Study of Factors Affecting the Prognosis of Stomach Cancer after Surgical Treatment -Retrospective Evaluation on Intraperitoneal OK-432 Therapy Using the Proportional Hazard Model by Cox-

Michio Kato, Shirou Kawamura, Touru Morishita, Yasuyuki Tada, Masato Funasaka, Etsuji Shimada, Keizou Kikkawa, Takeshi Nakamura, Yoichi Saitoh

First Department of Surgery, Kobe University, School of Medicine

We explored factors affecting longterm results after surgical treatment of stomach cancer in 38 patients who additionally received a high intraperitoneal dose of OK-432 administration and 159 patients without OK-432 therapy during the 7-year period from 1977 to 1983. The following 12 variables were analyzed; sex, age, macroscopic type of cancer, macroscopic extent of liver metastasis, extent of disseminated peritoneal metastasis, histological extent of lymph node metastasis, histological typing of the cancer, depth of the cancer, histologial staging, extent of lymph node excision, extent of radical resection, and presence/absence of OK-432 therapy. Because of the great bias in background variables, stratified analysis was not adopted. Instead we used the proportional hazard model by Cox (a model for multivariate analysis). Analysis of the coefficient of determination disclosed that the major factors affecting the survival period after surgical treatment of stomach cancer are macroscopic type of cancer, histological extent of lymph node metastasis, extent of disseminated peritoneal metastasis, extent of lymph node excision, and extent of radical treatment. Intraperitoneal OK-432 therapy did not affect the postoperative survival. These results indicate that in surgical treatment of advanced stomach cancer or stomach cancer with disseminated peritoneal metastasis, it is essential to select a radical procedure for curative excision allowing complete removal of the tumor and to perform lymph node dissection as widely as possible.

Key words
gastric cancer prognosis, intraperitoneal OK-432 therapy, peritoneal dissemination of gastric cancer, Cox proportional hazard model

Reprint requests
Michio Kato First Department of Surgery, Kobe University, School of Medicine
7-5-2 Kusunoki-cho, Chuou-ku, Kobe, 650 JAPAN

Accepted
July 10, 1990

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