Prognostic significance of intraoperatively estimated surgical stage in curatively resected gastric cancer patients.
BACKGROUND
The aim of this study was to assess the prognostic significance of intraoperatively estimated surgical stage (sStage) as a complementary role for pathologic stage (pStage) in gastric cancer.


METHODS
This was a retrospective study of 1,543 patients who underwent curative resection for gastric cancer. Clinicopathologic and therapeutic factors, including sStage, were analyzed for prognostic significance. Prognosis was stratified by sStage and pStage, and the prognoses of patients with an overestimated sStage were compared with those with a nonoverestimated sStage in the same pStage.


RESULTS
Overall accuracy of sStage versus pStage was 39% (T stage, 73.0%; N stage, 43.5%). Survival curves were obviously stratified by sStage and pStage: Ia (97.5% versus 97.9%), Ib (94.3% versus 92.4%), II (89.6% versus 84.2%), IIIa (74.2% versus 69.3%), IIIb (54.4% versus 50.4%), and IV (55.6% versus 36.7%), respectively (p < 0.001). In addition to pStage, age and sStage were found to be significantly associated with overall survival by univariate and multivariate analysis. In pStages II, IIIa, and IIIb, intraoperatively overestimated patients had significantly poorer survival than nonoverestimated patients.


CONCLUSIONS
sStage should be considered as a complementary prognostic factor for pStage in gastric cancer after curative resection, especially in stages II and III patients.
Department of Surgery, Konyang University Hospital, [corrected] Republic of Korea.
Sang Eok
SE
Lee
Keun Won
KW
Ryu
Byung Ho
BH
Nam
Jun Ho
JH
Lee
Il Ju
IJ
Choi
Myeong-Cherl
MC
Kook
Sook Ryun
SR
Park
Young-Woo
YW
Kim
D000368:Aged; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods; D006801:Humans; D053208:Kaplan-Meier Estimate; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D016017:Odds Ratio; D011237:Predictive Value of Tests; D011379:Prognosis; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology* / Q000601:surgery*