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November 1987

Influence of the Extent of Resection on Survival After Curative Treatment of Gastric Carcinoma: A Retrospective Multivariate Analysis

Author Affiliations

From the Departments of Surgery (Drs Shiu, Moore, Chaiyaphruk, Wesdorp, and Brennan), Pathology (Drs Sanders and Huvos), and Biostatistics and Epidemiology (Mr Freedman and Dr Goodbold), Memorial Sloan-Kettering Cancer Center, New York.

Arch Surg. 1987;122(11):1347-1351. doi:10.1001/archsurg.1987.01400230135024

• The therapeutic value of extensive gastric resection and regional lymphadenectomy in the curative treatment of gastric adenocarcinoma is controversial. We undertook a retrospective study of 210 patients treated with curative intent from 1960 to 1980. A multivariate survival analysis using the Cox model revealed five significant variables predictive of death from gastric cancer—two inherent pathologic factors: (1) nonpyloric site and (2) metastases in more than three lymph nodes, and three treatment factors that could often be controlled by the surgeon: (3) microscopic positive gastric resection margin, (4) inadequate lymphadenectomy, and (5) total gastrectomy. These observations reaffirm the value of wide gastric resection and adequate lymphadenectomy but argue against a general policy of elective total gastrectomy in the curative treatment of gastric carcinoma.

(Arch Surg 1987;122:1347-1351)