Tumor size as a prognostic factor in patients with node-negative gastric cancer invading the muscularis propria and subserosa (pT2-3N0M0 stage).

BACKGROUND/AIMS: To explore the impact of tumor size on outcomes in patients with pT2-3N0M0 stage.

METHODOLOGY: ROC curve analysis was used to determine the appropriate cut-off value for tumor size in 115 patients of pT2-3N0M0 stage gastric cancer. Based on this cut-off value, patients were divided into two groups. The five-year overall survival (OS) rates in the two groups were compared according to the independent prognostic factors.

RESULTS: Using this cut-off value of 3.7cm, 62 patients had large-sized tumors (LSTs, tumor size >3.7cm) and 53 had small-sized tumors (SSTs, tumor size <3.7cm). Patients with LSTs had a significantly lower five-year OS rate than those with SSTs (60.7% vs. 88.4%, p=0.000). Depth of tumor invasion, histological type and tumor size were independent prognostic factors. In patients with pT2N0M0 stage tumors or pT2-3N0M0 stage patients with undifferentiated type tumors, five-year OS rates were significantly lower for LSTs than for SSTs (p<0.05 each).

CONCLUSIONS: Tumor size is a prognostic factor in patients with pT2-3N0M0 stage. Especially for pT2N0M0 stage gastric cancer and pT2-3N0M0 stage gastric cancer with undifferentiated type tumors, the prognosis was poorer in patients with tumor size >3.7cm than that in patients with tumor size <3.7cm.