The prognostic role of tumor size in patients with gastric cancer

Abstract

AIM: The identification of prognostic factors in gastric cancer is important for predicting patients’ survival and determining therapeutic strategies.

MATERIALS OF STUDY: A retrospective analysis ofpatients who underwent surgery for gastric cancer between 1996 and 2010. The appropriate cut-off value of tumor size related to survival was determined using receiver-operating characteristic (ROC) curves and it was 2,5 cm. Patients were divided into three groups: a small size group (SSG, < 2,5 cm), a medium size group (MSG, between 2,5 and 5 cm) and a large size group (LSG, ≥ 5 cm).

RESULTS: Depth of invasion and lymph node metastasis resulted significantly related to tumor size (p < 0.05). KaplanMeier survival curves showed that OS rate was significantly higher in SSG patients. The prognosis of patients with tumor size < 2,5 cm was better than patients with tumors ≥ 2.5 cm in size (p < 0.01).

DISCUSSION: The tumor size resulted significantly related to OS and it was related to depth of invasion and lymph node metastasis that are themselves prognostic factors. These results confirm and reinforced literature and suggest that at diagnostic pre-operative work-up we can yet define a prognostic value based on tumor size and underline the primary role of complete resection with free surgical margins and D2 lymphadenectomy.

CONCLUSION: In patients with gastric cancer tumor size suggests information about the malignancy of the tumor: it is an important predictor of survival and 2,5 cm may be considered as a valid cut-off to define a better or worse prognosis.