Zhu Yan-Li, Yang Li, Sui Zi-Qi, Liu Liang, Du Jing-Feng
Digestive Department, The First Affiliated Hospital of Jiamusi University, Jiamusi City 154003, Heilongjiang Province, China.
J BUON. 2016 Nov-Dec;21(6):1471-1475.
Borrmann type IV gastric cancer is still detected at an advanced stage and survival rates for these patients remain poor. The purpose of this study was to provide valuable prognostic and surgical information on patients with Borrmann type IV gastric cancer.
We compared the clinicopathological features of Borrmann type IV gastric cancer with those of other types of gastric cancer. Clinicopathologic features of patients with Borrmann type IV gastric cancer were evaluated as prognostic predictors by univariate and multivariate analyses.
The results showed that Borrmann type IV gastric cancer had more advanced and unfavorable clinicopathological factors compared with other Borrman types. The 5-year overall survival rate was 16.7%, and the median survival 25 months. The 5-year overall survival rate was influenced by tumor size, depth of invasion, lymph node metastasis, and chemotherapy. Of these, independent prognostic factors were lymph node metastasis (present vs absent, risk ratio 1.855, p=0.002) and radical (R0) resection (no vs yes, risk ratio 2.035, p<0.001). A significant survival benefit for radical resection was observed, with a 5-year overall survival rate of 30.7% compared with non-radically resected cases (4.8%).
Early detection and radical resection were essential to improve the prognosis of patients with Borrmann type IV gastric cancer.
Borrmann Ⅳ型胃癌仍在晚期被发现，这些患者的生存率仍然很低。本研究的目的是为 Borrmann Ⅳ型胃癌患者提供有价值的预后和手术信息。
我们比较了 Borrmann Ⅳ型胃癌与其他类型胃癌的临床病理特征。通过单因素和多因素分析评估 Borrmann Ⅳ型胃癌患者的临床病理特征作为预后预测指标。
结果显示，与其他 Borrmann 类型相比，Borrmann Ⅳ型胃癌具有更晚期和不利的临床病理因素。5 年总生存率为 16.7%，中位生存期为 25 个月。5 年总生存率受肿瘤大小、浸润深度、淋巴结转移和化疗的影响。其中，独立预后因素为淋巴结转移（存在 vs 不存在，风险比 1.855，p = 0.002）和根治性（R0）切除（否 vs 是，风险比 2.035，p < 0.001）。观察到根治性切除有显著的生存获益，5 年总生存率为 30.7%，而非根治性切除病例为 4.8%。
早期发现和根治性切除对于改善 Borrmann Ⅳ型胃癌患者的预后至关重要。
