Surgical Outcomes and Prognostic Factors of T4 Gastric Cancer Patients without Distant Metastasis

Abstract

OBJECTIVE: To evaluate surgical outcomes and prognostic factors for T4 gastric cancer treated with curative resection. METHODS: Between January 1994 and December 2008, 94 patients diagnosed with histological T4 gastric carcinoma and treated with curative resection were recruited. Patient characteristics, surgical complications, survival, and prognostic factors were analyzed. RESULTS: Postoperative morbidity and mortality were 18.1% and 2.1%, respectively. Multivariate analysis indicated lymph node metastasis (hazard ratio, 2.496; 95% confidence interval, 1.218-5.115; p = 0.012) was independent prognostic factor. CONCLUSIONS: For patients with T4 gastric cancer, lymph node metastasis was associated with poorer survival. Neoadjuvant chemotherapy or aggressive adjuvant chemotherapy after radical resection was strongly recommended for these patients.