title: Tumor size as a recommendable variable for accuracy of the prognostic prediction of gastric cancer: a retrospective analysis of 1,521 patients.
abstract: BACKGROUND
  It is still controversial whether tumor size (Ts) should be considered an important indicator for evaluation the prognosis of gastric cancer (GC). The purpose of this study was to elucidate the prognostic prediction superiority of Ts in the large-scale cohort of GC patients.
  
  
  METHODS
  Data from 1,521 patients who underwent the curative resection were analyzed for demonstration the prognostic value of Ts. In addition, a tumor size-node-metastasis (TsNM) classification system was proposed to evaluate the comparative superiorities of the prognostic prediction of GC patients.
  
  
  RESULTS
  With the univariate and multivariate analyses, Ts was identified as an independently prognostic predictor of GC patients, as was T stage. Ts was demonstrated to have smaller Akaike information criterion and Bayesian Information Criterion values within the Cox regression analyses than shown by T stage, which represented the optimum prognostic stratification. TsNM classification was also found to be competent for accurately prognostic evaluation of GC patients. The matched case-control logistic regression showed that TsNM classification could provide very powerful discriminations of patients' overall survival, compared with TNM classification. Additionally, Ts stage was found to enhance the survival discriminations in patients with certain clinicopathological characteristics, including male gender, T4a stage, N0 stage, diffuse type of Lauren classification, or age ≤60 years.
  
  
  CONCLUSIONS
  Ts should be recommended as an important clinicopathologic variable to enhance the accuracy of the prognostic prediction of GC clinical patients.
authors.affiliation: Department of Gastric Cancer Surgery, National Clinical Research Center for Cancer, City Key Laboratory of Tianjin Cancer Center, Tianjin Medical University Cancer Hospital, Tianjin, China.
authors.forename: Jingyu
authors.initials: J
authors.lastname: Deng
authors.forename: Rupeng
authors.initials: R
authors.lastname: Zhang
authors.forename: Yuan
authors.initials: Y
authors.lastname: Pan
authors.forename: Xuewei
authors.initials: X
authors.lastname: Ding
authors.forename: Mingzhi
authors.initials: M
authors.lastname: Cai
authors.forename: Yong
authors.initials: Y
authors.lastname: Liu
authors.forename: Honggen
authors.initials: H
authors.lastname: Liu
authors.forename: Tao
authors.initials: T
authors.lastname: Bao
authors.forename: Xuguang
authors.initials: X
authors.lastname: Jiao
authors.forename: Xishan
authors.initials: X
authors.lastname: Hao
authors.forename: Han
authors.initials: H
authors.lastname: Liang
mesh_terms: D000230:Adenocarcinoma / Q000188:drug therapy / Q000473:pathology / Q000601:surgery; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D005260:Female; D005743:Gastrectomy; D006801:Humans; D008197:Lymph Node Excision; D008198:Lymph Nodes / Q000473:pathology; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D013274:Stomach Neoplasms / Q000188:drug therapy / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis; D055815:Young Adult