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Published on: February 16, 2024
Clinical implication of serosal change in pathologic subserosa-limited gastric cancer
Joo Mee Kim1, Hun Jung, Jun Suh Lee
1Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Korea.
Background:
The aim of this study was to evaluate the clinical implication of serosal change in pathologic subserosa-limited gastric cancer based on a retrospective analysis.
Methods:
A total of 285 patients who were diagnosed with pathologically subserosa-limited gastric cancer were included. The patients were divided into two groups: the accordance group, with subserosa-limited cancer without macroscopic serosa change (n = 124); the discordance group, with subserosa-limited cancer showing macroscopic serosal change (n = 161).
Results:
Tumor size, number of metastatic lymph nodes, and pathologic N stage were significantly associated with macroscopic serosal change. Serosal change patients presented a higher recurrence rate compared with patients without serosal change (38.0 vs. 20.2% for the 5-year recurrence rate, P = 0.002), and peritoneal seeding presented frequently in serosal-change patients with significance (41.1%). Likewise, the overall survival of serosal-change patients was significantly worse than that for those without serosal change (66.9 vs. 81.4% for the 5-year survival rate, P = 0.002). Serosal change was an independent prognostic factor for overall survival (relative risk 1.784, P = 0.039).
Conclusions:
Serosal change in pathologic subserosa-limited gastric cancer is related to poor survival. Therefore, adjuvant chemotherapy should be considered for these patients, and adequate follow-up programs instituted for early detection of peritoneal seeding.
