Abstract
Purpose
We evaluated the impact of histological type to evaluate prognostic factors after adjuvant chemotherapy (AC) in patients with pStage II and III gastric cancer.
Methods
Overall, 384 patients with pStage II and III gastric cancer undergoing R0 gastrectomy were included. Of these, 143 underwent AC. Univariate and multivariate analyses for prognostic factors of relapse-free survival (RFS) and overall survival (OS) were performed.
Results
Multivariate analysis revealed that macroscopically ill-defined type, histologically poorly cohesive carcinoma with not otherwise specified and signet ring cell subtype (PCC-NOS/SRC) and pStage III independently and adversely affected RFS. Alternatively, male sex, macroscopically ill-defined type, less D2 lymph node dissection and pStage IIB and III independently and adversely affected OS. In multivariate analysis of patients receiving AC, histological phenotype and tumour diameter independently influenced RFS. Compared with NON-PCC, PCC-NOS/SRC showed worse RFS, whereas SRC showed favourable RFS. Moreover, tumour diameter ≥ 80 mm showed worse RFS. Multivariate analysis for OS in patients undergoing AC revealed similar results.
Conclusion
Histologically PCC-NOS/SRC type and tumour diameter of ≥ 80 mm indicated poor survival even after AC in patients with pStage II and III gastric cancer. An effective therapeutic regimen needs to be developed for such histological subtypes.