Pathology and ploidy in the prognosis of gastric cancer with no extranodal metastasis.
BACKGROUND
The prognostic relevance of morphology in advanced gastric cancer is well known. Data on tumor cell DNA content are still inadequate and contradictory.


METHODS
Morphologic parameters and DNA ploidy were evaluated in 76 gastric cancer patients with no extranodal metastases (Stage I, 10 cases; Stage II, 20 cases; and Stage III, 46 cases), using formalin-fixed paraffin-embedded tissue. All cases were followed for at least 6 years after surgery or until death.


RESULTS
Among the potential prognostic factors analyzed by Mantel-Cox and generalized Wilcoxon statistics, male sex (P = 0.02), cardiac location of neoplasia (P = 0.02), deeper infiltration of the gastric wall (P = 0.001), vascular neoplastic invasion (P = 0.006), metastatic lymph nodes (P = 0.001), pathologic stage (P = 0.0001), and aneuploidy (P = 0.01) were significantly associated with lower survival rate. Testing of all of the above-mentioned variables by the Cox stepwise multiple regression model disclosed that factors independently associated with survival were stage (P = 0.0001), ploidy (P = 0.0006), and vascular carcinomatous invasion (P = 0.01).


CONCLUSIONS
In gastric cancer with no extranodal metastases, DNA ploidy was found to be the most significant prognostic parameter after pathologic stage.
Rugge
M
M
Department of Pathology, Istituto Scientifico per lo Studio e la Cura dei Tumori, Genova, Italy.
Sonego
F
F
Panozzo
M
M
Baffa
R
R
Rubio
J
J
Farinati
F
F
Nitti
D
D
Ninfo
V
V
Ming
S C
SC
D000368:Aged; D004273:DNA, Neoplasm / Q000032:analysis*; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011003:Ploidies; D011379:Prognosis; D013274:Stomach Neoplasms / Q000235:genetics / Q000401:mortality* / Q000473:pathology*; D015996:Survival Rate
D004273:DNA, Neoplasm