Prognostic value of S-phase fraction in T3N0M0 gastric cancer. Implications for adjuvant chemotherapy.
BACKGROUND
The prognosis of patients with T3N0M0 gastric cancer is still unfavourable and the role of adjuvant chemotherapy is unclear. We addressed this study to evaluate whether the analysis of the S-Phase Fraction (SPF) might have prognostic implications in serosa-positive, node-negative gastric cancer.


METHODS
Specimens of resected gastric cancer were studied by flow cytometry for SPF analysis. Consecutive patients with stage pT3N0M0, adequate follow-up information and sufficient archival tumor tissue were considered eligible for the study. The tumor SPF indices were related to the timing of recurrences, the relapse rate and the disease-free survival of patients.


RESULTS
The analysis was carried out on samples of 137 patients with surgically-resected, stage pT3N0M0 gastric cancer. SPF resulted high and low in 39% and 61% of cases, respectively. Fifty-seven patients relapsed (42%) and early recurrences (within 18 months after surgery) occurred more frequently among cases with high SPF (p < .03). Patients with high SPF tumors showed a worse relapse rate and disease-free survival than patients with low SPF tumors. (p < .005).


CONCLUSIONS
The SPF analysis showed prognostic differences among patients with stage pT3N0M0 gastric cancer. These data may be of value in the planning of future adjuvant chemotherapy trials in gastric cancer.
Cascinu
S
S
Azienda Ospedale S. Salvatore, Ospedale Muraglia, Via Lombroso, 61100 Pesaro, Italy.
Graziano
F
F
Catalano
V
V
Valentini
M
M
Rossi
M C
MC
Baldelli
A M
AM
Ghiselli
R
R
Saba
V
V
Giordani
P
P
Catalano
G
G
D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D018572:Disease-Free Survival; D005260:Female; D005434:Flow Cytometry / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011237:Predictive Value of Tests; D011379:Prognosis; D012008:Recurrence; D016196:S Phase; D013274:Stomach Neoplasms / Q000188:drug therapy* / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D013997:Time Factors