Proliferation kinetics and prognosis in gastric cancer after resection.
The influence of proliferation and proliferation kinetics on prognosis in gastric cancer after complete resection are controversial. In a prospective study we investigated the tumour specimens of 111 patients after resection of gastric cancer, who received 200 mg intravenous (i.v.) bromodeoxyuridine (BrdU) pre-operatively. The following biological parameters were analysed in the tumour tissue using flow-cytometry: DNA ploidy, proportion of S-phase cells, BrdU labelling index (LI), DNA synthesis time (T(s)), potential tumour doubling time (T(pot)), proliferating cell nuclear antigen (PCNA) and Ki-67 LI. The median follow-up time was 40 months (range 19-62 months). Besides the established pathohistological prognostic factors, univariate analysis revealed a prognostic influence on survival for BrdU LI, T(pot) and the proportion of S-phase cells. By multivariate Cox analysis of the completely resected cases, only tumour stage and T(pot) had a significant, independent influence on survival. By classification and regression trees (CART) analysis, resection status, tumour stage and T(pot) defined risk groups with significantly different outcomes. A short T(pot) was a predictor of better survival in stage I, II and IIIA tumours. Ploidy and the other investigated proliferation-related parameters failed to demonstrate any influence on prognosis after resection of gastric cancer.
Sendler
A
A
Chirurgische Klinik und Poliklinik, Klinikum rechts der Isar der Technischen Universität München, Ismaninger Str. 22, 81675, München, Germany. sendler@nt.1chir.med.tu-muenchen.de
Gilbertz
K P
KP
Becker
I
I
Mueller
J
J
Berger
U
U
Fink
U
U
van Beuningen
D
D
Siewert
J R
JR
D000230:Adenocarcinoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000964:Antimetabolites, Antineoplastic / Q000008:administration & dosage; D001973:Bromodeoxyuridine / Q000008:administration & dosage; D002455:Cell Division; D004273:DNA, Neoplasm / Q000032:analysis; D005260:Female; D005434:Flow Cytometry; D006801:Humans; D007262:Infusions, Intravenous; D019394:Ki-67 Antigen / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D011003:Ploidies; D011182:Postoperative Care / Q000379:methods; D011300:Preoperative Care / Q000379:methods; D018809:Proliferating Cell Nuclear Antigen / Q000378:metabolism; D012044:Regression Analysis; D016196:S Phase / Q000502:physiology; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis
D000964:Antimetabolites, Antineoplastic; D004273:DNA, Neoplasm; D019394:Ki-67 Antigen; D018809:Proliferating Cell Nuclear Antigen; D001973:Bromodeoxyuridine