Tumor Diameter as a Prognostic Factor in Patients with Gastric Cancer

Kunisaki, Chikara; Makino, Hirochika; Takagawa, Ryo; Oshima, Takashi; Nagano, Yasuhiko; Kubo, Takashi; Ono, Hideki; Otsuka, Yuichi; Akiyama, Hirotoshi; Ichikawa, Yasushi; Shimada, Hiroshi

doi:10.1245/s10434-008-9884-3

Cited by 45 publications

(32 citation statements)

References 14 publications

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“…The results from our study also support the previously described finding that patient age at the time of diagnosis is significantly associated with overall survival in Western and Eastern GC patients [23,24]. Confirming previous reports [25][26][27], tumor size was also identified as a poor prognostic factor in the current study.…”

Section: Discussionsupporting

confidence: 93%

The survival difference between gastric cancer patients from the UK and Japan remains after weighted propensity score analysis considering all background factors

et al. 2015

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Background Previous studies comparing survival between gastric cancer (GC) patients from the West and the East were based on the assumption that background factors and prognostic factors were identical. The aim of the current study was to compare the survival of GC patients from the UK and Japan using weighted propensity score analysis after identifying all different background factors. Methods Data from 464 patients from the Leeds Teaching Hospital NHS Trust, Leeds, UK (LTHT), and 465 patients from the Kanagawa Cancer Center Hospital, Yokohama, Japan (KCCH), who had surgery for GC were analyzed. Prognostic factors for overall survival (OS) and cancer-specific survival (CSS) were identified by univariate and multivariate analyses. Survival was compared by propensity score weighting after adjusting for all significantly different background factors. Results Most background factors were different between LTHT and KCCH patients. Unadjusted stage-specific OS and CSS were significantly better in KCCH. Independent prognostic factors for unadjusted OS and CSS were pT and pN in KCCH and in addition tumor location, pancreatectomy, resection margin status and number of examined lymph nodes in LTHT. Even after adjusting for all background characteristics, survival remained better in KCCH. Conclusions These results suggest that differences in background factors are unable to fully explain the survival difference of GC patients between UK and Japan. Comprehensive studies into the biology of GC and/or host factors are needed to fully understand the survival difference.

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Section: Discussionsupporting

confidence: 93%

The survival difference between gastric cancer patients from the UK and Japan remains after weighted propensity score analysis considering all background factors

et al. 2015

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“…For example, Kunisaki et al [8] examined 1215 patients with gastric cancer and classified them into groups with smaller tumors and those with larger tumors, by setting 100 mm as the cutoff value for the maximal tumor diameter. They found that OS was markedly different between stage II/III patients with smaller and larger tumors.…”

Section: Discussionmentioning

confidence: 99%

Macroscopic tumor size as an independent prognostic factor for stage II/III gastric cancer patients who underwent D2 gastrectomy followed by adjuvant chemotherapy with S-1

et al. 2011

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Background In patients with stage II/III gastric cancer, tumors often recur even after curative D2 gastrectomy followed by adjuvant S-1 chemotherapy. The objective of this retrospective study was to clarify the prognostic factors in these patients that might be useful for future patients. Methods Overall survival (OS) was examined in 82 gastric cancer patients who underwent curative D2 surgery; were diagnosed with stage IIA, IIB, IIIA, IIIB, or IIIC pathologically; and received adjuvant S-1 after surgery between June 2002 and March 2010. Results When length of OS was evaluated by the log-rank test, significant differences were observed with regard to macroscopic tumor diameter and the depth of tumor invasion. A macroscopic tumor diameter [70 mm was regarded as a critical point of classification considering survival. Univariate and multivariate Cox's proportional hazard analyses demonstrated that macroscopic tumor diameter was the only significant independent prognosticator. The 5-year survival was 64.9% in patients with a macroscopic tumor diameter \70 mm, and 33.1% in patients with a macroscopic tumor diameter C70 mm (P = 0.022). Conclusions The macroscopic tumor diameter was the most important prognostic factor for survival in patients with stage II/III gastric cancer who underwent D2 gastrectomy followed by adjuvant S-1 chemotherapy. Prognostic factors can be affected by adjuvant chemotherapy.

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“…Gross appearance and size of the tumor has also been introduced as an indicator for deciding the extend of lymph node resection even in early stages of gastric cancer (Tsujitani et al, 1999) and leads to modification of curative and palliative interventions (Li et al, 2009). However results of these studies differ in regard of the proposed threshold of tumor size; ranging between 35 to 100mm and even up to 8cm (Kunisaki et al, 2008). This difference could be a result of histopathology of the tumor or may be influenced by other factors affecting the survival like treatment methods.…”

Section: Discussionmentioning

confidence: 96%

“…This difference could be a result of histopathology of the tumor or may be influenced by other factors affecting the survival like treatment methods. Further researches are needed to make a conclusion before performing recommendation of researchers to include the tumor size in staging system of gastric cancer (Kunisaki et al, 2008;Wang et al, 2008;Liu et al, 2009).…”

Section: Discussionmentioning

confidence: 99%

Clinicopathological Factors and Gastric Cancer Prognosis in the Iranian Population: a Meta-analysis

Somi

Ghojazadeh²,

Bagheri³

et al. 2015

Asian Pacific Journal of Cancer Prevention

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Background: Gastric cancer is the most common cancer in the Iranian population. The aim of this study was to determine the effect of clinicopathological factors on prognosis by meta-analysis. Materials and Methods: A literature search was conducted using MEDLINE, EMBASE and Cochrane library and extensive literature search using the Persian databases until February 2011. Prospective follow up studies with multivariate analysis of overall survival of the patients with gastric cancer were included in this review. The data were analyzed by CMA.2. Publication bias are checked by funnel plot and data are shown as Forest plots. Results: From a total of 63 articles, 14 retrospective studies which examined 5 prognostic factors and involving 10,500 patients were included. Tumor size (>35mm) was the main significant factor predicting an unfavorable prognosis for the patients with gastric cancer (RR=1.829 , p<0.001) followed by presence of distant metastases (RR=1.607 , p<0.001), poor differentiation (RR=1.408 , p<0.001) and male sex (RR=1.194, p<0.001). Lymph node metastases (RR=1.058, p=0.698) and moderate differentiation (RR=0.836, p=0.043) were not statistically significant as prognostic factors. Conclusions: This meta-analysis suggests that tumor size>35mm, poor differentiation, presence of distant metastasis and male gender are strongly associated with a poor prognosis in Iranian patients with gastric cancer.

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Tumor Diameter as a Prognostic Factor in Patients with Gastric Cancer

Cited by 45 publications

References 14 publications

The survival difference between gastric cancer patients from the UK and Japan remains after weighted propensity score analysis considering all background factors

The survival difference between gastric cancer patients from the UK and Japan remains after weighted propensity score analysis considering all background factors

Macroscopic tumor size as an independent prognostic factor for stage II/III gastric cancer patients who underwent D2 gastrectomy followed by adjuvant chemotherapy with S-1

Clinicopathological Factors and Gastric Cancer Prognosis in the Iranian Population: a Meta-analysis

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