patients was 91.6% and 10-year survival rate 87.1%. Statistically significant prognostic factors were depth of invasion (P<0.001), lymph node metastasis (P<0.001), stage (P<0.001), tumor location (P=0.036) and size (P=0.001), extent of gastric resection (P<0.001), and chemotherapy (P<0.001) on univariate analyses. However, depth of invasion (P=0.001), lymph node metastasis (P<0.001), and total gastrectomy (P<0.001) emerged as statistically significant poor prognostic factor on a multivariate analysis. Adjuvant chemotherapy did not increase the survival rate of patients after Resection A surgery, even in patients with stage II disease.
CONCLUSION
In selecting the patients for adjuvant therapy, both the stage of gastric cancer and the quality of surgery should be considered.

Keyword

Stomach neoplasm; Quality of surgery; Adjuvant chemotherapy

MeSH Terms

Chemotherapy, Adjuvant
Gastrectomy
Humans
Lymph Nodes
Multivariate Analysis
Neoplasm Metastasis
Prognosis
Retrospective Studies
Stomach Neoplasms
Survival Rate

Figure

• 

  Fig. 1 Survival distributions of patients with stage II (T2N1M0) gastric cancer according to adjuvant chemotherapy (P=0.714, log rank test).

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