title: [The prognostic analysis of tumor size in T4a stage gastric cancer].
abstract: OBJECTIVE
  To investigate the impact of tumor size in the prognosis of T4a stage gastric cancer.
  
  
  METHODS
  The best cut-off point depending on tumor size was selected by Kaplan-Meier. Compare cliniclópathological characteristics between small size gastric cancer (SSG) and large size gastric cancer (LSG). Univariate analysis was done by Log-rank test and multivariate analysis was performed using the Cox proportional hazard regression model. The independent prognostic factors of patients were performed subgroup analysis.
  
  
  RESULTS
  Eight centimetre was the optimal cut-off of tumor size for T4a stage gastric cancer. There were significantly differences between SSG and LSG in tumor location (χ² = 15.695), histological grade (χ² = 4.393), macroscopic type (χ² = 5.629) and early recurrence (χ² = 4.292). Univariate analysis showed age (χ² = 4.463), tumor size (χ² = 9.057), macroscopic type (χ² = 6.679), histological grade (χ² = 5.122), location of tumor (χ² = 8.707) and N stage (χ² = 132.954) are related to survival (P < 0.05). Among them, tumor size (HR = 1.339), histological grade (HR = 1.169) and N stage (HR = 1.876) were independent risk factor for survival (P = 0.05). For SSG, N stage (HR = 2.014) and histological grade (HR = 1.192) were independent risk factor for survival (P = 0.05), and for LSG, N stage (HR = 1.876) was independent risk factor for survival (P = 0.000). Further stratified analysis indicated that the 5-year survival rate of LSG is significantly lower than that of SSG in T4a stage patients of gastric cancer without lymph nodes metastasis or poorly differentiated (HR = 0.182 and 0.653, P < 0.01).
  
  
  CONCLUSIONS
  Tumor size is an independent prognostic factor in patients of T4a stage gastric cancer. Tumor size cut-off point of 8 cm can exert significant impact on the prognosis of T4a stage gastric cancer without lymph nodes metastasis or poorly differentiated.
authors.affiliation: Department of Gastrointestinal Oncology Surgery, Key Lab of Cancer Treatment and Prevention, Tianjin Cancer Hospital, Tianjin Medical University, Tianjin 300060, China.
authors.forename: Hong-gen
authors.initials: HG
authors.lastname: Liu
authors.forename: Han
authors.initials: H
authors.lastname: Liang
authors.forename: Jing-yu
authors.initials: JY
authors.lastname: Deng
authors.forename: Li
authors.initials: L
authors.lastname: Wang
authors.forename: Yue-xiang
authors.initials: YX
authors.lastname: Liang
authors.forename: Xu-guang
authors.initials: XG
authors.lastname: Jiao
mesh_terms: D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009367:Neoplasm Staging; D011379:Prognosis; D013270:Stomach / Q000473:pathology*; D013274:Stomach Neoplasms / Q000401:mortality* / Q000473:pathology*; D015996:Survival Rate