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A new staging system based on tumor volume in gastric cancer
S Kikuchi1, S Sakuramoto, N Kobayashi
1Department of Surgery, School of Medicine, Kitasato University, Sagamihara-shi, Kanagawa, Japan.
Background:
Development of a more appropriate staging system for gastric cancer may prove useful in clinical practice.
Materials And Methods:
A total of 171 patients with solitary carcinoma of the stomach (112 males and 59 females; age range, 20 to 84 years; mean, 57.7 years) who underwent curative surgery were examined. The volume of each tumor was measured from serial tumor tissue sections using a computer software program. The utility of a new staging system based on tumor volume was assessed with respect to patient survival in comparison with other clinicopathological factors and conventional staging.
Results:
Significant differences in survival time were found for depth of invasion (T1 vs T2 or T3; p=0.008), nodal status (n0 vs n1 or n2; p=0.032), tumor volume (< or = 2,000 mm vs >2,000 mm3; p<0.001) and stage (stage I vs stage II, III or IV; p =0. 003). However, multivariate analysis only identified tumor volume as a significant prognostic factor in the present study (p <0.001; relative risk 10.351).
Conclusion:
The above findings suggest that a new staging system based on tumor volume may have advantages over the conventional staging system in the assessment of gastric cancer.