Prognostic factors in stage I gastric cancer: A retrospective analysis

Abstract

PurposeThe purpose of this research is to investigate the prognostic factors of patients with stage I gastric cancer (GC) and to determine whether adjuvant chemotherapy improves the prognosis for high-risk patients.MethodsWe performed a retrospective analysis at Sir Run Run Shaw Hospital, Zhejiang University School of Medicine, and HwaMei Hospital, University of Chinese Academy of Sciences from January 2001 to December 2015. Cox regression and Kaplan-Meier were used to evaluate the relationship between the patients’ clinicopathologic characteristics and prognosis.ResultsA total of 1,550 patients were eligible for the study. The 5-year disease-free survival (DFS) rate of all enrolled patients was 96.5%. The pT and pN stages were significantly associated with the prognosis. The 5-year DFS rates of the three subgroups (T1N0, T2N0, and T1N1) were 97.8%, 95.7%, and 90.5%, respectively (p < 0.001). In the T1N1 subgroup, patients not undergoing chemotherapy showed a lower 5-year DFS rate compared to those undergoing chemotherapy, although the difference was not statistically significant.ConclusionsBoth the pT and pN stages were closely associated with the prognosis of patients with stage I GC. We also found that the danger coefficient of the pN stage was higher than that of the pT stage, and that postoperative adjuvant chemotherapy might be a reasonable approach to improve outcomes of high-risk patients, particularly in the T1N1 group.

Tumor size as a significant prognostic factor in T1 gastric cancer: a Surveillance, Epidemiology, and End Results (SEER) Database analysis

“…It is well known that lymph node metastasis was an inescapable prognostic factor that indicated the mode and range of surgery (31,32). The survival markedly decreased with the increase of the lymph nodes metastasis (33)(34)(35). However, Sekiguchi M et al found that the prevalence of LNM was rarely low, about 12.3%, in early gastric cancer(36).…”

Clinical significance of the largest histopathological metastatic lymph node size for postoperative course of patients undergoing surgery for gastric cancer

“…Nodal involvement (N stage) was one of the prognostic factors for patients eligible for surgery in GC and used in the most commonly applied staging systems (2). It was reported as an independent prognostic factor since there's a close relationship between lymph nodes, tumor stage, and prognosis (14). In our MLN size <1.05 cm group, 48 patients were in the pN1 stage and 7 patients were in the pN3 stage.…”

Risk stratification for predicting postoperative recurrence of gastric cancer by grade of venous invasion

“…Although VI was not associated with postoperative recurrence in some studies which analyzed stage I and T4 GC [ 20 – 22 ], we speculate that it may be due to the intrinsic excellent and dismal prognoses of stage I and T4 GCs, respectively. In fact, many studies concluded that the lymphatic/vascular invasions are not directly related to patients’ prognosis with stage I GC [ 24 ]. The low sensitivity for detecting VI may also underlie the results when VI was assessed by the HE staining.…”