A recent study reports that the cross-sectional location of gastric cancer is associated with long-term survival outcomes of patients as tumor invasion deepens, published in Annals of Surgical Oncology (online October 4, 2017; doi:10.1245/s10434-017-6101-2).
The prognosis of gastric cancer is often times determined by tumor depth and lymph node metastasis. However, the effect of cross-sectional tumor location on prognosis remains to be fully understood.
A group of Korean researchers led by Yoon Ju Jung, department of surgery, College of Medicine, Seoul St Mary’s Hospital, The Catholic University of Korea, conducted a study to determine the prognostic implications of cross-sectional gastric cancer tumor location in patients. Researchers recruited 4820 patients who had been diagnosed with gastric cancer and underwent gastrectomy from 1989 to 2012. Cross-sectional location of the tumors was categorized into four regions: lesser curvatures (LC), greater curvatures (GC), anterior walls (AW) and posterior walls (PW).
Researchers noted that the most common tumor site among the four cross-sectional locations in the patient population was the LC (46.4%). Proportions of the other three cross-sectional locations were similar (PW, 19.9%; AW, 18.4%, GC, 15.4%).
Results of the analysis showed that overall survival was significantly different (P = .013) for patients depending on the cross-sectional location of their tumors. The categorization most associated with survival outcome was GC; five-year overall survival of those with tumors with a GC categorization was significantly worse (P = .003) than for those with any of the other three categorizations.
Subgroup multivariate analysis further revealed that GC location was an independent prognostic indicator for worse clinical outcome at T stage 3-4b (HR, 1.37; 95% CI, 1.15-1.62; P < .001). Additionally, researchers noted that a GC tumor had a higher recurrence rate in terms of peritoneal seeding compared with other tumor locations.
Authors of the study concluded that cross-sectional location of gastric cancer tumors is significantly associated with long-term survival. A poor prognosis is given for patients with a GC location and deeper T stages.—Zachary Bessette