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Aim . To investigate whether tumor size is a reasonable indication for adjuvant chemotherapy for T 3-4a N0M0 gastric cancer patients after D2 gastrectomy.  Method . We performed a retrospective study of 269 patients with a histological diagnosis of T 3-4a N0M0 stage gastric cancer who underwent D2 radical surgery at the Sun Yat-sen University Cancer Center or the Sixth Affiliated Hospital of Sun Yat-sen University between January 2006 and December 2010. The follow-up lasted until June of 2015. Chi-square tests and Kaplan-Meier methods were employed to compare the clinicopathological variables and prognoses.  Result . For this group of patients, univariate analyses revealed that tumor size ( p  < 0.001), pathological T stage ( p  < 0.001), and tumor location ( p  = 0.025) were significant prognostic factors. Adjuvant chemotherapy did not exhibit prognostic benefits. For patients with tumors larger than 5 cm, univariate analysis revealed that tumor location ( p  = 0.007), Borrmann type ( p  = 0.039), postoperative chemotherapy ( p  = 0.003), and pathological T stage ( p  < 0.001) were significant prognostic factors. Multivariate analysis revealed that postoperative chemotherapy and pathological T stage were independent prognostic factors.  Conclusion . Our results imply that tumor size should be a critical factor in the decision to utilize adjuvant chemotherapy for T 3-4a N0M0 gastric cancer patients after D2 gastrectomy. Additional randomized controlled trials are required before this conclusion can be considered definitive.

Tumor Size Is a Critical Factor in Adjuvant Chemotherapy for T3-4aN0M0 Gastric Cancer Patients after D2 Gastrectomy

Tumor Size Is a Critical Factor in Adjuvant Chemotherapy for T_3-4aN0M0 Gastric Cancer Patients after D2 Gastrectomy