Tumor Size Improves the Accuracy of the Prognostic Prediction of Lymph Node-Negative Gastric Cancer.
Age Factors
Aged
Antineoplastic Combined Chemotherapy Protocols
/ therapeutic use
Capecitabine
Chemotherapy, Adjuvant
/ methods
Deoxycytidine
/ analogs & derivatives
Female
Fluorouracil
/ analogs & derivatives
Follow-Up Studies
Gastrectomy
Humans
Kaplan-Meier Estimate
Leucovorin
/ therapeutic use
Lymph Node Excision
Lymph Nodes
/ pathology
Lymphatic Metastasis
/ diagnosis
Male
Middle Aged
Neoplasm Staging
Organoplatinum Compounds
/ therapeutic use
Oxaloacetates
Prognosis
Retrospective Studies
Stomach
/ pathology
Stomach Neoplasms
/ mortality
Treatment Outcome
Tumor Burden
Gastric carcinoma
Lymph node–negative
Prognosis
Tumor size
Journal
The Journal of surgical research
ISSN: 1095-8673
Titre abrégé: J Surg Res
Pays: United States
ID NLM: 0376340
Informations de publication
Date de publication:
08 2019
08 2019
Historique:
received:
29
07
2018
revised:
07
02
2019
accepted:
22
02
2019
pubmed:
27
3
2019
medline:
15
2
2020
entrez:
27
3
2019
Statut:
ppublish
Résumé
Tumor size has been regarded as the "T" stage of many solid tumors because of its effect on prognosis. However, the prognostic impact of tumor size in gastric cancer (GC) is still controversial. A total of 436 patients with curatively resected GC and those without lymph node metastasis in our center were retrospectively enrolled. The appropriate cutoff points for tumor size were determined. Potential prognostic factors were analyzed. In addition, a pathological tumor-size (pTS) classification system was proposed to evaluate the superiority of its prognostic prediction of node-negative GC patients compared with that of the pT staging system. The ideal cutoff points for tumor size were 4 and 8 cm. In the multivariate analysis, tumor size was identified as an independent prognostic factor for node-negative GC patients after surgery, as was pT stage. The pTS classification was found to be more appropriate for predicting the overall survival of node-negative GC patients after curative surgery than pT stage, and the -2 log-likelihood of the pTS classification (1680.782) was smaller than the value of pT (1695.239). As an independent prognostic factor, tumor size should be incorporated into the pT staging system to enhance the accuracy of the prognostic prediction of node-negative GC patients.
Sections du résumé
BACKGROUND
Tumor size has been regarded as the "T" stage of many solid tumors because of its effect on prognosis. However, the prognostic impact of tumor size in gastric cancer (GC) is still controversial.
MATERIALS AND METHODS
A total of 436 patients with curatively resected GC and those without lymph node metastasis in our center were retrospectively enrolled. The appropriate cutoff points for tumor size were determined. Potential prognostic factors were analyzed. In addition, a pathological tumor-size (pTS) classification system was proposed to evaluate the superiority of its prognostic prediction of node-negative GC patients compared with that of the pT staging system.
RESULTS
The ideal cutoff points for tumor size were 4 and 8 cm. In the multivariate analysis, tumor size was identified as an independent prognostic factor for node-negative GC patients after surgery, as was pT stage. The pTS classification was found to be more appropriate for predicting the overall survival of node-negative GC patients after curative surgery than pT stage, and the -2 log-likelihood of the pTS classification (1680.782) was smaller than the value of pT (1695.239).
CONCLUSIONS
As an independent prognostic factor, tumor size should be incorporated into the pT staging system to enhance the accuracy of the prognostic prediction of node-negative GC patients.
Identifiants
pubmed: 30913463
pii: S0022-4804(19)30103-9
doi: 10.1016/j.jss.2019.02.037
pii:
doi:
Substances chimiques
Organoplatinum Compounds
0
Oxaloacetates
0
Deoxycytidine
0W860991D6
Capecitabine
6804DJ8Z9U
Leucovorin
Q573I9DVLP
Fluorouracil
U3P01618RT
Types de publication
Comparative Study
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
89-96Informations de copyright
Copyright © 2019 Elsevier Inc. All rights reserved.