Factors influencing prognosis of gastric cancer after curative resection.
Four hundred eighty eight patients with gastric cancer were admitted to the Department of III Clinica Chirurgica of the University of Bologna-Italy; 451 patients underwent surgery: there were 17 deaths with an operative mortality rate of 3.8%. Only 286 curative resections were performed 252 sub-total gastrectomies and 34 total gastrectomies. The purpose of this paper is to define the prognostic role of some clinical and pathological variables in patients with carcinoma of the stomach who underwent curative resection. The hospital records of 229 patients submitted to curative resection between 1969 and 1982 were retrospectively reviewed. Fifty two patients were lost to follow-up study and 4 died for post-operative complications. The variables analyzed included: age (greater than 65 years, less than 65 years), sex, time of onset of clinical symptoms (greater than 6 months, less than 6 months), site of cancer (lower, two thirds, upper), size (greater than 3 cm, less than 3 cm), gross appearance (ulcerating, non ulcerating), histologic type (intestinal, diffuse), invasion of the gastric wall (T1-T2 vs. T3-T4), nodal status (negative, positive), stage (S1-S2 vs. S3-S4). The statistical significance of the results was calculated using chi 2 test and comparing survival at 1, 3 and 5 years. Of the variables selected only six (age greater than 65 years, size greater than 3 cm, diffuse histologic type, degree of the gastric wall invasion, positive nodal involvement, stage 3-4) were validated by statistic evaluation, whereas the others lost their prognostic relevance.(ABSTRACT TRUNCATED AT 250 WORDS)