Ulcer size as a novel indicator marker is correlated with prognosis of ulcerative gastric cancer.
OBJECTIVE
The objective of this study was to assess the significance of ulcer size for the survival of gastric cancer patients.


METHODS
A total of 260 patients with ulcerative gastric cancer who had undergone curative resection were reviewed. The diameter of the malignant ulcer was measured. Patients were divided into group U1 (< or =3 cm) and group U2 (>3 cm) according to the diameter of the ulcer. The prognostic significance of ulcer size was assessed by uni- and multivariate analyses.


RESULTS
Patient survival was correlated with age, gender, tumor location, tumor size, ulcer size, serosal invasion, node involvement and synchronism distant metastasis. The 5-year overall survival rate in U1 patients was 84.3% as compared with 67.5% in U2 patients (p < 0.001), and the 5-year recurrence-free survival rates were 82.9% for group U1 and 62.5% for group U2 (p = 0.001). Multivariate analysis revealed that ulcer size is an independently significant predictive factor for survival rates (overall: hazard ratio 1.222, p = 0.003; recurrence-free: hazard ratio 1.205, p = 0.006).


CONCLUSIONS
Ulcer size might be a potential indicator for advanced disease and the use of minimal local treatments must be considered carefully in larger ulcer size patients.
Xu
C Y
CY
Department of Surgical Oncology, Sir Run Run Shaw Hospital, Zhejiang University College of Medicine, Hangzhou 310016, China.
Shen
J G
JG
Shen
J Y
JY
Chen
W J
WJ
Wang
L B
LB
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D008137:Longitudinal Studies; D008197:Lymph Node Excision / Q000379:methods; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D013276:Stomach Ulcer / Q000473:pathology*; D016019:Survival Analysis; D016896:Treatment Outcome