Prognostic factors for noncurative gastric cancer: Univariate and multivariate analyses

Abstract

We performed univariate and multivariate analyses of possible prognostic factors related to postoperative clinical course of patients with advanced gastric cancer. Noncurative resection was done for 119 patients with hepatic metastasis, peritoneal seeding, extensive lymph node metastasis, or direct invasion to adjacent organs, either alone or in various combinations. In the univariate analysis, 6 of 17 items such as peritoneal seeding, lymphatic invasion, vascular invasion, mode of invasion, extent of lymphadenectomy, and width of serosal invasion significantly correlated to the prognosis. The multivariate analysis indicated that three inherent pathologic factors, mode of invasion, lymph node metastasis, and hepatic metastasis, and one treatment factor, extent of lymphadenectomy, were significant variables predictive of the prognosis and that the prognosis was expected to be very poor in cases of infiltrative type, nodal involvement to tertiary nodes, presence of hepatic metastasis, and lymphadenectomy less than R3. Prognosis in terms of the extent of lymphadenectomy shows that extensive lymphadenectomy (R3) proved to be significantly effective in prolonging survival time, even after noncurative gastrectomy. We recommend extensive lymphadenectomy to prolong survival time for such patients.

Prognostic impact of PCR-based identification of isolated tumour cells in the peritoneal lavage fluid of gastric cancer patients who underwent a curative R0 resection

“…The detection of micrometastases and disseminated cancer cells in patients with tumours who are undergoing curative surgery is a challenging field in oncology because the dissemination of neoplastic cells is the main reason for distant relapse and cancer-related death (Timar et al, 2001). Peritoneal dissemination is the most common type of recurrence after surgery in these advanced cases and is one of the reasons for their poor prognosis (Baba et al, 1989;Yoo et al, 2000). Peritoneal dissemination may arise from the free cancer cells in the peritoneal cavity exfoliated mainly from the serosal surface of the primary tumour.…”

Prediction of recurrence after curative resection of gastric carcinoma invading the muscularis propria: a multivariate analysis

“…The pm gastric cancer is usually treated by curative resection [3], and the 5-year survival rate for patients with pm gastric cancer was reported to be between 70% and 80%, a value between that for EGC and AGC [4,5]. Although pm gastric cancer belongs to the category of AGC, it is considered to be an intermediate stage between EGC and AGC [6], and the biological characteristics of pm gastric cancer are different from those of AGC [7].Recurrences of gastric cancer are likely to take a variety of forms and to be manifested in different organs, and the rate of recurrence increases in proportion to the degree of depth of invasion, even after curative resection for gastric cancer [8][9][10]. Although many prognostic factors for EGC and AGC have been identified [9,11], there are few reports concerning prognostic factors for pm gastric cancer, and the characteristics of recurrence are not well understood.…”

“…Recurrences of gastric cancer are likely to take a variety of forms and to be manifested in different organs, and the rate of recurrence increases in proportion to the degree of depth of invasion, even after curative resection for gastric cancer [8][9][10]. Although many prognostic factors for EGC and AGC have been identified [9,11], there are few reports concerning prognostic factors for pm gastric cancer, and the characteristics of recurrence are not well understood.…”

Retrospective analysis of clinical results and predictors of response in chemo-na�ve patients with advanced gastric cancer treated with S-1, an oral fluoropyrimidine derivative, as single-agent chemotherapy

“…The pretreatment variables examined were chosen by considering possible effects on the clinical course, as indicated by previous investigations [10][11][12][13], as well as those suggested from our own experience. The relationship of response to the following 11 categorized variables was studied: (1) Eastern Cooperative Oncology Group (ECOG) performance status (PS; 0 or 1); (2) histology (differentiated type or undifferentiated type); (3) macroscopic classification [9] (infiltrating type [type 4] or other types); (4) site of disease (classified as follows: primary lesion [present or absent]); (5) lymph node metastasis (present or absent); (6) liver metastasis (present or absent); (7) peritoneal disease, which included peritoneal dissemination and ascites (present or absent); (8) hemoglobin level (hemoglobin; male, м13.7 g/dl or Ͻ13.7 g/dl; female, м11.3 g/dl or Ͻ11.3 g/dl); (9) serum C-reactive protein (CRP; м1.0 mg/dl or Ͻ1.0 mg/dl); (10) serum lactate dehydrogenase (LDH; м230 U/l or Ͻ230 U/l); and (11) serum carcinoembryonic antigen (CEA; Ͼ5.0 ng/ml or Ϲ5.0 ng/ml).…”