Prognosis of Gastric Cancer Patients with a Large Tumor Size

Background: We evaluated the predictive factors associated with survival for gastric cancer patients with large tumor size (≥10 cm).Method: In this retrospective study, we investigated 279 gastric cancer patients with large-sized tumors, treated at the Chonnam National University Hospital, Gwangju, Korea. We analyzed the clinicopathological features and predictive factors associated with survival in these gastric cancer patients with large tumors. Survival was calculated using the Kaplan-Meier method and the relative prognostic importance of the parameters was investigated through Cox's proportional hazards model.Results: The recurrence rates were significantly different between the large and small tumor groups (76.3% and 36.6%, respectively; P < 0.001). Multivariate analysis showed that the presence of serosal invasion, nodal involvement, the extent of lymph node dissection, the presence of peritoneal dissemination, and curability had prognostic effects in gastric cancer patients with large-sized tumors. The 5-year survival rate was lower in patients with tumors ≥10 cm compared with those with smaller tumors (23.6% versus 57.0%, respectively; P < 0.0001). The 5-year survival rate was higher in patients with large tumor size who underwent curative resection (39.1%) than those who did not (10.0%) (P < 0.0001).Conclusion: The long-term survival of gastric cancer patients with large-sized tumors is related to curative resection. Thus, curative resection is of significance for predicting survival.