Department of Surgery, Ulsan University College of Medicine, Seoul, Korea.
Cancer Res Treat. 2005 Apr;37(2):87-91. doi: 10.4143/crt.2005.37.2.87. Epub 2005 Apr 30.
Borrmann type IV gastric cancer is often diagnosed only at an advanced stage, resulting in a prognosis poor. We performed a retrospective study of the clinical characteristics of Borrmann type IV gastric cancer and the prognostic factors affecting the survival rate in such patients.
Of 4,063 patients with all gastric cancers, 370 (9%) with Borrmann type IV gastric cancer were analyzed.
The clinical characteristics of these patients included a higher incidence rate in young females, and higher rates of serosa exposure, metastasis to lymph nodes and early peritoneal dissemination. Of patients presenting with peritoneal seeding, those resected had a higher survival rate than those that were not. A univariate analysis showed that the prognostic factors affecting the survival rate following a curative resection were the location, occupied area and depth of the primary tumor, as well as the presence of lymph node metastasis and the tumor stage. A multivariate analysis indicated that the tumor location and stage were significant independent prognostic factors after a curative resection for Borrmann type IV gastric cancer.
In conclusion, the early diagnosis and treatment of patients with Borrmann type IV gastric cancer are essential for the better survival of these patients. Even in patients with advanced tumors, a noncurative palliative resection may improve the prognosis.
Borrmann Ⅳ型胃癌通常仅在晚期诊断,预后较差。我们对 Borrmann Ⅳ型胃癌的临床特征以及影响此类患者生存率的预后因素进行了回顾性研究。
在 4063 例所有胃癌患者中,分析了 370 例 Borrmann Ⅳ型胃癌患者。
这些患者的临床特征包括年轻女性发病率较高,浆膜暴露、淋巴结转移和早期腹膜播散的发生率较高。在有腹膜播种的患者中,接受手术切除的患者生存率高于未接受手术切除的患者。单因素分析显示,影响根治性切除术后生存率的预后因素为肿瘤原发灶的位置、受累面积和浸润深度,以及淋巴结转移和肿瘤分期。多因素分析表明,Borrmann Ⅳ型胃癌根治性切除术后,肿瘤位置和分期是显著的独立预后因素。
总之,早期诊断和治疗 Borrmann Ⅳ型胃癌对于改善此类患者的生存至关重要。即使对于晚期肿瘤患者,非治愈性姑息性切除也可能改善预后。