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The prognostic impact of macroscopic serosal change on resectable advanced gastric cancer

Authors :
Takeyuki Wada
Takaki Yoshikawa
Hitoshi Katai
Sho Otsuki
Masahiro Yura
Tsutomu Hayashi
Toshirou Nishida
Yukinori Yamagata
Source :
BMC Cancer, BMC Cancer, Vol 21, Iss 1, Pp 1-9 (2021)
Publication Year :
2021
Publisher :
BioMed Central, 2021.

Abstract

Background Advanced gastric cancer sometimes causes macroscopic serosal change (MSC) due to direct invasion or inflammation. However, the prognostic significance of MSC remains unclear. Methods A total of 1410 patients who had been diagnosed with deeper-than-pathological-T2 gastric cancer and undergone R0 gastrectomy with lymph node dissection at the National Cancer Center Hospital during January 2000 and December 2012 were restrospectively reviewed. Results MSC was not found in 108 of the 506 patients with pathological T4a (21.3%), whereas it was detected in 250 of the 904 patients with pathological T2-T3 (27.7%). The sensitivity, specificity and accuracy for diagnosing pathological serosa exposed (SE) by MSC were 78.7, 72.3 and 74.6%, respectively. The MSC-positive cases had a worse 5-year overall survival (OS) than the MSC-negative cases in pT3 (72.9% vs. 84.3%, p = 0.001), pT4a (56.2% vs. 73.4%, p = 0.001), pStageIIB (76.0% vs. 88.4%, p = 0.005), pStageIIIA (63.4% vs. 75.6%, p = 0.019), pStageIIIB (53.6% vs. 69.2%, p = 0.029) and pStage IIIC (27.6% vs. 50.0%, p = 0.062). A multivariate analysis showed that MSC was a significant independent predictor for the OS (hazard ratio [HR]: 1.587, 95%CI 1.209–2.083, p = 0.001) along with the tumor depth (HR: 7.742, 95%CI: 2.935–20.421, p p p Conclusions In this study, the MSC was one of the independent prognostic factors in patients with resectable locally advanced gastric cancer.

Details

Language :
English
ISSN :
14712407
Volume :
21
Database :
OpenAIRE
Journal :
BMC Cancer
Accession number :
edsair.doi.dedup.....4dfce104e1a4ebca06b8a76893066869