Impact Of Pyloric Stenosis On The Prognosis In D2 Radical Resection For Advanced Distal Gastric Cancer

Objective To investigate the impact of pyloric stenosis on the prognosis in D2 radical resection for advanced distal gastric cancer.Methods Clinical data of 284 patients with advanced distal gastric cancer who underwent D2 radical resection from January 1998 to December 2004 were analyzed retrospectively. Among them, 69 patients were proven with pyloric stenosis (pyloric stenosis group) and 215 patients without (no pyloric stenosis group). Clinicopathologic variables, survival outcomes, and postoperative morbidity and mortality of the two groups were compared.Results The 5-year survival rates in the pyloric stenosis group and the no pyloric stenosis group were 38.8 % and 62.4 % respectively with significantly difference(P<0.05). Pyloric stenosis was one of the independent prognostic factors. Logistic regression revealed that the tumor size, depth of invasion and lymph node involvement were independent covariates for pyloric stenosis (P<0.05). The postoperative morbidity and mortality occurred at similar rates in both groups (P>0.05).Conclusions The presence of pyloric stenosis is an independent prognostic factor after D2 radical resection for advanced distal gastric cancer and provides significantly poorer survival than those without. Pyloric stenosis would not increase the postoperative morbidity and mortality after radical surgery.