title: Tumor size predicts survival in mucinous gastric carcinoma.
abstract: BACKGROUND
  Mucinous gastric carcinoma (MGC) is a distinct histologic subtype of gastric cancer. However, the prognostic significances of the current TNM staging system and histology in MGC have not been studied.
  
  
  METHODS
  206 patients who underwent R0 resection for MGC were classified by tumor size (<3 cm as T1; ≥ 3-5 cm as T2; ≥ 5-9 cm as T3; and ≥ 9 cm as T4). Immunohistochemistry for EGFR and HER2 was also performed.
  
  
  RESULTS
  Tumor sizes ranged from 1.2 to 21.0 cm (median 6.2 cm). Large tumor size (≥ 5 cm) was significantly associated with older patient age, deeper invasion depth, and more frequent lymph node metastasis (P < 0.05). Tumor size was a significant prognostic factor in both univariate (P < 0.001) and multivariate (P < 0.04) analyses. However, depth of invasion was not significant in multivariate analyses. A modified staging system based on tumor size predicted survival more accurately than did the conventional TNM staging system. We verified our results in an independent validation cohort of 123 MGC patients. Overexpression of either EGFR or HER2 was rare.
  
  
  CONCLUSIONS
  In MGCs, tumor size is an independent prognostic factor and a modified TNM system based on tumor size predicted survival accurately.
authors.affiliation: Department of Pathology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors.forename: Chang Ohk
authors.initials: CO
authors.lastname: Sung
authors.forename: Sun Mi
authors.initials: SM
authors.lastname: Lee
authors.forename: Jong Sun
authors.initials: JS
authors.lastname: Choi
authors.forename: Kyoung-Mee
authors.initials: KM
authors.lastname: Kim
authors.forename: Min-Gew
authors.initials: MG
authors.lastname: Choi
authors.forename: Jae Hyung
authors.initials: JH
authors.lastname: Noh
authors.forename: Tae Sung
authors.initials: TS
authors.lastname: Sohn
authors.forename: Jae Moon
authors.initials: JM
authors.lastname: Bae
authors.forename: Woo Ho
authors.initials: WH
authors.lastname: Kim
authors.forename: Cheol-Keun
authors.initials: CK
authors.lastname: Park
authors.forename: Sung
authors.initials: S
authors.lastname: Kim
mesh_terms: D002288:Adenocarcinoma, Mucinous / Q000401:mortality / Q000473:pathology*; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D066246:ErbB Receptors / Q000032:analysis; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D018719:Erb-b2 Receptor Tyrosine Kinases / Q000032:analysis; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology*
chemical_list: D066246:ErbB Receptors; D018719:Erb-b2 Receptor Tyrosine Kinases; C508053:ERBB2 protein, human