Published in:
01-12-2011 | Original Article
Defining a High-Risk Subgroup of Pathological T2N0 Gastric Cancer by Prognostic Risk Stratification for Adjuvant Therapy
Published in: Journal of Gastrointestinal Surgery | Issue 12/2011
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Background
Adjuvant therapy is not usually recommended in AJCC T2N0M0 gastric cancer, yet sometimes is indicated for high-risk patients. The purpose of this study is to stratify the risk of pathological T2N0 gastric cancer after gastrectomy based on clinicopathological factors so as to predict prognosis and guide treatment.
Methods
We analyzed our documented clinical database of 233 patients with T2N0M0 gastric cancer who underwent radical resection between 2000 and 2007. No adjuvant chemotherapy was applied.
Results
For the entire study group, the overall 5-year survival rate was 88.5%. Multivariate analysis indicated there were three tumor characteristics which were independent prognostic factors: lymphatic and/or blood vessel invasion (p = 0.025), tumor diameter (p = 0.004), and perineural invasion (p = 0.009). Three risk groups were created based on weighted variables with overall 5-year survival of 97.7%, 83%, and 50.3% as low-risk, intermediate-risk, and high-risk groups, respectively (p < 0.001).
Conclusion
Patients with T2N0 gastric cancer have a favorable prognosis after radical resection. A prognostic risk model of patients with pT2N0 gastric cancer undergoing radical resection is constructed based on lymphatic and/or blood vessel invasion, tumor diameter, and perineural invasion. The prognostic risk model identifies a small subgroup of patients with an increased risk of death, suggesting adjuvant therapy may be considered for these patients.