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Pathology and ploidy in the prognosis of gastric cancer with no extranodal metastasis
Author(s) -
Rugge Massimo,
Sonego Fulvia,
Panozzo Marina,
Baffa Raffale,
Rubio Juan,
Farinati Fabio,
Nitti Donato,
Ninfo Vito,
Ming SiChun
Publication year - 1994
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19940215)73:4<1127::aid-cncr2820730402>3.0.co;2-q
Subject(s) - medicine , stage (stratigraphy) , cancer , pathology , lymph , metastasis , proportional hazards model , lymphovascular invasion , aneuploidy , oncology , biology , chromosome , paleontology , biochemistry , gene
Background . The prognostic relevance of morphology in advanced gastric cancer is well known. Data on tumor cell DNA content are still inadequate and contradictory. Methods . Morphologic parameters and DNA ploidy were evaluated in 76 gastric cancer patients with no extranodal metastases (Stage I, 10 cases; Stage II, 20 cases; and Stage III, 46 cases), using formalin‐fixed paraffin‐embedded tissue. All cases were followed for at least 6 years after surgery or until death. Results . Among the potential prognostic factors analyzed by Mantel‐Cox and generalized Wilcoxon statistics, male sex ( P = 0.02), cardiac location of neoplasia ( P = 0.02), deeper infiltration of the gastric wall ( P = 0.001), vascular neoplastic invasion ( P = 0.006), metastatic lymph nodes ( P = 0.001), pathologic stage ( P = 0.0001), and aneuploidy ( P = 0.01) were significantly associated with lower survival rate. Testing of all of the above‐mentioned variables by the Cox stepwise multiple regression model disclosed that factors independently associated with survival were stage ( P = 0.0001), ploidy ( P = 0.0006), and vascular carcinomatous invasion ( P = 0.01). Conclusions . In gastric cancer with no extranodal metastases, DNA ploidy was found to be the most significant prognostic parameter after pathologic stage.