Published online Nov 15, 2020. doi: 10.4251/wjgo.v12.i11.1325
Peer-review started: July 26, 2020
First decision: August 9, 2020
Revised: August 20, 2020
Accepted: September 25, 2020
Article in press: September 25, 2020
Published online: November 15, 2020
Processing time: 108 Days and 17.1 Hours
Borrmann type IV (B-4) gastric cancer (GC) accounts for about 10% of all GC cases in Asia. Some B-4 patients were found to have no distant metastasis by preoperative detection and underwent curative surgery, which was defined as circumscribed B-4 in our study.
Research of clinicopathological characteristics and prognosis in B-4 is rare, especially for the circumscribed B-4 patients.
In this study, we aimed to identify the factors related to prognosis and postoperative peritoneal cavity metastasis (PPCM) for circumscribed B-4 patients and to further explore the appropriate therapeutic strategies.
A total of 117 circumscribed B-4 patients were included in this study. Survival analysis and Pearson correlation analyses were performed to identify the factors related to prognosis.
Subtotal gastrectomy combined with chemotherapy could significantly improve the long-term survival time for circumscribed B-4. Positive lymph node staus was the only factor correlated with PPCM, and chemotherapy was useful for suppressing PPCM in patients with subtotal gastrectomy but not in those with total gastrectomy.
Lymph node status is an independent prognostic factor for circumscribed B-4 patients. Subtotal gastrectomy and chemotherapy could effectively improve prognosis and suppress PPCM.
This study recommended reasonable treatment schedules for circumscribed B-4 patients, but a multi-center study on a larger scale is necessary in the future.