Objective: To investigate the impact of tumor size on the prognosis of patients with T3 gastric cancer.
Methods: D2 curative resection was performed on 408 patients with T3 gastric cancer. Cox proportional hazards model was used to identify the optimal cut-off of tumor size. Potential prognostic factors were evaluated by univariate and multivariate analysis. Multivariate analysis was performed to evaluate the prognostic factors stratified by tumor size.
Results: Among 408 patients with T3 gastric cancer, Cox proportional hazards model showed that 8 cm was the optimal cut-off of tumor size. There were 85 patients with tumor size ≥8 cm(large size group), and 323 patients with tumor size <8 cm(small size group). The 5-year survival rate was significantly lower for patients with small size tumor(33.8% vs. 52.2%, P<0.05). Cox proportional hazards model showed that lymph node metastasis, tumor size, and Borrmann type were independent prognostic factors for the entire cohort. Borrmann type IIII( and N2-3 nodal metastasis were independent prognostic factors for the large size group. Lymph node metastasis was independent prognostic factor for the small size group.
Conclusions: Tumor size is an independent prognostic factor in patients with T3 gastric cancer. Lymph node metastasis is a significant predictor for the prognosis regardless of tumor size. Furthermore, Borrmann classification is associated with the prognosis in patients with tumor size ≥8 cm.