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Gastric cancer and the search for a good prognostic classification: a challenge.
MedLine Citation:
PMID:  21694854     Owner:  NLM     Status:  PubMed-not-MEDLINE    
INTRODUCTION: Gastric cancer is the second most common cancer worldwide. The standard treatment is radical surgical resection, but 60% of patients will present recurrence. TNM classification (6th edition, American Joint Committee on Cancer) recommends the removal of at least 15 regional lymph nodes to carry out an adequate pathological staging. But in our environment, only 20% of cases have the minimum recommended, so it would be very important to have an alternative prognostic. We designed a retrospective study to evaluate different prognostic factors in patients inadequately staged.
MATERIAL AND METHODS: We focused on patients with serosal involvement (pT3). The evaluation included general parameters such as age, sex, tumor site, histological type, type of gastrectomy, histological grade, number of nodes analyzed </≥ 10, lymph node ratio (LNR) with a 20% cutoff value, and adjuvant treatment. The association between clinicopathological variables and recurrence was investigated by univariate and multivariate logistic regression. It was considered statistically significant with P < 0.05.
RESULTS: A total of 92 patients who met the criteria were studied. Median age 65 years; 68% men, 32% women; median follow-up time for the overall population, 44 months (range 15-119 months); number of nodes analyzed, median 7 (range 0-14 nodes); recurrence in 59%; median time to recurrence, 15 months (range 3-48 months); the cumulative risk of relapse at five years, 64%. Multivariate statistical analysis showed that the LNR (P = 0.03) and total number of nodes analyzed </≥ 10 (P = 0.04) were independent predictors for the risk of recurrence.
CONCLUSION: LNR and total number of nodes analyzed with a threshold of 10 (</≥ 10 nodes analyzed) were independent predictors of recurrence in patients with gastric carcinoma pT3 and an insufficient number of nodes examined.
Esther Uña Cidón
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Publication Detail:
Type:  Journal Article     Date:  2010-07-22
Journal Detail:
Title:  Clinical and experimental gastroenterology     Volume:  3     ISSN:  1178-7023     ISO Abbreviation:  Clin Exp Gastroenterol     Publication Date:  2010  
Date Detail:
Created Date:  2011-06-22     Completed Date:  2011-07-14     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101532800     Medline TA:  Clin Exp Gastroenterol     Country:  New Zealand    
Other Details:
Languages:  eng     Pagination:  113-6     Citation Subset:  -    
Medical Oncology Service, Clinical University Hospital of Valladolid, Valladolid, Spain.
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