The effect of curative surgery in Borrmann type IV advanced gastric cancer.

176 Background: The aims of the present study are to know the significance of curative surgery in Borrmann type IV and prove the causes related with poor prognosis by analyzing the recurrence patterns and unique diagnostic characteristics. Methods: We analyzed 168 patients with Borrmann type IV undergoing surgery at Seoul St. Mary Hospital from 1989 to 2010. We categorized the patients into curative (R0) and non-curative (R1, R2 and no-resection) group. Results: The numbers of curative and non-curative group were 91 and 77. The 3- and 5-yr OSRs of patients in curative group were significantly higher than those in non-curative group (curative: 52.4% and 33.0%, non-curative: 18.6% and 7.0%; p<0.001). In multivariate analysis, the curability was not a significant prognostic factor for survival (p=0.527). The most frequent recurrence site was peritoneum (64.7%). Most of recurrences were presented within early 2 years. The preoperative diagnostic rate of Borrmann type IV was only 50.5%. The reasons for non-curative surgery were unexpected peritoneal seeding (28.4%) and resection margin involvement (6.4%). Conclusions: The role of surgery for Borrmann type IV is quite limited. It has poor prognosis even after curative surgery, because it is very difficult to diagnose preoperatively and make curative surgery. [Table: see text]

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Limited significance of curative surgery in Borrmann type IV gastric cancer

Medical Oncology ◽

10.1007/s12032-016-0783-3 ◽

2016 ◽

Vol 33 (7) ◽

Cited By ~ 7

Author(s):

Eun Young Kim ◽

Han Mo Yoo ◽

Kyo Young Song ◽

Cho Hyun Park

Keyword(s):

Gastric Cancer ◽

Curative Surgery ◽

Type Iv ◽

Borrmann Type ◽

Borrmann Type Iv

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Borrmann Type IV Gastric Cancer: Focus on the Role of Gastrectomy

Journal of Gastrointestinal Surgery ◽

10.1007/s11605-019-04236-7 ◽

2019 ◽

Vol 24 (5) ◽

pp. 1026-1032 ◽

Cited By ~ 1

Author(s):

Chengcai Liang ◽

Guoming Chen ◽

Baiwei Zhao ◽

Haibo Qiu ◽

Wei Li ◽

...

Keyword(s):

Gastric Cancer ◽

Type Iv ◽

Borrmann Type ◽

Borrmann Type Iv

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Is Borrmann type IV gastric carcinoma a surgical disease? An old problem revisited with reference to the result of peritoneal washing cytology

Journal of Surgical Oncology ◽

10.1002/jso.1144 ◽

2001 ◽

Vol 78 (3) ◽

pp. 175-181 ◽

Cited By ~ 20

Author(s):

Yasuhiro Kodera ◽

Yoshitaka Yamamura ◽

Seiji Ito ◽

Yukihide Kanemitsu ◽

Yasuhiro Shimizu ◽

...

Keyword(s):

Gastric Carcinoma ◽

Surgical Disease ◽

Type Iv ◽

Borrmann Type ◽

Peritoneal Washing ◽

Peritoneal Washing Cytology ◽

Borrmann Type Iv

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Clinicopathologic study of patients with Borrmann type iv gastric carcinoma

Journal of Surgical Oncology ◽

10.1002/jso.2930580208 ◽

1995 ◽

Vol 58 (2) ◽

pp. 112-117 ◽

Cited By ~ 32

Author(s):

Kaoru Kitamura ◽

Richiko Beppu ◽

Hideaki Anai ◽

Koji Ikejiri ◽

Shigeru Yakabe ◽

...

Keyword(s):

Gastric Carcinoma ◽

Type Iv ◽

Clinicopathologic Study ◽

Borrmann Type ◽

Borrmann Type Iv

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Intraoperatively assessed macroscopic serosal changes in patients with curatively resected advanced gastric cancer (GC): Clinical implications for prognosis and peritoneal recurrence.

Journal of Clinical Oncology ◽

10.1200/jco.2015.33.3_suppl.23 ◽

2015 ◽

Vol 33 (3_suppl) ◽

pp. 23-23

Author(s):

Changhoon Yoo ◽

Min-Hee Ryu ◽

Heung-Moon Chang ◽

Jeong Hwan Yook ◽

Young Soo Park ◽

...

Keyword(s):

Gastric Cancer ◽

Peritoneal Recurrence ◽

Phase Iii ◽

Diffuse Gastric Cancer ◽

Type Iv ◽

Borrmann Type ◽

Phase Iii Trials ◽

N Stage ◽

Borrmann Type Iv

23 Background: To validate the prognostic relevance of macroscopic serosal changes in patients with resected GC, we analyzed prospectively collected databases of two multicenter randomized phase III trials on adjuvant chemotherapy. Methods: In total, 655 patients in the control groups of AMC 0101 (NCT00296322) and 0201 (NCT00296335) trials were selected. Macroscopic serosal changes were determined according to disruptions in serosal continuity, such as changes in color or nodular texture by the operating surgeon. Correlations with recurrence-free survival (RFS), overall survival (OS), and time-to-peritoneal recurrence were analyzed. Results: About two-thirds of the patients were male (69%), and the median age was 55 years (range = 29–70 years). According to Lauren’s classification, 215 patients (33%) showed intestinal type. After a median follow-up period of 61.6 months (range = 2.6–113.9 months), the 5-year RFS and OS rates were 55.0% (95% CI = 51.2–58.9%) and 59.9% (95% CI = 56.2–63.6%), respectively. Intraoperatively assessed macroscopic serosal changes were identified in 432 patients (66%). This was significantly associated with multifocal or diffuse gastric cancer (p = 0.001), Borrmann type IV (p = 0.005), advanced pathological T stage (p < 0.001), advanced pathological N stage (p < 0.001), advanced pathological stage (p < 0.001), and total gastrectomy (p < 0.001). In multivariate analyses, which included prognostic factors of localized gastric cancer, macroscopically serosal changes were significantly associated with poor RFS (hazard ratio [HR] = 2.0, 95% CI 1.4–2.7; p < 0.001) and OS (HR = 2.1, 95% CI 1.5–3.0; p < 0.001). It was also significantly related with shorter time-to-peritoneal recurrence (HR = 2.9; 95% CI = 1.7–5.0; p< 0.001). Conclusions: Intraoperatively assessed macroscopic serosal changes confer a poor prognosis and increased peritoneal recurrence in patients with curatively resected GC. Macroscopic assessment of serosal changes may be a useful indicator that allows better risk stratification of patients with resected GC in terms of prognosis and peritoneal recurrence.

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