Skip to main content

Advertisement

Log in

Prognostic Significance of Tumor Size in T3 Gastric Cancer

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Clinical significance of tumor size remains elusive in gastric cancer. The aim of this study was to evaluate the prognostic value of tumor size in T3 gastric cancer.

Methods

A total of 273 patients with T3 gastric cancer who underwent curative D2 gastrectomy between 1996 and 2005 were evaluated. In terms of average value of tumor size, patients were divided into two groups according to tumor size: small-size group (SSG, tumor ≤6 cm) and large-size group (LSG, tumor >6 cm). The prognostic value of tumor size and the correlation between tumor size and other clinicopathologic factors were investigated.

Results

LSG accounted for 34.8% in all patients. Tumor size was correlated with histological type, lymphatic invasion, venous invasion, and resection type. The prognosis of LSG patients was worse than that of SSG patients. Multivariate analysis showed that type of resection, status of lymph nodes, metastatic lymph node ratio, and tumor size were defined as independent prognostic factors for patients with T3 gastric cancer. A comparison between LSG patients and SSG patients showed differences in the survival of those with stage IIIB and IV disease.

Conclusions

Tumor size is a simple and reliable prognostic factor for patients with T3 gastric cancer; it might be a candidate for the gastric cancer staging system.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Adachi Y, Mori M, Maehara Y, et al. Dukes’s classification: a valid prognostic indicator for gastric cancer. Gut. 1994;35:1368–71.

    Article  PubMed  CAS  Google Scholar 

  2. Maruyama K. The most important prognostic factors for gastric cancer patients: a study using univariate and multivariate analyses. Scand J Gastroenterol. 1987;22:63–8.

    Article  Google Scholar 

  3. Galizia G, Lieto E, Orditura M, et al. Epidermal growth factor receptor (EGFR) expression is associated with a worse prognosis in gastric cancer patients undergoing curative surgery. World J Surg. 2007;31:1458–68.

    Article  PubMed  Google Scholar 

  4. Kim J, Sohn S, Chae Y, et al. Vascular endothelial growth factor gene polymorphisms associated with prognosis for patients with gastric cancer. Ann Oncol. 2007;18:1030–6.

    Article  PubMed  CAS  Google Scholar 

  5. Griffiths EA, Pritchard SA, Valentine HR, et al. Hypoxiainducible factor-1 alpha expression in gastric carcinogenesis sequence and its prognostic role in gastric and gastrooesophageal adenocarcinomas. Br J Cancer. 2007;96:95–103.

    Article  PubMed  CAS  Google Scholar 

  6. Aung PP, Oue N, Mitani Y, et al. Systematic search for gastric cancer-specific genes based on SAGE data: melanoma inhibitory activity and matrix metalloproteinase-10 are novel prognostic factors in patients with gastric cancer. Oncogene. 2006;25:2546–57.

    Article  PubMed  CAS  Google Scholar 

  7. Adachi Y, Oshiro T, Mori M, et al. Tumor size as a simple prognostic indicator for gastric carcinoma. Ann Surg Oncol. 1997;4:137–40.

    Article  PubMed  CAS  Google Scholar 

  8. Saito H, Osaki T, Murakami D, et al. Macroscopic tumor size as a simple prognos- tic indicator in patients with gastric cancer. Am J Surg. 2006;192:296–300.

    Article  PubMed  Google Scholar 

  9. Wang X, Wan F, Pan J, et al. Tumor size: a non-neglectable independent prognostic factor for gastric cancer. J Surg Oncol. 2008;97:236–40.

    Article  PubMed  Google Scholar 

  10. Yoo CH, Noh SH, Kim YI, et al. Comparison of prognostic significance of nodal staging between old (4th edition) and new (5th edition) UICC TNM classification for gastric carcinoma. World J Surg. 1999;23:492–8.

    Article  PubMed  CAS  Google Scholar 

  11. Kim JP. Surgical results in gastric cancer. Semin Surg Oncol. 1999;17:132–8.

    Article  PubMed  CAS  Google Scholar 

  12. Sobin LH, Wittekind CH, editors. TNM: classification of malignant tumours. 6th ed. New York: Wiley-Liss; 2002.

    Google Scholar 

  13. Sierra A, Regueira FM, Hernandez-Lizoain JL, et al. Role of the extended lymphadenectomy in gastric cancer surgery: experience in a single institution. Ann Surg Oncol. 2003;10:219–26.

    Article  PubMed  Google Scholar 

  14. Bando E, Yonemura Y, Taniguchi K, et al. Outcome of ratio of lymph node metastasis in gastric carcinoma. Ann Surg Oncol. 2002;9:775–84.

    Article  PubMed  Google Scholar 

  15. Marchet A, Mocellin S, Ambrosi A, et al. The ratio between metastatic and examined lymph nodes (N ratio) is an independent prognostic factor in gastric cancer regardless of the type of lymphadenectomy: results from an Italian multicentric study in 1853 patients. Ann Surg. 2007;245:543–52.

    Article  PubMed  Google Scholar 

  16. Japanese Gastric Cancer Association. Japanese classification of gastric cancer, 2nd English ed. Gastric Cancer. 1998;1:8–24.

    Article  Google Scholar 

  17. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc. 1958;53:457–81.

    Article  Google Scholar 

  18. Cox DR. Regression models and life-tables. J R Stat Soc B. 1972;34:187–220.

    Google Scholar 

  19. Hyung WJ, Noh SH, Yoo CH, et al. Prognostic significance of metastatic lymph node ratio in T3 gastric cancer. World J Surg. 2002;26:323–9.

    Article  PubMed  Google Scholar 

  20. Kattan MW, Karpeh MS, Mazumdar M, et al. Postoperative nomogram for disease-specific survival after an R0 resection for gastric carcinoma. J Clin Oncol. 2003;21:3647–50.

    Article  PubMed  Google Scholar 

  21. Cunningham D, Allum WH, Stenning SP, et al. Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med. 2006;355:11–20.

    Article  PubMed  CAS  Google Scholar 

  22. Tanemura H, Oshita H, Kanno A, et al. Neoadjuvant chemotherapy using TS-1 and CDDP against large type 3/Type 4/Bulky N 2 advanced gastric cancer. Gan To Kagaku Ryoho. 2005;32:2079–85.

    PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Yanong Wang MD, PhD.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Liu, X., Xu, Y., Long, Z. et al. Prognostic Significance of Tumor Size in T3 Gastric Cancer. Ann Surg Oncol 16, 1875–1882 (2009). https://doi.org/10.1245/s10434-009-0449-x

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1245/s10434-009-0449-x

Keywords

Navigation