Does tumor size have an impact on gastric cancer? A single institute experience

Purpose The present study investigated the prognostic significance of tumor size in gastric carcinoma patients. Methods Nine hundred seventy-three gastric carcinoma patients who underwent curative gastrectomy were included and hospital records were reviewed to determine the relationship between tumor size and survival. Results First, the patients were divided based on the mean value of the tumor size in respective stages to control selection bias. Only in stages I and III was tumor size a significant independent prognostic factor. Second, we analyzed the appropriate cutoff value for the large tumor. The minimum criterion for a large tumor, which was determined by the receiver-operating characteristic curve for cancer-related death, was 3.5 cm. There were significant differences between patients with large and small tumors with respect to depth of invasion, number of lymph node metastasis, and stage of disease. Conclusions Tumor size serves as an indicator of prognosis in gastric cancer patients and a tumor size of 3.5 cm can be used as a significant lower limit of standard size criterion.