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Tumor size predicts survival in mucinous gastric carcinoma
Author(s) -
Sung Chang Ohk,
Lee Sun Mi,
Choi Jong Sun,
Kim KyoungMee,
Choi MinGew,
Noh Jae Hyung,
Sohn Tae Sung,
Bae Jae Moon,
Kim Woo Ho,
Park CheolKeun,
Kim Sung
Publication year - 2012
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.23141
Subject(s) - medicine , histology , univariate analysis , multivariate analysis , immunohistochemistry , gastric carcinoma , lymph node , cancer , proportional hazards model , lymph node metastasis , oncology , gastroenterology , metastasis , pathology
Background Mucinous gastric carcinoma (MGC) is a distinct histologic subtype of gastric cancer. However, the prognostic significances of the current TNM staging system and histology in MGC have not been studied. Methods 206 patients who underwent R0 resection for MGC were classified by tumor size (<3 cm as T1; ≥3–5 cm as T2; ≥5–9 cm as T3; and ≥9 cm as T4). Immunohistochemistry for EGFR and HER2 was also performed. Results Tumor sizes ranged from 1.2 to 21.0 cm (median 6.2 cm). Large tumor size (≥5 cm) was significantly associated with older patient age, deeper invasion depth, and more frequent lymph node metastasis ( P < 0.05). Tumor size was a significant prognostic factor in both univariate ( P < 0.001) and multivariate ( P < 0.04) analyses. However, depth of invasion was not significant in multivariate analyses. A modified staging system based on tumor size predicted survival more accurately than did the conventional TNM staging system. We verified our results in an independent validation cohort of 123 MGC patients. Overexpression of either EGFR or HER2 was rare. Conclusions In MGCs, tumor size is an independent prognostic factor and a modified TNM system based on tumor size predicted survival accurately. J. Surg. Oncol. 2012; 106:757–764. © 2012 Wiley Periodicals, Inc.