Clinicopathologic Analysis of Gastric Carcinoma Patients with Outlet Obstruction

ABSTRACT

PURPOSE: This study was conducted to analyze the clinical course of patients of gastric cancer with outlet obstruction by comparing them with the gastric cancer patients without outlet obstruction. METHODS: The records of gastric cancer patients with outlet obstruction and who underwent radical gastrectomy from January 1996 to December 2005 were retrospectively reviewed and compared with those patients with gastric cancer and who were without outlet obstruction. RESULTS: The number of the patients who underwent radical gastrectomy was 461. Out of 461 patients, the number of gastric cancer patients with outlet obstruction was 42 (9.1%), and they had nasogastric tube insertion for an average of 4.4 days before operation. These patients showed several significant features such as large tumor size, advanced stage, an increased the number of involved LNs, a low serum albumin level, a frequent antral tumor location and duodenal invasion. There was no difference in complication rates between the two groups, but a higher mortality rate was noted in the gastric cancer patients with outlet obstruction than that in the other patients (P=0.038). The survival rate after the operation was significantly lower among the gastric cancer patients with outlet obstruction (P=0.0008), whereas no difference was found in the survival rate between the above two groups at the same stage (P=0.1951). CONCLUSION: The gastric cancer patients with outlet obstruction showed a comparatively poorer prognosis than those gastric cancer patients without outlet obstruction. However, there was no significant difference in the complication rate and the survival rate for both types of patients who were at the same stage. These results suggest that the patients with outlet obstruction can show the same result as the patients without outlet obstruction by undergoing radical gastrectomy.