| Popis: |
Background: Although tumor size (Ts) is regarded as the “T” stage of the Tumor-Node-Metastasis (TNM) staging system for many solid tumors, the prognostic impact in gastric cancer (GC) remains uncertain and conflicting. Methods: We enrolled 6960 eligible cases from the Surveillance, Epidemiology, and End Results (SEER) database. The X-tile program was used to select the best cutoff value of Ts. Then the Kaplan-Meier method and the Cox proportional hazards model were applied to examine the efficacy of Ts on prognostic prediction for overall survival (OS) and gastric cancer-specific survival (GCSS). The presence of nonlinear association was determined by restricted cubic splines (RCS). Results: Ts was divided into three groups: small size (≤ 2.5 cm), medium size (2.6-5.2 cm), and large size (≥ 5.3 cm). After adjusting by covariates, Ts larger than 2.5 cm predicted a worse prognosis; however, no survival difference on OS was suggested between the medium and large groups. Similarly, according to the adjusted RCS models, for tumors larger than 3.9 cm, large tumor size showed no significant differences on OS and GCSS with those smaller. However, the stratified analyses proposed the usage of the 3-way cut of Ts in prognostic prediction for patients with both inadequate lymphadenectomy and negative lymph node metastasis. Conclusions: Ts as a prognostic predictor may not have good clinical applicability in GC. Otherwise, it is recommended for patients with both insufficient examination of lymph nodes and stage N0 disease. |
