Study of survival and prognostic factors in patients undergoing resection for gastric linitis plastica: a review of 86 cases

A retrospective study was conducted in a series of 86 patients (51 men and 35 women; mean age 63.4 years) treated from 1979 to 1995 for linitis plasti ca of the stomach (LP). The mean interval between the first manifestations and surgery was 3.5 months. The most frequent clinical sign was epigastric pain which occurred in 80.4% of cases. Biopsies were positive in 75.6% of c ases. Typical features of LP were found in only 46% of esogastric barium en emas and 11.8% of upper gastrofiberscopic examinations. Seventy-four patien ts had surgical excision (51 total and 23 partial gastrectomies). There wer e 6 (7%) postoperative deaths and 10 (11.6%) surgical complications. Node i nvolvement was found in 54 (72.9%) patients. Overall actuarial survival (n = 86) was 50% at 12 months, 40% at 18 months and 7.5% at 84 months. Surviva l did not depend on the delay in diagnosis, histological analysis of the ex tremities of the excised piece, associated tissue differentiation, node inv olvement or the type of surgical excision. The prognosis differed according to tumor height (P <0.01) and involvement of the deep stomach wall (P <0.0 01). No independent prognostic factor was found in multivariate analysis. S urgery remains the sole possibility for curative therapy in these patients.