Prognostic Significance of Intraoperatively Estimated Surgical Stage in Curatively Resected Gastric Cancer Patients
Received 26 March 2009; received in revised form 30 May 2009; accepted 2 June 2009. published online 10 August 2009.
Background
The aim of this study was to assess the prognostic significance of intraoperatively estimated surgical stage (sStage) as a complementary role for pathologic stage (pStage) in gastric cancer.
Study Design
This was a retrospective study of 1,543 patients who underwent curative resection for gastric cancer. Clinicopathologic and therapeutic factors, including sStage, were analyzed for prognostic significance. Prognosis was stratified by sStage and pStage, and the prognoses of patients with an overestimated sStage were compared with those with a nonoverestimated sStage in the same pStage.
Results
Overall accuracy of sStage versus pStage was 39% (T stage, 73.0%; N stage, 43.5%). Survival curves were obviously stratified by sStage and pStage: Ia (97.5% versus 97.9%), Ib (94.3% versus 92.4%), II (89.6% versus 84.2%), IIIa (74.2% versus 69.3%), IIIb (54.4% versus 50.4%), and IV (55.6% versus 36.7%), respectively (p < 0.001). In addition to pStage, age and sStage were found to be significantly associated with overall survival by univariate and multivariate analysis. In pStages II, IIIa, and IIIb, intraoperatively overestimated patients had significantly poorer survival than nonoverestimated patients.
Conclusions
sStage should be considered as a complementary prognostic factor for pStage in gastric cancer after curative resection, especially in stages II and III patients.
aGastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea
bCancer Registration and Biostatistics Branch, Research Institute and Hospital, National Cancer Center, Goyang-si, Republic of Korea
Correspondence address: Keun Won Ryu, MD, Gastric Cancer Branch, Research Institute and Hospital, National Cancer Center, Korea, 111 Jungbalsan-ro, Ilsandong-gu, Goyang-si, Gyeonggi-do, 410-769, Republic of Korea
ABSTRACT