A new staging system based on tumor volume in gastric cancer.
BACKGROUND
Development of a more appropriate staging system for gastric cancer may prove useful in clinical practice.


METHODS
A total of 171 patients with solitary carcinoma of the stomach (112 males and 59 females; age range, 20 to 84 years; mean, 57.7 years) who underwent curative surgery were examined. The volume of each tumor was measured from serial tumor tissue sections using a computer software program. The utility of a new staging system based on tumor volume was assessed with respect to patient survival in comparison with other clinicopathological factors and conventional staging.


RESULTS
Significant differences in survival time were found for depth of invasion (T1 vs T2 or T3; p=0.008), nodal status (n0 vs n1 or n2; p=0.032), tumor volume (< or = 2,000 mm vs >2,000 mm3; p<0.001) and stage (stage I vs stage II, III or IV; p =0. 003). However, multivariate analysis only identified tumor volume as a significant prognostic factor in the present study (p <0.001; relative risk 10.351).


CONCLUSIONS
The above findings suggest that a new staging system based on tumor volume may have advantages over the conventional staging system in the assessment of gastric cancer.
Kikuchi
S
S
Department of Surgery, School of Medicine, Kitasato University, Sagamihara-shi, Kanagawa, Japan.
Sakuramoto
S
S
Kobayashi
N
N
Shimao
H
H
Sakakibara
Y
Y
Sato
K
K
Kakita
A
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy; D006801:Humans; D015993:Life Tables; D008197:Lymph Node Excision; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging / Q000379:methods*; D011379:Prognosis; D012306:Risk; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis