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Research article
Takaki Yoshikawa
National Cancer Center Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1936-9484
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This work is licensed under a CC BY 4.0 License. Read Full License
Background: Advanced gastric cancer sometimes causes macroscopic serosal change (MSC) due to direct invasion or inflammation. However, the prognostic significance of MSC remains unclear.
Methods: We retrospectively reviewed the clinical records of 1410 patients who had been diagnosed with deeper-than-pathological-T2 gastric cancer and undergone R0 gastrectomy with lymph node dissection between January 2000 and December 2012 at the National Cancer Center Hospital, Japan.
Results: MSC was not found in 108 of the 506 patients with pathological T4a (21.3%), whereas it was detected in 250 of the 904 patients with pathological T2-T3 (27.7%). The sensitivity, specificity and accuracy for diagnosing pathological serosa exposed (SE) by MSC were 78.7%, 72.3% and 74.6%, respectively. The MSC-positive cases had a worse 5-year overall survival (OS) than the MSC-negative cases in pT3 (72.9% vs. 84.3%, p=0.001), pT4a (56.2% vs. 73.4%, p=0.001), pStageIIB (76.0% vs. 88.4%, p=0.005), pStageIIIA (63.4% vs. 75.6%, p=0.019), pStageIIIB (53.6% vs. 69.2%, p=0.029) and pStage IIIC (27.6% vs. 50.0%, p=0.062). A multivariate analysis showed that MSC was a significant independent predictor for the OS (hazard ratio [HR], 1.587) along with the tumor depth (HR, 7.742), nodal status (HR, 5.783) and age (HR, 2.382). Peritoneal recurrence rates were higher in the MSC-positive cases than in the MSC-negative cases at each pT stage.
Conclusions: MSC was an important prognostic factor in patients with resectable locally advanced gastric cancer. MSC should be considered when predicting the patient prognosis.
Keywords
macroscopic serosal change, gastric cancer, prognostic factor
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CURRENT STATUS: Under Review
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Received 22 Feb, 2021
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Received 18 Feb, 2021
Reviewer #2 agreed
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Reviewer #1 agreed
On 31 Jan, 2021
Editor assigned
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On 14 Dec, 2020
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A new preprint design is coming!
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This preprint is under consideration at BMC Cancer. A preprint is a preliminary version of a manuscript that has not completed peer review at a journal. Research Square does not conduct peer review prior to posting preprints. The posting of a preprint on this server should not be interpreted as an endorsement of its validity or suitability for dissemination as established information or for guiding clinical practice.
Learn more about In Review
Research article
Takaki Yoshikawa
National Cancer Center Hospital
Corresponding Author
ORCiD: https://orcid.org/0000-0003-1936-9484
Badges
Prescreen
This manuscript passed our Prescreen assessment
Complete author information
Appropriate declaration statements
Potential risks to human health
Prescreen
Peer Review Timeline
CURRENT STATUS: Under Review
Version 1
Posted 18 May, 2021
No community comments so far
Review #2 received
Received 22 Feb, 2021
Review #1 received
Received 18 Feb, 2021
Reviewer #2 agreed
On 03 Feb, 2021
Reviewers invited
Invitations sent on 31 Jan, 2021
Reviewer #1 agreed
On 31 Jan, 2021
Editor assigned
On 14 Dec, 2020
Submission checks complete
On 14 Dec, 2020
Editor invited
On 14 Dec, 2020
First submitted
On 12 Dec, 2020
Metrics
Comments: 0
PDF Downloads: ...
HTML Views: ...
License:
This work is licensed under a CC BY 4.0 License. Read Full License
Background: Advanced gastric cancer sometimes causes macroscopic serosal change (MSC) due to direct invasion or inflammation. However, the prognostic significance of MSC remains unclear.
Methods: We retrospectively reviewed the clinical records of 1410 patients who had been diagnosed with deeper-than-pathological-T2 gastric cancer and undergone R0 gastrectomy with lymph node dissection between January 2000 and December 2012 at the National Cancer Center Hospital, Japan.
Results: MSC was not found in 108 of the 506 patients with pathological T4a (21.3%), whereas it was detected in 250 of the 904 patients with pathological T2-T3 (27.7%). The sensitivity, specificity and accuracy for diagnosing pathological serosa exposed (SE) by MSC were 78.7%, 72.3% and 74.6%, respectively. The MSC-positive cases had a worse 5-year overall survival (OS) than the MSC-negative cases in pT3 (72.9% vs. 84.3%, p=0.001), pT4a (56.2% vs. 73.4%, p=0.001), pStageIIB (76.0% vs. 88.4%, p=0.005), pStageIIIA (63.4% vs. 75.6%, p=0.019), pStageIIIB (53.6% vs. 69.2%, p=0.029) and pStage IIIC (27.6% vs. 50.0%, p=0.062). A multivariate analysis showed that MSC was a significant independent predictor for the OS (hazard ratio [HR], 1.587) along with the tumor depth (HR, 7.742), nodal status (HR, 5.783) and age (HR, 2.382). Peritoneal recurrence rates were higher in the MSC-positive cases than in the MSC-negative cases at each pT stage.
Conclusions: MSC was an important prognostic factor in patients with resectable locally advanced gastric cancer. MSC should be considered when predicting the patient prognosis.
Figure 1
Figure 2
Figure 3
This is a list of supplementary files associated with this preprint. Click to download.
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