Retrospective Study
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Oncol. Nov 15, 2020; 12(11): 1325-1335
Published online Nov 15, 2020. doi: 10.4251/wjgo.v12.i11.1325
Subtotal gastrectomy combined with chemotherapy: An effective therapy for patients with circumscribed Borrmann type IV gastric cancer
Hai-Bo Huang, Zi-Ming Gao, An-Qi Sun, Wei-Tian Liang, Kai Li
Hai-Bo Huang, Zi-Ming Gao, An-Qi Sun, Wei-Tian Liang, Kai Li, Department of Surgical Oncology and General Surgery, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, The First Affiliated Hospital of China Medical University, Shenyang 110001, Liaoning Province, China
Author contributions: Huang HB and Li K designed the research; Gao ZM and Li K treated the patients and collected the material and clinical data from the patients; Huang HB and Sun AQ performed the assays; Liang WT and Huang HB analyzed the data; Huang HB wrote the paper.
Institutional review board statement: This study was reviewed and approved by the Ethics Committee of First Affiliated Hospital of China Medical University.
Informed consent statement: Written informed consent was obtained from each patient.
Conflict-of-interest statement: All authors declare no conflicts of interest.
Data sharing statement:  No additional data are available.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Kai Li, PhD, Professor, Department of Surgical Oncology and General Surgery, Key Laboratory of Precision Diagnosis and Treatment of Gastrointestinal Tumors, Ministry of Education, The First Affiliated Hospital of China Medical University, No. 155 Nanjing Street, Shenyang 110001, Liaoning Province, China. cmu_likai@163.com
Received: July 26, 2020
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
ARTICLE HIGHLIGHTS
Research background

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 motivation

Research of clinicopathological characteristics and prognosis in B-4 is rare, especially for the circumscribed B-4 patients.

Research objectives

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.

Research methods

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.

Research results

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.

Research conclusions

Lymph node status is an independent prognostic factor for circumscribed B-4 patients. Subtotal gastrectomy and chemotherapy could effectively improve prognosis and suppress PPCM.

Research perspectives

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.