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Risk stratification for serosal invasion using preoperative predictors in patients with advanced gastric cancer.

Park SS, Min JS, Lee KJ, Jin SH, Park S, Bang HY, Yu HJ, Lee JI - J Gastric Cancer (2012)

Bottom Line: We retrospectively analyzed clinicopathological features of 3,529 advanced gastric cancer patients with Borrmann type I/II/III who underwent gastrectomy at Korea Cancer Center Hospital between 1991 and 2005.Patients were subdivided into 12 subgroups in combination of Borrmann type, size, and histology.A subgroup with Borrmann type II, large size (≥7 cm), and undifferentiated histology and 2 subgroups with Borrmann type III, large size, and regardless of histology belonged to high-risk group and corresponded to 25% of eligible patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.

ABSTRACT

Purpose: Although serosal invasion is a critical predisposing factor for peritoneal dissemination in advanced gastric cancer, the accuracy of preoperative assessment using routine imaging studies is unsatisfactory. This study was conducted to identify high-risk group for serosal invasion using preoperative factors in patients with advanced gastric cancer.

Materials and methods: We retrospectively analyzed clinicopathological features of 3,529 advanced gastric cancer patients with Borrmann type I/II/III who underwent gastrectomy at Korea Cancer Center Hospital between 1991 and 2005. We stratified patients into low- (≤40%), intermediate- (40~70%), and high-risk (>70%) groups, according to the probability of serosal invasion.

Results: Borrmann type, size, longitudinal and circumferential location, and histology of tumors were independent risk factors for serosal invasion. Most tumors of whole stomach location or encircling type had serosal invasion, so they belonged to high-risk group. Patients were subdivided into 12 subgroups in combination of Borrmann type, size, and histology. A subgroup with Borrmann type II, large size (≥7 cm), and undifferentiated histology and 2 subgroups with Borrmann type III, large size, and regardless of histology belonged to high-risk group and corresponded to 25% of eligible patients.

Conclusions: This study have documented high-risk group for serosal invasion using preoperative predictors. And risk stratification for serosal invasion through the combination with imaging studies may collaboratively improve the accuracy of preoperative assessment, reduce the number of eligible patients for further staging laparoscopy, and optimize therapeutic strategy for each individual patient prior to surgery.

No MeSH data available.


Related in: MedlinePlus

Overall survival curves for low-, intermediate- and high-risk groups of serosal invasion in patients with advanced gastric cancer.
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Figure 2: Overall survival curves for low-, intermediate- and high-risk groups of serosal invasion in patients with advanced gastric cancer.

Mentions: Each group was classified into the following; low-risk, intermediate-risk, and high-risk groups according to the positive rate of serosal invasion ≤40%, 40~70%, and >70%, respectively (Fig. 1). The serosal invasion rate was shown to be 21~32% in the group with tumor size <7 cm and Borrmann I type, corresponding to the low risk group. Meanwhile, it was shown to be 84~87% in the group with tumor size ≥7 cm and Borrmann III type and group with tumor size ≥7 cm, Borrmann II type, and undifferentiated type, which corresponded to the high risk group. The classification of serosal invasion risk showed that 25% of the total patients corresponded to the high risk group. In addition, when the overall survival curve was compared via the comparison of prognosis among the three groups, a poor prognosis was shown in the high risk, intermediate risk, and low risk groups, in that order (Fig. 2).


Risk stratification for serosal invasion using preoperative predictors in patients with advanced gastric cancer.

Park SS, Min JS, Lee KJ, Jin SH, Park S, Bang HY, Yu HJ, Lee JI - J Gastric Cancer (2012)

Overall survival curves for low-, intermediate- and high-risk groups of serosal invasion in patients with advanced gastric cancer.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3473221&req=5

Figure 2: Overall survival curves for low-, intermediate- and high-risk groups of serosal invasion in patients with advanced gastric cancer.
Mentions: Each group was classified into the following; low-risk, intermediate-risk, and high-risk groups according to the positive rate of serosal invasion ≤40%, 40~70%, and >70%, respectively (Fig. 1). The serosal invasion rate was shown to be 21~32% in the group with tumor size <7 cm and Borrmann I type, corresponding to the low risk group. Meanwhile, it was shown to be 84~87% in the group with tumor size ≥7 cm and Borrmann III type and group with tumor size ≥7 cm, Borrmann II type, and undifferentiated type, which corresponded to the high risk group. The classification of serosal invasion risk showed that 25% of the total patients corresponded to the high risk group. In addition, when the overall survival curve was compared via the comparison of prognosis among the three groups, a poor prognosis was shown in the high risk, intermediate risk, and low risk groups, in that order (Fig. 2).

Bottom Line: We retrospectively analyzed clinicopathological features of 3,529 advanced gastric cancer patients with Borrmann type I/II/III who underwent gastrectomy at Korea Cancer Center Hospital between 1991 and 2005.Patients were subdivided into 12 subgroups in combination of Borrmann type, size, and histology.A subgroup with Borrmann type II, large size (≥7 cm), and undifferentiated histology and 2 subgroups with Borrmann type III, large size, and regardless of histology belonged to high-risk group and corresponded to 25% of eligible patients.

View Article: PubMed Central - PubMed

Affiliation: Department of Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences, Seoul, Korea.

ABSTRACT

Purpose: Although serosal invasion is a critical predisposing factor for peritoneal dissemination in advanced gastric cancer, the accuracy of preoperative assessment using routine imaging studies is unsatisfactory. This study was conducted to identify high-risk group for serosal invasion using preoperative factors in patients with advanced gastric cancer.

Materials and methods: We retrospectively analyzed clinicopathological features of 3,529 advanced gastric cancer patients with Borrmann type I/II/III who underwent gastrectomy at Korea Cancer Center Hospital between 1991 and 2005. We stratified patients into low- (≤40%), intermediate- (40~70%), and high-risk (>70%) groups, according to the probability of serosal invasion.

Results: Borrmann type, size, longitudinal and circumferential location, and histology of tumors were independent risk factors for serosal invasion. Most tumors of whole stomach location or encircling type had serosal invasion, so they belonged to high-risk group. Patients were subdivided into 12 subgroups in combination of Borrmann type, size, and histology. A subgroup with Borrmann type II, large size (≥7 cm), and undifferentiated histology and 2 subgroups with Borrmann type III, large size, and regardless of histology belonged to high-risk group and corresponded to 25% of eligible patients.

Conclusions: This study have documented high-risk group for serosal invasion using preoperative predictors. And risk stratification for serosal invasion through the combination with imaging studies may collaboratively improve the accuracy of preoperative assessment, reduce the number of eligible patients for further staging laparoscopy, and optimize therapeutic strategy for each individual patient prior to surgery.

No MeSH data available.


Related in: MedlinePlus