Tumor Size Is a Critical Factor in Adjuvant Chemotherapy for T3-4aN0M0 Gastric Cancer Patients after D2 Gastrectomy.
Aim. To investigate whether tumor size is a reasonable indication for adjuvant chemotherapy for T3-4aN0M0 gastric cancer patients after D2 gastrectomy.Method. We performed a retrospective study of 269 patients with a histological diagnosis of T3-4aN0M0 stage gastric cancer who underwent D2 radical surgery at the Sun Yat-sen University Cancer Center or the Sixth Affiliated Hospital of Sun Yat-sen University between January 2006 and December 2010. The follow-up lasted until June of 2015. Chi-square tests and Kaplan-Meier methods were employed to compare the clinicopathological variables and prognoses.Result. For this group of patients, univariate analyses revealed that tumor size (p< 0.001), pathological T stage (p< 0.001), and tumor location (p= 0.025) were significant prognostic factors. Adjuvant chemotherapy did not exhibit prognostic benefits. For patients with tumors larger than 5 cm, univariate analysis revealed that tumor location (p= 0.007), Borrmann type (p= 0.039), postoperative chemotherapy (p= 0.003), and pathological T stage (p< 0.001) were significant prognostic factors. Multivariate analysis revealed that postoperative chemotherapy and pathological T stage were independent prognostic factors.Conclusion. Our results imply that tumor size should be a critical factor in the decision to utilize adjuvant chemotherapy for T3-4aN0M0 gastric cancer patients after D2 gastrectomy. Additional randomized controlled trials are required before this conclusion can be considered definitive.
The 6th Affiliated Hospital, Sun Yat-sen University, No. 26, Yuancun Erheng Road, Tianhe District, 510655 Guangzhou, China.
Shi
S
Chen
Department of Intensive Care Unit, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, 510060 Guangzhou, China.
Li-Ying
LY
Ou-Yang
Department of Gastropancreatic Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, 510060 Guangzhou, China.
Run-Cong
RC
Nie
Department of Gastropancreatic Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, 510060 Guangzhou, China.
Yuan-Fang
YF
Li
The 6th Affiliated Hospital, Sun Yat-sen University, No. 26, Yuancun Erheng Road, Tianhe District, 510655 Guangzhou, China.
Jun
J
Xiang
Department of Gastropancreatic Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, 510060 Guangzhou, China.
Zhi-Wei
ZW
Zhou
Department of Gastropancreatic Surgery, Sun Yat-sen University Cancer Center, 651 Dongfeng East Road, 510060 Guangzhou, China.
Ying-Bo
0000-0003-2509-3381
YB
Chen
The 6th Affiliated Hospital, Sun Yat-sen University, No. 26, Yuancun Erheng Road, Tianhe District, 510655 Guangzhou, China.
Jun-Sheng
0000-0002-7975-4176
JS
Peng