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

Content Provider	Springer Nature : BioMed Central
Author	Yura, Masahiro Yoshikawa, Takaki Wada, Takeyuki Otsuki, Sho Hayashi, Tsutomu Yamagata, Yukinori Katai, Hitoshi Nishida, Toshirou
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 < 0.001), nodal status (HR:5.783, 95% CI 3.985–8.391, p < 0.001) and age (HR:2.382, 95%CI: 1.918–2.957, p < 0.001). Peritoneal recurrence rates were higher in the MSC-positive cases than in the MSC-negative cases at each pT stage. Conclusions In this study, the MSC was one of the independent prognostic factors in patients with resectable locally advanced gastric cancer.
Related Links	https://bmccancer.biomedcentral.com/counter/pdf/10.1186/s12885-021-08767-8.pdf
Ending Page	9
Page Count	9
Starting Page	1
File Format	HTM / HTML
ISSN	14712407
DOI	10.1186/s12885-021-08767-8
Journal	BMC Cancer
Issue Number	1
Volume Number	21
Language	English
Publisher	BioMed Central
Publisher Date	2021-09-25
Access Restriction	Open
Subject Keyword	Cancer Research Oncology Surgical Oncology Health Promotion and Disease Prevention Biomedicine Medicine Public Health Macroscopic serosal change Gastric cancer Prognostic factor Medicine/Public Health
Content Type	Text
Resource Type	Article
Subject	Cancer Research Oncology Genetics
Journal Impact Factor	3.4/2023
5-Year Journal Impact Factor	3.8/2023

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