Prognostic analysis of submucosa-invasive gastric cancer with lymph node metastasis
Background The aims of this study were to identify prognostic factors of patients with submucosa-invasive (T1b) gastric cancer and to verify the validity of adjuvant chemotherapy for this disease. Methods We retrospectively examined the cases of 1,236 consecutive patients in our prospectively mainta...
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| Veröffentlicht in: | Surgery 2015-04, Vol.157 (4), p.716-722 |
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| creator | Hanyu, Takaaki, MD, PhD Matsuki, Atsushi, MD, PhD Kosugi, Shin-ichi, MD, PhD Ishikawa, Takashi, MD, PhD Nashimoto, Atsushi, MD, PhD Yabusaki, Hiroshi, MD, PhD Aizawa, Masaki, MD, PhD Ichikawa, Hiroshi, MD, PhD Shimada, Yoshifumi, MD, PhD Hirose, Yuki, MD Wakai, Toshifumi, MD, PhD |
| description | Background The aims of this study were to identify prognostic factors of patients with submucosa-invasive (T1b) gastric cancer and to verify the validity of adjuvant chemotherapy for this disease. Methods We retrospectively examined the cases of 1,236 consecutive patients in our prospectively maintained database with T1b gastric cancer who underwent gastrectomy in 1995–2012. We used 11 clinicopathologic characteristics to identify prognostic factors by univariate and multivariate analyses. We compared the survival of the 160 node-positive T1b gastric cancer patients with that of 133 patients in the same database who had node-positive muscularis propria-invasive (T2) gastric cancer and had undergone gastrectomy without adjuvant chemotherapy during the same period, as a reference cohort. Results The 5-year overall survival rate was 91.4% for all 1,236 patients. Advanced age (hazard ratio [HR] 4.51; 95% confidence interval [CI] 3.26–6.24; P |
| doi_str_mv | 10.1016/j.surg.2014.10.009 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_1665495424</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0039606014007053</els_id><sourcerecordid>1665495424</sourcerecordid><originalsourceid>FETCH-LOGICAL-c411t-17cf8b64064acd40942769a0106340aa1ba47fef84ad732f0b2371942db763193</originalsourceid><addsrcrecordid>eNp9kc9q3DAQh0VpabZpX6CH4mMv3s5IsrSGUiih_yCQQpKzkGV5o61tbTX2hn2bPkuerDKb9tBDT4Lh-_3QfMPYa4Q1Aqp3uzXNabvmgDIP1gD1E7bCSvBSC4VP2QpA1KUCBWfsBdEOMiFx85yd8UoKoflmxW6-p7gdI03BFXa0_ZECFbEraG6G2UWyZRgPlsLBF1tLU8qYs6PzqbgP093Dr_447O-KMba-GPyUiczSS_assz35V4_vObv9_Onm4mt5efXl28XHy9JJxKlE7bpNoyQoaV0r8-e4VrUFBCUkWIuNlbrz3UbaVgveQcOFxky1jVYCa3HO3p569yn-nD1NZgjkfN_b0ceZDCpVybqSXGaUn1CXIlHyndmnMNh0NAhmsWl2ZrFpFpvLLLvKoTeP_dmGb_9G_ujLwPsT4POWh-CTIRd81tOG5N1k2hj-3__hn7jrwxic7X_4o6ddnFM-Sd7DEDdgrpd7LudECaChEuI39vKcAg</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>1665495424</pqid></control><display><type>article</type><title>Prognostic analysis of submucosa-invasive gastric cancer with lymph node metastasis</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><creator>Hanyu, Takaaki, MD, PhD ; Matsuki, Atsushi, MD, PhD ; Kosugi, Shin-ichi, MD, PhD ; Ishikawa, Takashi, MD, PhD ; Nashimoto, Atsushi, MD, PhD ; Yabusaki, Hiroshi, MD, PhD ; Aizawa, Masaki, MD, PhD ; Ichikawa, Hiroshi, MD, PhD ; Shimada, Yoshifumi, MD, PhD ; Hirose, Yuki, MD ; Wakai, Toshifumi, MD, PhD</creator><creatorcontrib>Hanyu, Takaaki, MD, PhD ; Matsuki, Atsushi, MD, PhD ; Kosugi, Shin-ichi, MD, PhD ; Ishikawa, Takashi, MD, PhD ; Nashimoto, Atsushi, MD, PhD ; Yabusaki, Hiroshi, MD, PhD ; Aizawa, Masaki, MD, PhD ; Ichikawa, Hiroshi, MD, PhD ; Shimada, Yoshifumi, MD, PhD ; Hirose, Yuki, MD ; Wakai, Toshifumi, MD, PhD</creatorcontrib><description>Background The aims of this study were to identify prognostic factors of patients with submucosa-invasive (T1b) gastric cancer and to verify the validity of adjuvant chemotherapy for this disease. Methods We retrospectively examined the cases of 1,236 consecutive patients in our prospectively maintained database with T1b gastric cancer who underwent gastrectomy in 1995–2012. We used 11 clinicopathologic characteristics to identify prognostic factors by univariate and multivariate analyses. We compared the survival of the 160 node-positive T1b gastric cancer patients with that of 133 patients in the same database who had node-positive muscularis propria-invasive (T2) gastric cancer and had undergone gastrectomy without adjuvant chemotherapy during the same period, as a reference cohort. Results The 5-year overall survival rate was 91.4% for all 1,236 patients. Advanced age (hazard ratio [HR] 4.51; 95% confidence interval [CI] 3.26–6.24; P < .01), male sex (HR 2.26; 95% CI 1.56–3.26; P < .01), and the presence of lymph node metastasis (HR 1.89; 95% CI 1.33–2.70; P < .01) were independent prognostic factors. The 5-year overall survival rates were 92.5% in node-negative patients, 84.5% in patients with 1 or 2 metastatic nodes, and 80.1% in patients with 3 or more metastatic nodes ( P < .01). The 5-year overall survival rates of the node-positive T1b and T2 gastric cancer patients were 83.6% and 81.2%, respectively ( P = .73). Conclusion The prognosis of node-positive T1b gastric cancer patients after curative gastrectomy was unsatisfactory. Adjuvant chemotherapy should be considered for these patients, especially those with 3 or more metastatic nodes.</description><identifier>ISSN: 0039-6060</identifier><identifier>EISSN: 1532-7361</identifier><identifier>DOI: 10.1016/j.surg.2014.10.009</identifier><identifier>PMID: 25433728</identifier><language>eng</language><publisher>United States: Elsevier Inc</publisher><subject>Adult ; Aged ; Aged, 80 and over ; Antineoplastic Agents - therapeutic use ; Chemotherapy, Adjuvant ; Female ; Gastrectomy ; Gastric Mucosa - pathology ; Gastric Mucosa - surgery ; Humans ; Logistic Models ; Lymphatic Metastasis ; Male ; Middle Aged ; Neoplasm Invasiveness ; Neoplasm Staging ; Prognosis ; Retrospective Studies ; Stomach Neoplasms - drug therapy ; Stomach Neoplasms - mortality ; Stomach Neoplasms - pathology ; Stomach Neoplasms - surgery ; Surgery ; Survival Rate ; Treatment Outcome</subject><ispartof>Surgery, 2015-04, Vol.157 (4), p.716-722</ispartof><rights>Elsevier Inc.</rights><rights>2015 Elsevier Inc.</rights><rights>Copyright © 2015 Elsevier Inc. All rights reserved.</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c411t-17cf8b64064acd40942769a0106340aa1ba47fef84ad732f0b2371942db763193</citedby><cites>FETCH-LOGICAL-c411t-17cf8b64064acd40942769a0106340aa1ba47fef84ad732f0b2371942db763193</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktohtml>$$Uhttps://www.sciencedirect.com/science/article/pii/S0039606014007053$$EHTML$$P50$$Gelsevier$$H</linktohtml><link.rule.ids>314,776,780,3537,27901,27902,65306</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/25433728$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Hanyu, Takaaki, MD, PhD</creatorcontrib><creatorcontrib>Matsuki, Atsushi, MD, PhD</creatorcontrib><creatorcontrib>Kosugi, Shin-ichi, MD, PhD</creatorcontrib><creatorcontrib>Ishikawa, Takashi, MD, PhD</creatorcontrib><creatorcontrib>Nashimoto, Atsushi, MD, PhD</creatorcontrib><creatorcontrib>Yabusaki, Hiroshi, MD, PhD</creatorcontrib><creatorcontrib>Aizawa, Masaki, MD, PhD</creatorcontrib><creatorcontrib>Ichikawa, Hiroshi, MD, PhD</creatorcontrib><creatorcontrib>Shimada, Yoshifumi, MD, PhD</creatorcontrib><creatorcontrib>Hirose, Yuki, MD</creatorcontrib><creatorcontrib>Wakai, Toshifumi, MD, PhD</creatorcontrib><title>Prognostic analysis of submucosa-invasive gastric cancer with lymph node metastasis</title><title>Surgery</title><addtitle>Surgery</addtitle><description>Background The aims of this study were to identify prognostic factors of patients with submucosa-invasive (T1b) gastric cancer and to verify the validity of adjuvant chemotherapy for this disease. Methods We retrospectively examined the cases of 1,236 consecutive patients in our prospectively maintained database with T1b gastric cancer who underwent gastrectomy in 1995–2012. We used 11 clinicopathologic characteristics to identify prognostic factors by univariate and multivariate analyses. We compared the survival of the 160 node-positive T1b gastric cancer patients with that of 133 patients in the same database who had node-positive muscularis propria-invasive (T2) gastric cancer and had undergone gastrectomy without adjuvant chemotherapy during the same period, as a reference cohort. Results The 5-year overall survival rate was 91.4% for all 1,236 patients. Advanced age (hazard ratio [HR] 4.51; 95% confidence interval [CI] 3.26–6.24; P < .01), male sex (HR 2.26; 95% CI 1.56–3.26; P < .01), and the presence of lymph node metastasis (HR 1.89; 95% CI 1.33–2.70; P < .01) were independent prognostic factors. The 5-year overall survival rates were 92.5% in node-negative patients, 84.5% in patients with 1 or 2 metastatic nodes, and 80.1% in patients with 3 or more metastatic nodes ( P < .01). The 5-year overall survival rates of the node-positive T1b and T2 gastric cancer patients were 83.6% and 81.2%, respectively ( P = .73). Conclusion The prognosis of node-positive T1b gastric cancer patients after curative gastrectomy was unsatisfactory. Adjuvant chemotherapy should be considered for these patients, especially those with 3 or more metastatic nodes.</description><subject>Adult</subject><subject>Aged</subject><subject>Aged, 80 and over</subject><subject>Antineoplastic Agents - therapeutic use</subject><subject>Chemotherapy, Adjuvant</subject><subject>Female</subject><subject>Gastrectomy</subject><subject>Gastric Mucosa - pathology</subject><subject>Gastric Mucosa - surgery</subject><subject>Humans</subject><subject>Logistic Models</subject><subject>Lymphatic Metastasis</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Neoplasm Invasiveness</subject><subject>Neoplasm Staging</subject><subject>Prognosis</subject><subject>Retrospective Studies</subject><subject>Stomach Neoplasms - drug therapy</subject><subject>Stomach Neoplasms - mortality</subject><subject>Stomach Neoplasms - pathology</subject><subject>Stomach Neoplasms - surgery</subject><subject>Surgery</subject><subject>Survival Rate</subject><subject>Treatment Outcome</subject><issn>0039-6060</issn><issn>1532-7361</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kc9q3DAQh0VpabZpX6CH4mMv3s5IsrSGUiih_yCQQpKzkGV5o61tbTX2hn2bPkuerDKb9tBDT4Lh-_3QfMPYa4Q1Aqp3uzXNabvmgDIP1gD1E7bCSvBSC4VP2QpA1KUCBWfsBdEOMiFx85yd8UoKoflmxW6-p7gdI03BFXa0_ZECFbEraG6G2UWyZRgPlsLBF1tLU8qYs6PzqbgP093Dr_447O-KMba-GPyUiczSS_assz35V4_vObv9_Onm4mt5efXl28XHy9JJxKlE7bpNoyQoaV0r8-e4VrUFBCUkWIuNlbrz3UbaVgveQcOFxky1jVYCa3HO3p569yn-nD1NZgjkfN_b0ceZDCpVybqSXGaUn1CXIlHyndmnMNh0NAhmsWl2ZrFpFpvLLLvKoTeP_dmGb_9G_ujLwPsT4POWh-CTIRd81tOG5N1k2hj-3__hn7jrwxic7X_4o6ddnFM-Sd7DEDdgrpd7LudECaChEuI39vKcAg</recordid><startdate>20150401</startdate><enddate>20150401</enddate><creator>Hanyu, Takaaki, MD, PhD</creator><creator>Matsuki, Atsushi, MD, PhD</creator><creator>Kosugi, Shin-ichi, MD, PhD</creator><creator>Ishikawa, Takashi, MD, PhD</creator><creator>Nashimoto, Atsushi, MD, PhD</creator><creator>Yabusaki, Hiroshi, MD, PhD</creator><creator>Aizawa, Masaki, MD, PhD</creator><creator>Ichikawa, Hiroshi, MD, PhD</creator><creator>Shimada, Yoshifumi, MD, PhD</creator><creator>Hirose, Yuki, MD</creator><creator>Wakai, Toshifumi, MD, PhD</creator><general>Elsevier Inc</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20150401</creationdate><title>Prognostic analysis of submucosa-invasive gastric cancer with lymph node metastasis</title><author>Hanyu, Takaaki, MD, PhD ; Matsuki, Atsushi, MD, PhD ; Kosugi, Shin-ichi, MD, PhD ; Ishikawa, Takashi, MD, PhD ; Nashimoto, Atsushi, MD, PhD ; Yabusaki, Hiroshi, MD, PhD ; Aizawa, Masaki, MD, PhD ; Ichikawa, Hiroshi, MD, PhD ; Shimada, Yoshifumi, MD, PhD ; Hirose, Yuki, MD ; Wakai, Toshifumi, MD, PhD</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c411t-17cf8b64064acd40942769a0106340aa1ba47fef84ad732f0b2371942db763193</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Adult</topic><topic>Aged</topic><topic>Aged, 80 and over</topic><topic>Antineoplastic Agents - therapeutic use</topic><topic>Chemotherapy, Adjuvant</topic><topic>Female</topic><topic>Gastrectomy</topic><topic>Gastric Mucosa - pathology</topic><topic>Gastric Mucosa - surgery</topic><topic>Humans</topic><topic>Logistic Models</topic><topic>Lymphatic Metastasis</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Neoplasm Invasiveness</topic><topic>Neoplasm Staging</topic><topic>Prognosis</topic><topic>Retrospective Studies</topic><topic>Stomach Neoplasms - drug therapy</topic><topic>Stomach Neoplasms - mortality</topic><topic>Stomach Neoplasms - pathology</topic><topic>Stomach Neoplasms - surgery</topic><topic>Surgery</topic><topic>Survival Rate</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Hanyu, Takaaki, MD, PhD</creatorcontrib><creatorcontrib>Matsuki, Atsushi, MD, PhD</creatorcontrib><creatorcontrib>Kosugi, Shin-ichi, MD, PhD</creatorcontrib><creatorcontrib>Ishikawa, Takashi, MD, PhD</creatorcontrib><creatorcontrib>Nashimoto, Atsushi, MD, PhD</creatorcontrib><creatorcontrib>Yabusaki, Hiroshi, MD, PhD</creatorcontrib><creatorcontrib>Aizawa, Masaki, MD, PhD</creatorcontrib><creatorcontrib>Ichikawa, Hiroshi, MD, PhD</creatorcontrib><creatorcontrib>Shimada, Yoshifumi, MD, PhD</creatorcontrib><creatorcontrib>Hirose, Yuki, MD</creatorcontrib><creatorcontrib>Wakai, Toshifumi, MD, PhD</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Hanyu, Takaaki, MD, PhD</au><au>Matsuki, Atsushi, MD, PhD</au><au>Kosugi, Shin-ichi, MD, PhD</au><au>Ishikawa, Takashi, MD, PhD</au><au>Nashimoto, Atsushi, MD, PhD</au><au>Yabusaki, Hiroshi, MD, PhD</au><au>Aizawa, Masaki, MD, PhD</au><au>Ichikawa, Hiroshi, MD, PhD</au><au>Shimada, Yoshifumi, MD, PhD</au><au>Hirose, Yuki, MD</au><au>Wakai, Toshifumi, MD, PhD</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Prognostic analysis of submucosa-invasive gastric cancer with lymph node metastasis</atitle><jtitle>Surgery</jtitle><addtitle>Surgery</addtitle><date>2015-04-01</date><risdate>2015</risdate><volume>157</volume><issue>4</issue><spage>716</spage><epage>722</epage><pages>716-722</pages><issn>0039-6060</issn><eissn>1532-7361</eissn><abstract>Background The aims of this study were to identify prognostic factors of patients with submucosa-invasive (T1b) gastric cancer and to verify the validity of adjuvant chemotherapy for this disease. Methods We retrospectively examined the cases of 1,236 consecutive patients in our prospectively maintained database with T1b gastric cancer who underwent gastrectomy in 1995–2012. We used 11 clinicopathologic characteristics to identify prognostic factors by univariate and multivariate analyses. We compared the survival of the 160 node-positive T1b gastric cancer patients with that of 133 patients in the same database who had node-positive muscularis propria-invasive (T2) gastric cancer and had undergone gastrectomy without adjuvant chemotherapy during the same period, as a reference cohort. Results The 5-year overall survival rate was 91.4% for all 1,236 patients. Advanced age (hazard ratio [HR] 4.51; 95% confidence interval [CI] 3.26–6.24; P < .01), male sex (HR 2.26; 95% CI 1.56–3.26; P < .01), and the presence of lymph node metastasis (HR 1.89; 95% CI 1.33–2.70; P < .01) were independent prognostic factors. The 5-year overall survival rates were 92.5% in node-negative patients, 84.5% in patients with 1 or 2 metastatic nodes, and 80.1% in patients with 3 or more metastatic nodes ( P < .01). The 5-year overall survival rates of the node-positive T1b and T2 gastric cancer patients were 83.6% and 81.2%, respectively ( P = .73). Conclusion The prognosis of node-positive T1b gastric cancer patients after curative gastrectomy was unsatisfactory. Adjuvant chemotherapy should be considered for these patients, especially those with 3 or more metastatic nodes.</abstract><cop>United States</cop><pub>Elsevier Inc</pub><pmid>25433728</pmid><doi>10.1016/j.surg.2014.10.009</doi><tpages>7</tpages></addata></record> |
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| subjects | Adult Aged Aged, 80 and over Antineoplastic Agents - therapeutic use Chemotherapy, Adjuvant Female Gastrectomy Gastric Mucosa - pathology Gastric Mucosa - surgery Humans Logistic Models Lymphatic Metastasis Male Middle Aged Neoplasm Invasiveness Neoplasm Staging Prognosis Retrospective Studies Stomach Neoplasms - drug therapy Stomach Neoplasms - mortality Stomach Neoplasms - pathology Stomach Neoplasms - surgery Surgery Survival Rate Treatment Outcome |
| title | Prognostic analysis of submucosa-invasive gastric cancer with lymph node metastasis |
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