Stage-Stratified Analysis of Prognostic Significance of Tumor Size in Patients with Gastric Cancer

BackgroundThe prognostic significance of tumor size in gastric cancer is not well defined. The objective of this study was to identify the prognostic value of tumor size in patients with gastric cancer. MethodsWe retrospectively reviewed a total of 1800 patients with gastric cancer admitted to our hospital between 1997 and 2007. These patients were divided into two groups according to tumor size: small size group (SSG, tumor ≤5 cm) and large size group (LSG, tumor >5 cm). We compared clinico-pathologic features of the two groups and investigated the prognostic factors by performing univariate, multivariate, and stage- stratified analyses according to tumor size. ResultsLSG had more aggressive clinico-pathologic features than SSG. Tumor size was an independent prognostic indicator in patients with gastric cancer. In a stratified-pT, pN, and pTNM analysis, survival of patients with LSG was significantly worse than that of patients with SSG and advanced stage. Tumor size was not a significant predictor of survival in patients with early stage tumors. Large tumor size was associated with shorter survival in patients with stages N0, N1, N2, and N3, and stages I, II, III, and IV. ConclusionsTumor size is a simple and practical prognostic factor in patients with gastric cancer. Tumor size could supplement clinical staging in the future.背景 胃癌肿瘤大小的预后意义尚未明确。本研究旨在明确肿瘤大小在胃癌患者中的预后价值。方法 本研究回顾性分析了1997年至2007年于本院收治的1800例胃癌患者。根据肿瘤大小将患者分为两组：小瘤组（SSG，肿瘤≤5 cm）与大瘤组（LSG，肿瘤＞5 cm）。比较两组的临床病理特征，并根据肿瘤大小分别开展单因素、多因素及分期分层分析，以探究预后影响因素。结果 大瘤组的临床病理侵袭性特征较小瘤组更为显著。肿瘤大小是胃癌患者的独立预后指标。在pT、pN及pTNM分层分析中，大瘤组患者的生存期显著差于小瘤组及晚期肿瘤患者。在早期肿瘤患者中，肿瘤大小并非生存的显著预测因子。在N0、N1、N2、N3分期以及I、II、III、IV期患者中，大肿瘤体积均与更短的生存期相关。结论 肿瘤大小是胃癌患者一项简便实用的预后因子，未来可用于补充临床分期体系。