GASTRIC-CARCINOMA WITH PYLORIC-STENOSIS

Background, The surgical outcome of gastric carcinomas with pyloric st enosis and their prognostic factors are sparsely documented. Methods, A clinicopathologic study of gastric carcinoma with pyloric stenosis ( PS group, n = 122) was done and findings were compared with the cases involving the antrum (A group n = 695). Independent prognostic factors for survival of the patients with PS were determined by Cox's proport ional hazard model. Results, There were no differences in age and gend er between the true groups. The PS group was characterized by an infil trating growth pattern and undifferentiated adenocarcinoma. The incide nce of serosal invasion, direct invasion into neighboring organs, peri toneal dissemination, lymph node metastasis, and lit,er metastasis of the PS group was higher than those of the A group (p < 0.01). The rese ction rate and 5-year survival of the PS group were 78% and 22%, respe ctively; these values were significantly lower than 98% and 58% of the A group, (p < 0.01). Multivariate analyses showed that operative cura bility resection of the stomach, liver metastasis, serosal invasion, a nd histologic type were the independent prognostic factors of the PS g roup. Conclusions. In cases of gastric carcinoma with pyloric stenosis , efforts should be made to do a curative operation, but for other pat ients with poor prognostic factors, intensive surgery and adjuvant the rapy should he considered.