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A Retrospective Multivariate Analysis

Man H. Shiu, MD; Eric Moore, MD; Melinda Sanders, MD; Andrew Huvos, MD; Berton Freedman, MPH; James Goodbold, PhD; Srichai Chaiyaphruk, MD; Rob Wesdorp, MD; Murray F. Brennan, MD

Arch Surg. 1987;122(11):1347-1351.

Abstract
• The therapeutic value of extensive gastric resection and regional lymphadenectomy in the curative treatment of gastric adenocarcinoma is controversial. We undertook a retrospective study of 210 patients treated with curative intent from 1960 to 1980. A multivariate survival analysis using the Cox model revealed five significant variables predictive of death from gastric cancer—two inherent pathologic factors: (1) nonpyloric site and (2) metastases in more than three lymph nodes, and three treatment factors that could often be controlled by the surgeon: (3) microscopic positive gastric resection margin, (4) inadequate lymphadenectomy, and (5) total gastrectomy. These observations reaffirm the value of wide gastric resection and adequate lymphadenectomy but argue against a general policy of elective total gastrectomy in the curative treatment of gastric carcinoma.

(Arch Surg 1987;122:1347-1351)

Author Affiliations
From the Departments of Surgery (Drs Shiu, Moore, Chaiyaphruk, Wesdorp, and Brennan), Pathology (Drs Sanders and Huvos), and Biostatistics and Epidemiology (Mr Freedman and Dr Goodbold), Memorial Sloan-Kettering Cancer Center, New York.

Footnotes
Accepted for publication July 29, 1987.

Read before the Annual Meeting of the Society of Surgical Oncology, London, April 29, 1987.

Reprint requests to Department of Surgery, Memorial Sloan-Kettering Cancer Center, 1275 York Ave, New York, NY 10021 (Dr Shiu).

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