[A tentative subgrouping of the stage IV gastric cancer based on their postoperative prognosis]

Out of 211 patients with the Stage IV gastric cancer who survived gastrectomy, 105 died within one year (short-lived group) and 40 survived more than two years (long-lived group). The grades of the four factors, P, H, N and S, were compared between them. Combination of P0 and H0 was seen less often in the former group than in the latter (48% vs. 78%, p less than 0.005). While no patient with P3, H2-3 or N4 could live more than two years. The year-by-year survival rates were calculated according to the grades of the four factors. The 1-year, 2-year, 3-year and 4-year survival rates for the patients with both P0 and H0 were significantly higher than those of the remaining patients. The 1-year and 2-year survival rates for the patients with N0-3 significantly exceeded those of N4 patients. Based on these findings, we finally proposed a new subgrouping of Stage IV:IVa [P0, H0, N3, S3] and IVb [P1-3, H1-3, N4]. At every year up to five, the survival rates for IVa significantly exceeded those of IVb. Another merit of this classification consists in that most cancer in IVa might be radically resected if we add the lymph nodes dissection of R3 and the combined resection of the invaded organs.