Biologic predictors of survival in node-negative gastric cancer Journal Article

   


Authors: Kooby, D. A.; Suriawinata, A.; Klimstra, D. S.; Brennan, M. F.; Karpeh, M. S.
Article Title: Biologic predictors of survival in node-negative gastric cancer
Abstract: Objective: To evaluate factors predictive of survival following curative resection for node-negative gastric adenocarcinoma. Summary Background Data: Presence or absence of lymph node metastases is the most powerful predictor of survival following curative resection for gastric adenocarcinoma. Factors predictive of survival in node-negative gastric cancer have not been clarified. Methods: Histopathology and clinical outcome for all patients undergoing RO resections for gastric adenocarcinoma at a tertiary center between 1985 and 2001 were reviewed. Results: Of 1,256 RO resections performed, 507 (40%) were node-negative, 465 were T1-T3, and 317 of these were adequately staged, as defined by histologic evaluation of at least 15 lymph nodes. Median age was 67 years, and 62% were male. Forty percent had T1 tumors, 34% were T2, and 26% were T3. Median tumor size was 3 cm. Vascular invasion (VI) was present in 17% of tumors and neural invasion (NI) in 31%. Extended (D2) lymphadenectomy was performed in 75% of cases. Five- and 10-year disease-specific survival rates were 79% and 67% respectively. Factors associated with poorer disease-specific survival on univariate analysis were male gender, serosal invasion, presence of VI, presence of NI, and resection other than distal subtotal gastrectomy. On multivariate analysis, NI was not an independent predictor of survival, but correlated directly with advancing T stage and tumor size. Conclusions: Serosal invasion and presence of VI are strong predictors of poor survival in this disease. NI correlates with T stage and tumor size and may serve as a marker of advanced disease.
Keywords: adult; cancer survival; treatment outcome; aged; aged, 80 and over; middle aged; cancer surgery; survival rate; retrospective studies; major clinical study; histopathology; mortality; advanced cancer; conference paper; cancer staging; lymph node metastasis; neoplasm staging; lymphadenectomy; adenocarcinoma; tumor volume; pathology; retrospective study; prediction; cancer invasion; statistical analysis; evaluation; blood vessel; gastrectomy; stomach cancer; multivariate analysis; neoplasm invasiveness; age distribution; stomach adenocarcinoma; stomach neoplasms; serosa; stomach tumor; vascular invasion; humans; prognosis; human; male; female; priority journal; article
Journal Title: Annals of Surgery
Volume: 237
Issue: 6
ISSN: 0003-4932
Publisher: Lippincott Williams & Wilkins  
Date Published: 2003-06-01
Start Page: 828
End Page: 837
Language: English
DOI: 10.1097/01.sla.0000072260.77776.39
PUBMED: 12796579
PROVIDER: scopus
PMCID: PMC1514693
DOI/URL:

https://www.scopus.com/inward/record.uri?eid=2-s2.0-85047690946&doi=10.1097%2f01.SLA.0000072260.77776.39&partnerID=40&md5=ded611f93324366ce2f94cd17895c9fe
Notes: Presented at the 114th Annual Session of the Southern Surgical Association; 2002 Dec 1-4; Palm Beach, FL -- Export Date: 25 September 2014 -- Source: Scopus
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MSK Authors
  1. Murray F Brennan
    1059 Brennan
  2. Arief Suriawinata
    19 Suriawinata
  3. Martin S Karpeh
    98 Karpeh
  4. David Kooby
    25 Kooby
  5. David S Klimstra
    978 Klimstra
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