TREATMENT AND STRATEGY OF STAGE IV GASTRIC CANCER

Abstract

Among 873 cases gastric cancer operations in our department, 190 cases with Stage IVgastric cancer were studied for treatment and strategy. The mean survival time for those undergoing curability B resection was significantly longer than that of curability C resection and non-resection. There are four factors (T, N, H, P) which decide clinical stage. In these factors, cases with two or more than two determinants regarding Stage IV were poor prognosis compared with th one factor. 3-year survivors were characterized by more extensive lymphadenectomy, less invasive of venous invasion and curability B. It therefore should be performed curability B operation in Stage IV gastric cancer patients, especially in cases with one determinant regarding Stage IV it should be considered extensive operation. With regard to curability C, there was tendency to be good prognosis in patients with one determinant regarding residual tumor comparison with those with two or more than two determinants. While extensive lymph node dessection was not improve for prognosis in curability C patients. Wiyh respect to un-resectable cases, as mean survival time was short (3.9 months), it required re-consideration of oprative indication. As a result of these clinical consequences of Stage IV gastric cancer, it should be considered to decide an adequate treatment and strategy dependent on each cases in Stage IV gastric cancer.