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Predictive factors for recurrence in T2N0 and T3N0 gastric cancer patients

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Abstract

Purpose

Adjuvant chemotherapy is an indispensable component of treatment for preventing recurrence in advanced gastric cancer patients after macroscopically complete tumor resection (R0). However, the efficacy of this treatment for patients with T2N0 and T3N0 gastric cancer is not well characterized.

Methods

This study examined 1019 T1, 126 T2N0, and 67 T3N0 gastric adenocarcinoma patients who underwent gastrectomies at our institution between 1975 and 2005 to determine the predictive factors for recurrence in T2N0 and T3N0 gastric cancer patients.

Results

Among 193 T2N0 and T3N0 patients, 14 patients (7.3 %) have recurred. The prevalence of ly2/3 and v2/3 was significantly higher in patients with recurrence compared with those without recurrence. The prognosis for either T2N0 or T3N0 gastric cancer patients was significantly worse than that for T1 gastric cancer patients. Multivariate analysis indicated that lymphatic and blood vessel invasion were independent prognostic indicators in T2N0 and T3N0 gastric cancer patients. Ten-year survival rates for T2N0 and T3N0 gastric cancer patients with both ly2/3 and v2/3, with either ly2/3 or v2/3, and without ly2/3 and v2/3 were 42.9, 86.1, and 96.7 %, respectively. T2N0 and T3N0 gastric cancer patients with both ly2/3 and v2/3 had a significantly worse prognosis than that of patients with either ly2/3 or v2/3 and those without ly2/3 and v2/3.

Conclusions

Our data indicate that T2N0 and T3N0 patients with both ly2/3 and v2/3 have a high risk of recurrence. Therefore, adjuvant chemotherapy should be administered to these patients.

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References

  1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D (2011) Global cancer statistics. CA Cancer J Clin 61:69–90

    Article  PubMed  Google Scholar 

  2. Cunningham D, Allum WH, Stenning SP, Thompson JN, Van de Velde CJ, Nicolson M, Scarffe JH, Lofts FJ, Falk SJ, Iveson TJ, Smith DB, Langley RE, Verma M, Weeden S, Chua YJ, Participants MT (2006) Perioperative chemotherapy versus surgery alone for resectable gastroesophageal cancer. N Engl J Med 355:11–20

    Article  CAS  PubMed  Google Scholar 

  3. Nakajima T, Kinoshita T, Nashimoto A, Sairenji M, Yamaguchi T, Sakamoto J, Fujiya T, Inada T, Sasako M, Ohashi Y (2007) Randomized controlled trial of adjuvant uracil-tegafur versus surgery alone for serosa-negative, locally advanced gastric cancer. Br J Surg 94:1468–1476

    Article  CAS  PubMed  Google Scholar 

  4. Sakuramoto S, Sasako M, Yamaguchi T, Kinoshita T, Fujii M, Nashimoto A, Furukawa H, Nakajima T, Ohashi Y, Imamura H, Higashino M, Yamamura Y, Kurita A, Arai K (2007) Adjuvant chemotherapy for gastric cancer with S-1, an oral fluoropyrimidine. N Engl J Med 357:1810–1820

    Article  CAS  PubMed  Google Scholar 

  5. Japanese Gastric Cancer Association (2011) Japanese gastric cancer treatment guidelines 2010 (ver. 3). Gastric Cancer : Off J Int Gastric Cancer Assoc Jpn Gastric Cancer Assoc 14:113–123

    Article  Google Scholar 

  6. Bang YJ, Kim YW, Yang HK, Chung HC, Park YK, Lee KH, Lee KW, Kim YH, Noh SI, Cho JY, Mok YJ, Kim YH, Ji J, Yeh TS, Button P, Sirzen F, Noh SH (2012) Adjuvant capecitabine and oxaliplatin for gastric cancer after D2 gastrectomy (CLASSIC): a phase 3 open-label, randomised controlled trial. Lancet 379:315–321

    Article  CAS  PubMed  Google Scholar 

  7. Japanese Gastric Cancer Association (2011) Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer : Off J Int Gastric Cancer Assoc Jpn Gastric Cancer Assoc 14:101–112

    Article  Google Scholar 

  8. Kim JW, Hwang I, Kim MJ, Jang SJ (2009) Clinicopathological characteristics and predictive markers of early gastric cancer with recurrence. J Korean Med Sci 24:1158–1164

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  9. Folli S, Dente M, Dell'Amore D, Gaudio M, Nanni O, Saragoni L, Vio A (1995) Early gastric cancer: prognostic factors in 223 patients. Br J Surg 82:952–956

    Article  CAS  PubMed  Google Scholar 

  10. Lawrence M, Shiu MH (1991) Early gastric cancer. Twenty-eight-year experience. Ann Surg 213:327–334

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  11. Japanese Gastric Cancer Association (1998) Japanese classification of gastric carcinoma—2nd English edition. Gastric Cancer : Off J Int Gastric Cancer Assoc Jpn Gastric Cancer Assoc 1:10–24

    Article  Google Scholar 

  12. Le Voyer TE, Sigurdson ER, Hanlon AL, Mayer RJ, Macdonald JS, Catalano PJ, Haller DG (2003) Colon Cancer survival is associated with increasing number of lymph nodes analyzed: a secondary survey of intergroup trial INT-0089. J Clin Oncol 21:2912–2919

    Article  CAS  PubMed  Google Scholar 

  13. Hyung WJ, Lee JH, Choi SH, Min JS, Noh SH (2002) Prognostic impact of lymphatic and/or blood vessel invasion in patients with node-negative advanced gastric cancer. Ann Surg Oncol 9:562–567

    Article  PubMed  Google Scholar 

  14. Borie F, Millat B, Fingerhut A, Hay JM, Fagniez PL, De Saxce B (2000) Lymphatic involvement in early gastric cancer: prevalence and prognosis in France. Arch Surg (Chicago, Ill : 1960) 135:1218–1223

    Article  CAS  Google Scholar 

  15. Imamura T, Komatsu S, Ichikawa D, Kubota T, Okamoto K, Konishi H, Shiozaki A, Fujiwara H, Morimura R, Murayama Y, Kuriu Y, Ikoma H, Nakanishi M, Sakakura C, Otsuji E (2015) Poor prognostic subgroup in T3N0 stage IIA gastric cancer, suggesting an indication for adjuvant chemotherapy. J Surg Oncol 111:221–225

    Article  PubMed  Google Scholar 

  16. Du C, Zhou Y, Huang K, Zhao G, Fu H, Shi Y (2011) Defining a high-risk subgroup of pathological T2N0 gastric cancer by prognostic risk stratification for adjuvant therapy. J Gastrointest Surg: Off J Soc Surg Aliment Tract 15:2153–2158

    Article  Google Scholar 

  17. Du C, Zhou Y, Cai H, Zhao G, Fu H, Shi YQ (2012) Poor prognostic factors in patients with stage I gastric cancer according to the seventh edition TNM classification: a comparative analysis of three subgroups. J Surg Oncol 105:323–328

    Article  PubMed  Google Scholar 

  18. CY D, Chen JG, Zhou Y, Zhao GF, Fu H, Zhou XK, Shi YQ (2012) Impact of lymphatic and/or blood vessel invasion in stage II gastric cancer. World J Gastroenterol 18:3610–3616

    Article  Google Scholar 

  19. Tianhang L, Guoen F, Jianwei B, Liye M (2008) The effect of perineural invasion on overall survival in patients with gastric carcinoma. J Gastrointest Surg: Off J Soc Surg Aliment Trac 12:1263–1267

    Article  Google Scholar 

  20. Bilici A, Seker M, Ustaalioglu BB, Kefeli U, Yildirim E, Yavuzer D, Aydin FM, Salepci T, Oncel M, Gumus M (2010) Prognostic significance of perineural invasion in patients with gastric cancer who underwent curative resection. Ann Surg Oncol 17:2037–2044

    Article  PubMed  Google Scholar 

  21. Yokoyama T, Kamada K, Tsurui Y, Kashizuka H, Okano E, Ogawa S, Obara S, Tatsumi M (2011) Clinicopathological analysis for recurrence of stage Ib gastric cancer (according to the second English edition of the Japanese classification of gastric carcinoma). Gastric Cancer: Off J Int Gastric Cancer Assoc Jpn Gastric Cancer Assoc 14:372–377

    Article  Google Scholar 

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Authors and Affiliations

  1. Department of Surgery, Division of Surgical Oncology, Tottori University School of Medicine, 36-1 Nishi-cho, Yonago, 683-8504, Japan

    Hiroaki Saito, Yuki Murakami, Kozo Miyatani, Hirohiko Kuroda, Tomoyuki Matsunaga, Yoji Fukumoto, Tomohiro Osaki & Masahide Ikeguchi

Authors
  1. Hiroaki Saito
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  2. Yuki Murakami
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  3. Kozo Miyatani
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  4. Hirohiko Kuroda
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  5. Tomoyuki Matsunaga
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  6. Yoji Fukumoto
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  7. Tomohiro Osaki
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  8. Masahide Ikeguchi
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Correspondence to Hiroaki Saito.

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The authors declare that they have no conflict of interest.

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Saito, H., Murakami, Y., Miyatani, K. et al. Predictive factors for recurrence in T2N0 and T3N0 gastric cancer patients. Langenbecks Arch Surg 401, 823–828 (2016). https://doi.org/10.1007/s00423-016-1480-6

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  • DOI: https://doi.org/10.1007/s00423-016-1480-6

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