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Prognostic significance of perinodal extension in gastric cancer
Author(s) -
Choi Won Hyuk,
Kim Sungsoo,
Shen Jiayun,
Cheong Jae Ho,
Hyung Woo Jin,
Kim Yong Il,
Choi Seung Ho,
Noh Sung Hoon,
Park Chan Il
Publication year - 2007
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20734
Subject(s) - medicine , metastasis , cancer , stage (stratigraphy) , gastrectomy , incidence (geometry) , surgery , optics , biology , paleontology , physics
Background The grouping of patients who have a poor prognosis is important in determining a treatment strategy. The aim of this study was to investigate the clinicopathologic features and prognosis in patients with perinodal extension, with a focus on the difference of survival between homogenous groups. Methods This study included a total of 1,092 patients who underwent curative gastrectomy for gastric adenocarcinoma from 1997 to 2004 at the Department of Surgery, Yongdong Severance Hospital, Yonsei University College of Medicine. Results One hundred sixty‐one patients had perinodal extension. The incidence of perinodal extension was positively correlated for T and N stages. Perinodal extension was identified as an independent prognostic factor and had more influence on survival than T and N stages. Patients who had nodal metastasis without serosal exposure and who had serosal exposure without nodal metastasis were selected as homogenous groups, and there was no difference of survival between these groups. However, when the nodal metastasis group was subdivided according to the perinodal extension, perinodal extension subgroup had significant poorer prognosis than no perinodal extension subgroup. Conclusions The perinodal extension was the most important independent prognostic factor in gastric cancer, and should be included in the TNM gastric cancer staging system. J. Surg. Oncol. 2007;95:540–545. © 2007 Wiley‐Liss, Inc.