Evaluation of the prognostic factors in patients with pT3N0 or pT1N2-3 gastric cancer: a single institutional retrospective cohort study.

PURPOSE: The impact of adjuvant chemotherapy on the survival of patients with the pT3N0/pT1N2-3 subset of Stage II gastric cancer is unclear. The aim of this study was to evaluate the survival rate of pT3N0/pT1N2-3 patients who were treated by surgery alone and to identify a high-risk group within this cohort.

METHODS: A total of 258 patients with pT3N0/pT1N2-3 gastric cancer who underwent gastrectomy alone in our hospital between January 1992 and December 2012 were enrolled in the present study. Their medical records were retrospectively reviewed to evaluate the survival rates and investigate prognostic factors.

RESULTS: The 3- and 5-year recurrence-free survival rates of this cohort were 84 and 80%, respectively. The 3- and 5-year overall survival rates were 89 and 83%, respectively. A multivariate analysis revealed that pathological venous infiltration was an independent prognostic factor. The survival of patients with pathological venous infiltration was significantly worse than that of those without (5-year recurrence-free survival, 75 vs. 90%, p = 0.0005; 5-year overall survival, 78 vs. 91%, p = 0.0062).

CONCLUSIONS: The prognosis of pT3N0/pT1N2-3 gastric cancer patients treated by surgery alone was relatively good; however, patients with pathological vessel infiltration may be at high risk of recurrence and could be candidates for adjuvant chemotherapy.