title: Preoperative tumor size is a critical prognostic factor for patients with Borrmann type III gastric cancer.
abstract: OBJECTIVE
  This study was designed to clarify whether preoperative tumor size is an independent prognostic factor (IPF) for patients with Borrmann type III gastric cancer.
  
  
  METHODS
  The study group comprised 350 patients with Borrmann type III gastric cancer. We performed a log-rank plot analysis to establish the threshold value of preoperative tumor size for the prediction of overall survival (OS). Factors with P < 0.10 on univariate prognostic analyses for OS were put into a Cox's proportional hazards model to identify the IPFs.
  
  
  RESULTS
  Peritoneal lavage cytology (CY) was the strongest IPF for patients with Borrmann type III gastric cancer (P < 0.0001). We were able to measure the tumor size preoperatively in 135 patients with negative CY results (CY0). The cutoff tumor size for the prediction of OS was 5.3 cm. A Cox's proportional hazards model showed that pathological lymph-node metastasis (P = 0.007) and preoperative tumor size (P = 0.018) were significant IPFs in the CY0 patients. Patients with a preoperative tumor size of <5.3 cm had satisfactory outcomes, with a 5-year OS rate of >80 %.
  
  
  CONCLUSIONS
  Preoperative tumor size is an IPF for patients with Borrmann type III gastric cancer and CY0. Thus, preoperative tumor size may be a useful factor for deciding on whether neoadjuvant chemotherapy is indicated.
authors.affiliation: Department of Surgery, Kitasato University School of Medicine, Kitasato 1-15-1, Minami-ku, Sagamihara, Kanagawa, 252-0374, Japan, k.hosoda@kitasato-u.ac.jp.
authors.forename: Kei
authors.initials: K
authors.lastname: Hosoda
authors.forename: Keishi
authors.initials: K
authors.lastname: Yamashita
authors.forename: Natsuya
authors.initials: N
authors.lastname: Katada
authors.forename: Hiromitsu
authors.initials: H
authors.lastname: Moriya
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Mieno
authors.forename: Shinichi
authors.initials: S
authors.lastname: Sakuramoto
authors.forename: Shiro
authors.initials: S
authors.lastname: Kikuchi
authors.forename: Masahiko
authors.initials: M
authors.lastname: Watanabe
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy; D006801:Humans; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy; D009367:Neoplasm Staging; D057234:Preoperative Period; D011379:Prognosis; D012189:Retrospective Studies; D012306:Risk; D013274:Stomach Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy; D015996:Survival Rate; D013997:Time Factors; D055815:Young Adult