title: Clinical implication of serosal change in pathologic subserosa-limited gastric cancer.
abstract: BACKGROUND
  The aim of this study was to evaluate the clinical implication of serosal change in pathologic subserosa-limited gastric cancer based on a retrospective analysis.
  
  
  METHODS
  A total of 285 patients who were diagnosed with pathologically subserosa-limited gastric cancer were included. The patients were divided into two groups: the accordance group, with subserosa-limited cancer without macroscopic serosa change (n = 124); the discordance group, with subserosa-limited cancer showing macroscopic serosal change (n = 161).
  
  
  RESULTS
  Tumor size, number of metastatic lymph nodes, and pathologic N stage were significantly associated with macroscopic serosal change. Serosal change patients presented a higher recurrence rate compared with patients without serosal change (38.0 vs. 20.2% for the 5-year recurrence rate, P = 0.002), and peritoneal seeding presented frequently in serosal-change patients with significance (41.1%). Likewise, the overall survival of serosal-change patients was significantly worse than that for those without serosal change (66.9 vs. 81.4% for the 5-year survival rate, P = 0.002). Serosal change was an independent prognostic factor for overall survival (relative risk 1.784, P = 0.039).
  
  
  CONCLUSIONS
  Serosal change in pathologic subserosa-limited gastric cancer is related to poor survival. Therefore, adjuvant chemotherapy should be considered for these patients, and adequate follow-up programs instituted for early detection of peritoneal seeding.
authors.affiliation: Department of Surgery, Seoul St. Mary's Hospital, The Catholic University of Korea, 505 Banpo-Dong, Seocho-Gu, Seoul, 137-701, Korea.
authors.forename: Joo Mee
authors.initials: JM
authors.lastname: Kim
authors.forename: Hun
authors.initials: H
authors.lastname: Jung
authors.forename: Jun Suh
authors.initials: JS
authors.lastname: Lee
authors.forename: Han Hong
authors.initials: HH
authors.lastname: Lee
authors.forename: Kyo Yung
authors.initials: KY
authors.lastname: Song
authors.forename: Cho Hyun
authors.initials: CH
authors.lastname: Park
authors.forename: Myung Hae
authors.initials: MH
authors.lastname: Jeon
mesh_terms: D000230:Adenocarcinoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009366:Neoplasm Seeding; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012704:Serous Membrane / Q000473:pathology*; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery; D016019:Survival Analysis; D015996:Survival Rate