Clinical significance of primary tumor score determined by tumor depth and size in patients with resectable gastric cancer
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Naoto Haraguchi1,*, Takaaki Arigami2,*, Yoshikazu Uenosono1, Shigehiro Yanagita1, Yasuto Uchikado1, Shinichiro Mori1, Hiroshi Kurahara1, Yuko Kijima1, Akihiro Nakajo1, Kosei Maemura1, Sumiya Ishigami1 and Shoji Natsugoe1,2
1Department of Digestive Surgery, Breast and Thyroid Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
2Onco-biological Surgery, Kagoshima University Graduate School of Medical and Dental Sciences, Kagoshima, Japan
*These authors contributed equally to this work
Takaaki Arigami, email: email@example.com
Keywords: primary tumor score; tumor size; depth of tumor invasion; prognostic factor; gastric cancer
Received: September 11, 2017 Accepted: November 16, 2017 Published: January 04, 2018
Although postoperative management of gastric cancer is determined by pathological stage based on the tumor-node-metastasis classification, predicting disease recurrence and prognosis in patients undergoing gastrectomy is clinically difficult. We investigated the depth of tumor invasion and tumor size in resected specimens from patients with gastric cancer and assessed the clinical utility of primary tumor score (PTS) calculated by tumor depth and size as a prognostic marker. We classified 247 patients with gastric cancer into three groups based on cut-off values for deeper tumor invasion (pT2–T4) and larger tumor size (≥ 45 mm) as a PTS of 2 (both abnormalities), 1 (one abnormality), or 0 (neither abnormality). PTS correlated significantly with lymph node metastasis, lymphovascular invasion, and stage (P < 0.0001 each). Survival differences among groups based on PTS were significant (P < 0.0001). Multivariate analysis identified PTS alone as an independent prognostic factor (P = 0.0363). PTS derived from primary tumor information alone is a potentially useful marker for predicting tumor progression and prognosis in postoperative patients with gastric cancer.
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