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Preoperative tumor size is a critical prognostic factor for patients with Borrmann type III gastric cancer

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Abstract

Purpose

This study was designed to clarify whether preoperative tumor size is an independent prognostic factor (IPF) for patients with Borrmann type III gastric cancer.

Methods

The study group comprised 350 patients with Borrmann type III gastric cancer. We performed a log-rank plot analysis to establish the threshold value of preoperative tumor size for the prediction of overall survival (OS). Factors with P < 0.10 on univariate prognostic analyses for OS were put into a Cox’s proportional hazards model to identify the IPFs.

Results

Peritoneal lavage cytology (CY) was the strongest IPF for patients with Borrmann type III gastric cancer (P < 0.0001). We were able to measure the tumor size preoperatively in 135 patients with negative CY results (CY0). The cutoff tumor size for the prediction of OS was 5.3 cm. A Cox’s proportional hazards model showed that pathological lymph-node metastasis (P = 0.007) and preoperative tumor size (P = 0.018) were significant IPFs in the CY0 patients. Patients with a preoperative tumor size of <5.3 cm had satisfactory outcomes, with a 5-year OS rate of >80 %.

Conclusions

Preoperative tumor size is an IPF for patients with Borrmann type III gastric cancer and CY0. Thus, preoperative tumor size may be a useful factor for deciding on whether neoadjuvant chemotherapy is indicated.

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Conflict of interest

Keishi Yamashita, Natsuya Katada, Hiromitsu Moriya, Hiroaki Mieno, Shinichi Sakuramoto, Shiro Kikuchi, Masahiko Watanabe, and Kei Hosoda have no conflicts of interest or financial ties to disclose for the present study.

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Authors and Affiliations

  1. Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan

    Kei Hosoda, Keishi Yamashita, Natsuya Katada, Hiromitsu Moriya, Hiroaki Mieno, Shiro Kikuchi & Masahiko Watanabe

  2. Department of Gastrointestinal Surgery, Saitama Medical University International Medical Center, Yamane 1387-1, Hidaka, Saitama, 350-1298, Japan

    Shinichi Sakuramoto

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  1. Kei Hosoda
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  2. Keishi Yamashita
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  3. Natsuya Katada
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  4. Hiromitsu Moriya
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  5. Hiroaki Mieno
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  6. Shinichi Sakuramoto
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  7. Shiro Kikuchi
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  8. Masahiko Watanabe
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Correspondence to Kei Hosoda.

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Hosoda, K., Yamashita, K., Katada, N. et al. Preoperative tumor size is a critical prognostic factor for patients with Borrmann type III gastric cancer. Surg Today 45, 68–77 (2015). https://doi.org/10.1007/s00595-014-1060-8

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  • DOI: https://doi.org/10.1007/s00595-014-1060-8

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