Abstract
Although postoperative management of gastric cancer is determined by pathological stage based on the tumor-node-metastasis classification, predicting disease recurrence and prognosis in patients undergoing gastrectomy is clinically difficult. We investigated the depth of tumor invasion and tumor size in resected specimens from patients with gastric cancer and assessed the clinical utility of primary tumor score (PTS) calculated by tumor depth and size as a prognostic marker. We classified 247 patients with gastric cancer into three groups based on cut-off values for deeper tumor invasion (pT2–T4) and larger tumor size (≥ 45 mm) as a PTS of 2 (both abnormalities), 1 (one abnormality), or 0 (neither abnormality). PTS correlated significantly with lymph node metastasis, lymphovascular invasion, and stage (P < 0.0001 each). Survival differences among groups based on PTS were significant (P < 0.0001). Multivariate analysis identified PTS alone as an independent prognostic factor (P = 0.0363). PTS derived from primary tumor information alone is a potentially useful marker for predicting tumor progression and prognosis in postoperative patients with gastric cancer.
Highlights
Gastric cancer is a common gastrointestinal malignancy and the third leading cause of cancer death globally [1]
We initially examined the relationship between clinicopathological factors and depth of tumor invasion or tumor size to assess their clinical impact during tumor progression in 247 patients with resectable gastric cancer
We assessed the clinical utility of tumor depth and size for predicting tumor progression in patients with resectable gastric cancer
Summary
Gastric cancer is a common gastrointestinal malignancy and the third leading cause of cancer death globally [1]. The need for administration of adjuvant chemotherapy is currently judged based on pathological stage in patients with resectable gastric cancer [2]. 4), induction of adjuvant chemotherapy is recommended for patients with stage II or III pathology [2] This therapeutic strategy indicates a high incidence of disease recurrence in postoperative patients with stage II-III. The sensitivity and specificity of these conventional tumor markers are clinically insufficient for predicting disease recurrence and prognosis [3, 4]. These key issues suggest few prognostic indicators are available for accurately predicting survival outcomes in patients with gastric cancer
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