title: Tumor Index as a Combined Indicator of Tumor Depth and Size in Gastric Cancer.
abstract: BACKGROUND
  We investigated the utility of a novel combined indicator of both tumor depth and size in gastric cancer.
  
  
  METHODS
  A total of 938 patients with gastric cancer were analyzed. We tested tumor index (TI), calculated by T category × tumor size (mm) as a novel combined indicator of tumor depth and size.
  
  
  RESULTS
  Patients were classified into two groups using a cut-off value of 180 (p<0.0001) by the Kaplan-Meier method. TI was significantly positively correlated with older age, tumor located in the upper third of stomach, advanced type of macroscopic appearance, undifferentiated type, lymphatic invasion, venous invasion, lymph node metastasis, and recurrence. TI>180 only correlated with peritoneal recurrence (p=0.0394). A multivariate analysis identified TI>180 as an independent prognostic factor (hazard ratio=2.38, p=0.0004).
  
  
  CONCLUSIONS
  TI may be a novel combined indicator of tumor status for predicting a poor prognosis and peritoneal recurrence in gastric cancer.
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
authors.forename: Takuma
authors.initials: T
authors.lastname: Ohashi
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan skomatsu@koto.kpu-m.ac.jp.
authors.forename: Shuhei
authors.initials: S
authors.lastname: Komatsu
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
authors.forename: Daisuke
authors.initials: D
authors.lastname: Ichikawa
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
authors.forename: Toshiyuki
authors.initials: T
authors.lastname: Kosuga
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
authors.forename: Kazuma
authors.initials: K
authors.lastname: Okamoto
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
authors.forename: Hirotaka
authors.initials: H
authors.lastname: Konishi
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Shiozaki
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
authors.forename: Hitoshi
authors.initials: H
authors.lastname: Fujiwara
authors.affiliation: Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kamigyo-ku, Kyoto, Japan.
authors.forename: Eigo
authors.initials: E
authors.lastname: Otsuji
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D016016:Proportional Hazards Models; D013274:Stomach Neoplasms / Q000473:pathology* / Q000601:surgery; D047368:Tumor Burden
keywords: Tumor size; gastric cancer; prognosis; tumor depth