Tumor Size Improves the Accuracy of the Prognostic Prediction of Lymph Node–Negative Gastric Cancer

Liang, Yuexiang; Liu, Lijie; Xie, Xiaoming; Xia, Li-Ping; Jin, Minghao; Xu, Ru; He, Donghua

doi:10.1016/j.jss.2019.02.037

Cited by 15 publications

(11 citation statements)

References 31 publications

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“…Our results also suggested that solitary ICC was a heterogeneous group, and larger tumor size was associated with malignant pathological factors, including worse tumor differentiation (20,22) and VI (20,24). It was believed that a larger tumor size was associated with various malignant variables (25)(26)(27)(28). The prognostic ability of these variables has also been reported in ICC (4,11,22), and tumor size has been integrated into several risk systems to predict the presence of malignant pathological factors and OS (24,29,30).…”

Section: Discussionsupporting

confidence: 69%

Effect of Tumor Size on Long-Term Survival After Resection for Solitary Intrahepatic Cholangiocarcinoma

et al. 2021

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BackgroundThe relationship between tumor size and survival in intrahepatic cholangiocarcinoma (ICC) is still controversial. This study aimed to evaluate the prognostic ability of tumor size for solitary ICC after resection and explore optimal cut-off values in different subgroups.MethodsPatients with solitary ICC who underwent liver resection from the Surveillance, Epidemiology, and End Results Program and Shandong Provincial Hospital were retrospectively analyzed. Kaplan-Meier and Cox regression analysis were used to assess the prognostic ability of tumor size. The log-rank test was used to determine the optimal cut-off values, and a minimum P was regarded as the optimal one in different subgroups.ResultsLarge tumor size groups had worse overall survival (OS) than small tumor size groups. Cox regression analysis suggested that tumor size was an independent prognostic factor for OS for solitary ICC after resection. Subgroup analysis showed tumor size was associated with OS for both solitary ICC with and without vascular invasion (VI). Furthermore, the optimal cut-off values for solitary ICC with and without VI were found to be 8 and 3 cm, respectively, which could divide the patients into two groups with significant differences in OS.ConclusionTumor size was an independent prognostic factor for solitary ICC after resection. The existing American Joint Committee on Cancer (AJCC) staging system could be improved if the cut-off value of the T1 stage was changed to 8 cm and if the T2 stage incorporated a tumor size with a cut-off value of 3 cm. Further studies with more cases are needed to validate these findings.

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Section: Discussionsupporting

confidence: 69%

Effect of Tumor Size on Long-Term Survival After Resection for Solitary Intrahepatic Cholangiocarcinoma

et al. 2021

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“…The former forms the tumor size, while the latter is the depth of infiltration. The integration of tumor size into the T-staging system of gastric cancer is controversial, although many previous studies have demonstrated that tumor size is a non-negligible prognostic factor for gastric cancer and that including tumor size in the staging system improves the prognostic prediction of gastric cancer [ 19 , 20 ]. However, they did not consider the effect of depth of infiltration on the prognostic significance of tumor size because many variables are interrelated and the effect of tumor size on prognosis can be accurately assessed only if the depth of tumor infiltration is clearly defined.…”

Section: Discussionmentioning

confidence: 99%

The prognostic role of tumor size in stage T1 gastric cancer

et al. 2022

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Background The purpose was to assess the contribution of tumor size to the prognosis of patients with gastric cancer. Methods Patient data were sourced from the Surveillance, Epidemiology, and End Results program (SEER) database. Cox proportional risk regression was performed to determine the prognostic role of tumor size. Kaplan-Meier curves were conducted to calculate survival curves. Consistency index (c-index) and subject exercise curve (ROC) were utilized to assess the predictive ability of each factor on the prognosis of gastric cancer. Results Tumor size is preferable to other widely accepted prognostic clinical features in forecasting the survival of patients with gastric cancer. Conclusions The discriminatory ability of tumor size at T1 stage is superior to many other clinical prognostic factors.

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“…Liang et al pointed out that tumor size can also affect the prognosis of hollow organ tumors such as gastric cancer and should be incorporated into T staging to better predict prognosis. 24 Furthermore, our study displayed that the survival of cardiac cancer was worse than that of non-cardiac cancer, which suggested that the site of gastric cancer was related to prognosis. Xue et al conducted a meta-analysis to compare the prognosis of proximal and distal gastric cancer patients who underwent gastrectomy, and the results showed that the prognosis of proximal gastric cancer patients was inferior than those of distal gastric cancer patients.…”

Section: Discussionmentioning

confidence: 77%

A Practical Nomogram for Predicting the Prognosis of Elderly Patients with Gastric Adenocarcinoma After Gastrectomy

Yang¹,

Ji²,

Jin³

et al. 2022

IJGM

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To establish a pragmatic prognostic nomogram for predicting the survival of elderly patients undergoing gastrectomy for gastric adenocarcinoma. Patients and Methods: Data of elderly patients undergoing gastrectomy for gastric adenocarcinoma between 2004 and 2015 were obtained from the Surveillance, Epidemiology, and End Results database. Prognostic factors were identified by the Kaplan-Meier method and the Cox proportional hazards model. Based on these factors, we developed a nomogram to predict the overall survival (OS) and gastric cancer-specific survival (GCSS). Concordance index (Cindex) and calibration curve are employed to assess the predictive accuracy of the model. Decision curve analysis (DCA) and receiver operating characteristic curve (ROC) analysis are applied to further appraise the clinical utility of the model. Results: A total of 8401 cases were incorporated into this research. After univariate and multivariate analyses, nine prognostic factors of OS were identified, including age (P < 0.001), race (P < 0.001), marital status (P < 0.001), tumor site (P < 0.001), tumor size (P = 0.024), differentiation (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), and M stage (P < 0.001); ten prognostic factors of GCSS were identified, including age (P < 0.001), race (P < 0.001), tumor site (P < 0.001), tumor size (P = 0.002), differentiation (P < 0.001), T stage (P < 0.001), N stage (P < 0.001), M stage (P < 0.001), radiotherapy (P < 0.001) and chemotherapy (P < 0.001). The C-index of the constructed nomogram for OS was 0.708 (95% CI: 0.701-0.715) while for GCSS was 0.745 (95% CI: 0.737-0.753). The calibration curves of the nomogram predictions and actual observations displayed good agreement for the 3-and 5-year OS and GCSS probabilities. The results of DCA and the area under the curve calculated by ROC analysis showed that the developed model was superior than TNM stage. Conclusion:The nomogram we established could accurately predict the prognosis of individual elderly patients who underwent gastrectomy for gastric adenocarcinoma.

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Tumor Size Improves the Accuracy of the Prognostic Prediction of Lymph Node–Negative Gastric Cancer

Cited by 15 publications

References 31 publications

Effect of Tumor Size on Long-Term Survival After Resection for Solitary Intrahepatic Cholangiocarcinoma

Effect of Tumor Size on Long-Term Survival After Resection for Solitary Intrahepatic Cholangiocarcinoma

The prognostic role of tumor size in stage T1 gastric cancer

A Practical Nomogram for Predicting the Prognosis of Elderly Patients with Gastric Adenocarcinoma After Gastrectomy

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