We conducted a clinicopathological study of cases of gastric
carcinoma with
pyloric stenosis and examined treatment outcomes and the prognosis of cases of stage IV gastric
carcinoma with
pyloric stenosis and the validity of
gastrectomy as
palliative surgery in these cases. The outcomes of 49 surgeries for gastric
carcinoma with
pyloric stenosis were compared with those of 671 surgeries for gastric
carcinoma without
pyloric stenosis. The diagnosis of
pyloric stenosis was confirmed with both upper gastrointestinal endoscopy and an upper gastrointestinal
barium series. The frequency of
pyloric stenosis in patients with gastric
carcinoma was 7.3%. Serosal invasion was observed in about 70% of all cases. Of these cases, 53.1% were classified as stage IV. The resection rate was 73.5%, and the resection was classified as curative in 44.9% of cases. The incidence of complications after surgery in cases of stage IV gastric
carcinoma was 47.1%. The median survival time was significantly greater in patients undergoing resection group than in those not undergoing resection (p=0.025). Most patients with
gastric cancer and
pyloric stenosis can be considered to have stage IV disease, which is associated with high rates of morbidity and mortality; thus, prevention of complications, and therefore, avoidance of
gastrectomy is recommended in such patients. Nonetheless, in this study,
gastrectomy was shown to improve prognoses in these patients.