Clinicopathological features of long-term survivors of scirrhous gastric cancer

Background/Aims: Prognosis of scirrhous gastric cancer remains low. To dete rmine the clinicopathological features that are correlated with prognosis, we studied long-term survivors of scirrhous gastric cancer (survival durati on more than 5 years) in comparison with patients with short survival. Methodology: Among 2719 gastric cancer patients who underwent surgery at Ma tsuyama Red Cross Hospital, 211 cases were diagnosed as scirrhous type gast ric cancer. Seventeen patients survived more than 5 years, and the rest had short survival (less than 5 years). Comparison of clinicopathological fact ors was done by chi (2) analysis. Multivariate analysis was done in order t o focus on the prognostic factors. Results: The 5-year survival of the total 211 patients was 12%. The 5-year survival of patients who underwent curative surgery (67 cases) was 30%, whi ch was significantly higher than that of the non-curative surgery group (14 4 cases, 6%). Significant differences were noted in the following variables : peritoneal dissemination, hepatic metastasis, lymph node dissection, patt ern of infiltrating growth, depth of invasion, histological lymph node meta stasis, histological stage,and histological curability. Patients with eithe r hepatic metastasis or peritoneal dissemination did not survive 5 years. M ultivariate analysis revealed that the most significant independent prognos tic factor was histological curability, followed by peritoneal disseminatio n. Conclusions: There is a possibility of long-term survival for patients with scirrhous gastric cancers without hepatic metastasis, peritoneal dissemina tion, or extensive lymph node metastasis. Curative surgery is important, su ggesting that the extended operation is rational if possible.