Tumor Size as a Recommendable Variable for Accuracy of the Prognostic Prediction of Gastric Cancer: A Retrospective Analysis of 1,521 Patients

Deng, Jingyu; Zhang, Rupeng; Pan, Yuan; Ding, Xiaobo; Cai, Mengxin; Liu, Yong; Liu, Honggen; Bao, Tao; Jiao, Xuguang; Hao, Xishan; Liang, Han

doi:10.1245/s10434-014-4014-x

Cited by 36 publications

(25 citation statements)

References 33 publications

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“…Hereby, we found both the proximal and distal resection margin distances did not differ between LG and OG, indicating LG possessed curability and oncological safety comparable to that of OG. It is proposed that tumor size should also be recommended as an important clinicopathological factor to enhance the accuracy of the prognostic prediction of GC patients [112]. Previous metaanalyses rarely made comparisons about this factor.…”

Section: Discussionmentioning

confidence: 99%

Comparison of laparoscopic versus open gastrectomy for advanced gastric cancer: an updated meta-analysis

Quan

Huang

et al. 2015

Gastric Cancer

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Background Laparoscopic gastrectomy (LG) has been used as an alternative to open gastrectomy (OG) to treat early gastric cancer. However, the use of LG for advanced gastric cancer (AGC) has been in debate. Methods Literature retrieval was performed by searching PubMed, EMBASE, and the Cochrane library up to July 2014. Potential studies comparing the surgical effects between LG with OG were evaluated and data were extracted accordingly. Meta-analysis was carried out using RevMan. The pooled risk ratio and weighted mean difference (WMD) with 95 % confidence interval (95 % CI) were calculated. Results Overall, 26 studies were included in this metaanalysis. LG had some advantages over OG, including shorter hospitalization (WMD, -3.63, 95 % CI, -4.66 to -2.60; P \ 0.01), less blood loss (WMD, -161.37, 95 % CI, -192.55 to -130.18; P \ 0.01), faster bowel recovery (WMD, -0.78, 95 % CI, -1.05 to -0.50; P \ 0.01), and earlier ambulation (WMD, -0.95, 95 % CI, -1.47 to -0.44; P \ 0.01). In terms of surgical and oncological safety, LG could achieve similar lymph nodes (WMD, -0.49, 95 % CI, -1.78 to 0.81; P = 0.46), a lower complication rate [odds ratio (OR), 0.71, 95 % CI, 0.59 to 0.87; P \ 0.01], and overall survival (OS) and disease-free survival (DFS) comparable to OG. Conclusions For AGCs, LG appeared comparable with OG in short-and long-term results. Although more time was needed to perform LG, it had some advantages over OG in achieving faster postoperative recovery. Ongoing trials and future studies could help to clarify this controversial issue.

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Section: Discussionmentioning

confidence: 99%

Comparison of laparoscopic versus open gastrectomy for advanced gastric cancer: an updated meta-analysis

Quan

Huang

et al. 2015

Gastric Cancer

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“…Thus, the prognostic risk factors for gastric cancer have been widely investigated, and age, tumor location, tumor size, tumor depth and lymph node metastasis, etc. [4, 7, 8] have already been demonstrated to be associated with the prognosis of gastric cancer patients previously.…”

Section: Introductionmentioning

confidence: 95%

Prognostic value of differentiation status in gastric cancer

et al. 2018

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BackgroundUp to date, investigation of the prognostic value of differentiation status mainly focused on signet ring cell and mucinous gastric cancer. Thus, the present study aims to investigate the clinicopathological features and prognosis of gastric cancer patients with well, moderately and poorly differentiation status.MethodsFrom September 2008 to March 2015, a total of 3090 gastric cancer patients treated with radical D2 gastrectomy were enrolled in the present study. Clinicopathological characteristics and prognosis of gastric cancer patients with well, moderately and poorly differentiation status were analyzed.ResultsThere were 2422 male (78.4%) and 668 female (21.6%). The median age was 58 (20–90) years. There were 370 (12.0%) well differentiated tumors, 836 (27.0%) moderately differentiated tumors and 1884 (61.0%) poorly differentiated tumors. Well and moderately differentiation status were associated with older age, male gender, smaller tumor, shallower invasion, less lymph node involvement and earlier tumor stage (all p < 0.001). Inversely, poorly differentiation status was associated with younger age, female gender, larger tumor, deeper invasion, more lymph node involvement and later tumor stage (all p < 0.001). With respect to prognosis, well differentiation status was associated with favorable overall survival and poorly differentiation status was associated with unfavorable overall survival (p < 0.001). However, after matching with age, tumor size, T and N stage, there was no significant difference among the overall survival of the three groups (p = 0.415).ConclusionsWell, moderately and poorly differentiation status was significantly associated with clinicopathological features of gastric cancer patients. However, it was not associated with the prognosis of gastric cancer patients.

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“…Saito et al [28] found that tumor diameter could also be used to predict the recurrence site of gastric cancer. Moreover, Deng et al [29] demonstrated that tumor diameter represented better prognostic stratification ability compared with T stage, while Zhao et al [16] reported that the prognostic prediction value was comparable between the two variables. In both studies above, they replaced T stage with tumor diameter in the TNM staging system and found that the new classification was more competent in predicting the prognosis of gastric cancer than the current TNM staging system.…”

Section: Discussionmentioning

confidence: 99%

Tumor volume increases the predictive accuracy of prognosis for gastric cancer: A retrospective cohort study of 3409 patients

et al. 2017

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Tumor diameter or T stage does not reflect the actual tumor burden and is not able to estimate accurate prognosis of gastric cancer. The current study aimed to evaluate the prognostic value of tumor volume (V) for gastric cancer. A total of 3409 enrolled gastric cancer patients were randomly divided into training set (n = 1705) and validation set (n = 1704). Tumor volume was calculated by the formula V = Tumor diameter × (T stage)2/2. The survival predictive accuracy and prognostic discriminatory ability between different variables and staging systems were analyzed. Four optimal cutoff points for V were obtained in training set (3.5, 8.6, 25.0, 45.0, all P < 0.001). V stage was significantly associated with tumor location, macroscopic type, differentiation degree, tumor diameter, T stage, N stage, vessel invasion, neural invasion and TNM stage (all P < 0.001). V stage was an independent prognostic factor both in training and validation set. V stage showed better predictive accuracy and prognostic discriminatory ability than tumor diameter and T stage. VNM staging system also have advantages in predictive accuracy and prognostic discriminatory ability than TNM staging system. The VNM multivariable model represent good agreement between the predicted survival and actual survival. In conclusion, tumor volume was significantly associated with clinicopathological features and prognosis of gastric cancer. In comparison with TNM staging system, VNM staging system could improve the predictive accuracy and prognostic discriminatory ability for gastric cancer.

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Tumor Size as a Recommendable Variable for Accuracy of the Prognostic Prediction of Gastric Cancer: A Retrospective Analysis of 1,521 Patients

Abstract: Ts should be recommended as an important clinicopathologic variable to enhance the accuracy of the prognostic prediction of GC clinical patients.

Cited by 36 publications

References 33 publications

Comparison of laparoscopic versus open gastrectomy for advanced gastric cancer: an updated meta-analysis

Comparison of laparoscopic versus open gastrectomy for advanced gastric cancer: an updated meta-analysis

Prognostic value of differentiation status in gastric cancer

Tumor volume increases the predictive accuracy of prognosis for gastric cancer: A retrospective cohort study of 3409 patients

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