Prognostic Significance of Tumor Size in T3 Gastric Cancer

Liu, Xiaowen; Xu, Yu; Long, Ziwen; Zhu, Huiyan; Wang, Yanong

doi:10.1245/s10434-009-0449-x

Cited by 41 publications

(24 citation statements)

References 19 publications

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“…Maximum tumor diameter >8 cm was associated with significantly poorer OS than maximum diameter <8 cm [22]. Errors may occur, however, when classifying tumor size without considering the effects of invasion depth and lymph node metastasis on tumor size [23]. It is difficult to identify the most important prognostic factors because many variables are interrelated.…”

Section: Discussionmentioning

confidence: 99%

Does Tumor Size Improve the Accuracy of Prognostic Predictions in Node-Negative Gastric Cancer (pT1-4aN0M0 Stage)?

Huang

Zheng

et al. 2014

PLoS ONE

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BackgroundThe prognostic importance of tumor size in gastric cancer is unclear. This study investigated whether the inclusion of tumor size could improve prognostic accuracy in node-negative gastric cancer.MethodsClinical and pathological data of 492 patients with node-negative gastric cancer who underwent radical surgery in our department from January 1995 to December 2008 were analyzed. The prognostic accuracy of T stage was compared with that of T stage plus tumor size. The ability of tumor size to improve the 95% confidence interval (CI) of postoperative 5-year survival rate in gastric cancer patients was assessed. Different T stages plus tumor size were further analyzed to assess improvements in prognosis.ResultsMean tumor size was 3.79±1.98 cm with a normal distribution. Multivariate analysis showed that tumor size and T stage were independent prognostic factors. Postoperative 5-year survival rate tended to decrease as tumor size increased in 1 cm increments. The addition of tumor size to T stage improved accuracy in predicting 5-year survival by 4.2% (P<0.05), as well as improving the 95% CI of postoperative 5-year survival rate by 3.2–5.1%. The addition of tumor size improved the predictive accuracy of postoperative 5-year survival rate by 3.9% (95% CI 70.4%–91.1%, P = 0.033) in patients with stage T3N0M0 tumors and by 6.5% (95% CI 68.7%–88.4%, P = 0.014) in patients with stage T4aN0M0 tumors.ConclusionsTumor size is an independent prognostic factor for survival in patients with node-negative gastric cancer, as well as improving prognostic accuracy in stage T3/4aN0M0 tumors.

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Section: Discussionmentioning

confidence: 99%

Does Tumor Size Improve the Accuracy of Prognostic Predictions in Node-Negative Gastric Cancer (pT1-4aN0M0 Stage)?

Huang

Zheng

et al. 2014

PLoS ONE

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“…8 Liu et al found tumor size to be an independent prognostic factor for patients with T3 gastric cancer in the 6th edition system, and the 5-year survival rates were 29.5 and 42.7% in the large-size (LSG, tumor [6 cm) and small-size groups (SSG, tumor B6 cm), respectively (P = 0.045). 9 Secondly, the subdivision of N classification based on the number of metastatic lymph nodes was changed. The N1 substage in the old system was divided into N1 and N2 in the new system, and N2 and N3 substages were merged into N3.…”

Section: Discussionmentioning

confidence: 99%

Comparison of the 6th and 7th editions of the UICC TNM staging system for gastric cancer: Results of a Chinese single-institution study of 1,503 patients.

Wang

2011

JCO

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Aim. To evaluate the prognostic efficacy of the 7th edition tumor-node-metastasis (TNM) classification compared with the 6th edition in gastric cancer patients. Methods. A total of 1,503 gastric cancer patients undergoing surgical resection were staged using the 6th and 7th edition staging systems. Homogeneity, discriminatory ability, and monotonicity of gradients of the two systems were compared using linear trend v 2 , likelihood ratio v 2 statistics, and Akaike information criterion (AIC) calculations.Results. Significant differences in 5-year survival rates were observed for the T, N, and M subgroups using the 7th edition system, except for stage N2 and N3 patients in the 6th edition system. There were no significant differences in survival between IB and IIA in the 7th edition system. Patients with stage IV disease due to T4/N3 in the 6th edition system who were downstaged to stage III in the 7th edition system had significantly better survival than those who remained at stage IV. The 7th edition system had higher linear trend and likelihood ratio v 2 scores, and smaller AIC values compared with those for the 6th edition, which represented the optimum prognostic stratification.Conclusions. Our study suggests that the 7th edition system performs better than the 6th edition in several aspects.Gastric cancer is the fourth most common malignant tumor in the world, with an estimated 1 million new cases every year.1 More new cases of gastric cancer are diagnosed in China each year than in any other country.

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“…However, it was impossible to precisely predict the prognosis through the conventional staging procedures as a result of the variability of prognosis within the same stage of gastric cancer. Liu et al [5] found that there were significant differences between the largersize tumor group and the small-size tumor group according to stage IIIb and IV. Therefore, it was essential to search for the other specific factors to identify subgroups of patients with more aggressive course of the disease especially in the 7th editions of the UICC TNM Staging System.…”

Section: Discussionmentioning

confidence: 99%

“…Therefore, it was essential to search for the other specific factors to identify subgroups of patients with more aggressive course of the disease. Recently, some studies have shown that other pathological factors, such as the number of positive lymph nodes, the presence of extracapsular lymph node involvement, and tumor size had additional prognostic value [3][4][5]. Given that some biological markers, such as oncogenes, tumor-suppressor genes, cell-cycle regulators, and DNA repair genes, were related to tumor genesis, growth, invasion and metastasis, many scientists were dedicated to searching for the new prognostic factors with these molecular markers.…”

Section: Introductionmentioning

confidence: 99%

The prognostic significance of apoptosis-related biological markers in Chinese gastric cancer patients.

Liu¹,

Yang²,

Long³

et al. 2011

JCO

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Prognostic Significance of Tumor Size in T3 Gastric Cancer

Abstract: 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.

Cited by 41 publications

References 19 publications

Does Tumor Size Improve the Accuracy of Prognostic Predictions in Node-Negative Gastric Cancer (pT1-4aN0M0 Stage)?

Does Tumor Size Improve the Accuracy of Prognostic Predictions in Node-Negative Gastric Cancer (pT1-4aN0M0 Stage)?

Comparison of the 6th and 7th editions of the UICC TNM staging system for gastric cancer: Results of a Chinese single-institution study of 1,503 patients.

The prognostic significance of apoptosis-related biological markers in Chinese gastric cancer patients.

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