BACKGROUND: Large @entity356 (LGC) is frequently associated with extended disease, and the role of surgical resection has been debated. We investigated the efficacy of surgical treatment for LGC. METHODS: The size of LGC was defined as 8 cm or greater. Four hundred and fifteen @entity1 with LGC who underwent gastrectomy were included. The clinicopathological features, the status of the @entity41 , the incidence and patterns of relapse, and the survival were analyzed. RESULTS: Macroscopically, diffuse-type @entity5 were dominant (60%). The numbers of @entity1 with @entity5 of T3 or greater, lymph node involvement, and peritoneal metastases were 356 (86%), 359 (87%), and 126 (30%), respectively. One hundred and eighty-eight @entity1 (45%) underwent incomplete @entity5 resection (R2). The R2/R0 (no @entity41 ) ratio was greater than 1 in @entity1 with type 4 @entity5 and N1 or greater @entity3 and in those with type 3 @entity5 and N2 or greater @entity3 . In contrast, T2, type 2, and type 5 @entity5 were more likely to be completely resected. The 5-year survival for all 415 @entity1 was 26%. The survival rates were inversely related to the @entity5 type, size, and lymph node @entity3 . In the 216 @entity1 with R0, the 5-year survivals of those with pN (International Union Against Cancer [UICC] classification) 0, 1, 2, and 3 were 66%, 56%, 36%, and 5%, respectively (P = 0.001). In 96 of these 216 @entity1 (44%) the @entity5 recurred, and peritoneal @entity3 was the most frequent mode of recurrence (48%). By Cox's proportional hazard model, the @entity5 size was an independent prognostic factor. CONCLUSION: The chance of achieving R0 resection for LGC is low, except for @entity6402 @entity5 . Primary resection should be avoided for other types of LGC.

The efficacy of gastrectomy for large XXXX .

@entity1 :: ('9606', 'Species') :: ['patients'] @entity41 :: ('MESH:D018365', 'Disease') :: ['residual tumor'] @entity5 :: ('MESH:D009369', 'Disease') :: ['tumor', 'tumors'] @entity3 :: ('MESH:D009362', 'Disease') :: ['metastasis'] @entity6402 :: ('292', 'Gene') :: ['T2, type 2, or type 5'] @entity356 :: ('MESH:D013274', 'Disease') :: ['gastric cancer']
@entity356 :: (MESH:D013274,Disease) :: ['gastric cancer']
