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Intraoperative Gastroscopy for Tumor Localization in Laparoscopic Surgery for Gastric Adenocarcinoma
Published on: August 9, 2016
Prognostic Factors in Operated T3-T4 Gastric Cancer
Orhan Uzun1, Selçuk Gulmez1, Aziz Serkan Senger1
1Department of Gastroenterological Surgery, University of Health Sciences, Kartal Kosuyolu Higher Specialty Training and Research Hospital, Istanbul, Turkey.
Objective:
To investigate the prognostic factors affecting survival in patients with a deep gastric wall invasion of T3-T4 advanced gastric cancer.
Study Design:
Descriptive study.
Place And Duration Of Study:
Department of Gastroenterological Surgery, Kartal Koşuyolu High Specialty Training and Research Hospital, between November 2006 and December 2018.
Methodology:
A retrospective review was made of 252 patients; and the clinicopathological characteristics and survival status in the presence of T1-T2 and T3-T4 patients were investigated. The cumulative survival of the two groups was analysed with a Kaplan-Meier test, and the differences were analysed with a log-rank test. The prognostic factors for T3-T4 patients were established through a stepwise Cox regression analysis.
Results:
Of the total, 52 (20.6%) patients had T1-T2 and 200 (79.4%) had T3-T4 gastric wall invasion. Statistical differences were noted in the Lauren classification as gender, tumor size, presence of lymph node involvement, presence of vascular and perineural invasion, and overall survival (p <0.001). A univariate analysis of the prognostic factors affecting survival in T3-T4 patients revealed a difference in the tumor localisation, tumor size, the presence of involved lymph nodes, perineural invasion, and vascular invasion. A multivariate analysis of the prognostic factors affecting survival identified differences in tumor size, the presence of involved lymph nodes and perineural invasion.
Conclusion:
The most significant prognostic factor affecting survival in patients with T3-T4 gastric cancer, based on the depth of gastric wall invasion, was the tumor size, lymph node involvement and perineural invasion. Key Words: Advanced gastric cancer, Prognostic factor, Survival.

