Macroscopic appearance of Type Ⅳ and giant Type Ⅲ is a high risk for a poor prognosis in pathological stage Ⅱ/Ⅲ advanced gastric cancer with postoperative adjuvant chemotherapy

• 作者: Keishi Yamashita Akira Ema Kei Hosoda Hiroaki Mieno Hiromitsu Moriya Natsuya Katada Masahiko Watanabe
• 来源期刊: 世界胃肠肿瘤学杂志：英文版（电子版）
• 学科: 医学
• 年，卷（期）: 2017,（4）
• 页码范围: 166-175
• 页数: 10页
• 分类号: R735.2

摘要

AIM To evaluate whether a high risk macroscopic appearance（Type Ⅳ and giant Type Ⅲ） is associated with a dismal prognosis after curative surgery, because its prognostic relevance remains elusive in pathological stage Ⅱ/Ⅲ（p Stage Ⅱ/Ⅲ） gastric cancer.METHODS One hundred and seventy-two advanced gastric cancer（defined as pT2 or beyond） patients with p Stage Ⅱ/Ⅲ who underwent curative surgery plus adjuvant S1 chemotherapy were evaluated, and the prognostic relevance of a high-risk macroscopic appearance was examined. RESULTS Advanced gastric cancers with a high-risk macroscopic appearance were retrospectively identified by preoperative recorded images. A high-risk macroscopic appearance showed a significantly worse relapse free survival（RFS）（35.7%） and overall survival（OS）（34%） than an average risk appearance（P = 0.0003 and P < 0.0001, respectively）. A high-risk macroscopic appearance was significantly associated with the 13th Japanese Gastric Cancer Association（JGCA） pT（P = 0.01）, but not with the 13th JGCA pN. On univariate analysis for RFS and OS, prognostic factors included 13th JGCA p Stage（P < 0.0001）and other clinicopathological factors including macroscopic appearance. A multivariate Cox proportional hazards model for univariate prognostic factors identified highrisk macroscopic appearance（P = 0.036, HR = 2.29 for RFS and P = 0.021, HR = 2.74 for OS） as an independent prognostic indicator. CONCLUSION A high-risk macroscopic appearance was associated with a poor prognosis, and it could be a prognostic factor independent of 13th JGCA stage in p Stage Ⅱ/Ⅲ advanced gastric cancer.