Adenocarcinoma of the stomach: a multivariate analysis of clinical, pathologic and treatment factors.

Overview

We performed a retrospective prognostic study of 246 patients treated for adenocarcinoma of the stomach with curative intent over the period 1960-1984. Lesions of the cardia and gastro-esophageal junction were excluded. The study examined the prognostic influence of nine clinicopathologic and six treatment variables by univariate and multivariate analysis. Five-year survival rates (Kaplan-Meier) for TNM stages, IA, IB, II, IIIA, and IIIB were 88%, 80%, 55%, 30% and 9%, respectively. The Cox models of proportional hazards identified five independent variables predictive of death from gastric cancer: high TNM stage, metastatic involvement of four or more regional lymph nodes, poor differentiation of tumor, splenectomy and insufficient scope of regional lymph-adenectomy relative to the nodal stage (R minus N less than 1.5).