OBJECTIVETo investigate the impact of tumor size on the prognosis of patients with T3 gastric cancer.

METHODSD2 curative resection was performed on 408 patients with T3 gastric cancer. Cox proportional hazards model was used to identify the optimal cut-off of tumor size. Potential prognostic factors were evaluated by univariate and multivariate analysis. Multivariate analysis was performed to evaluate the prognostic factors stratified by tumor size.

RESULTSAmong 408 patients with T3 gastric cancer, Cox proportional hazards model showed that 8 cm was the optimal cut-off of tumor size. There were 85 patients with tumor size ≥8 cm(large size group), and 323 patients with tumor size <8 cm(small size group). The 5-year survival rate was significantly lower for patients with small size tumor(33.8% vs. 52.2%, P<0.05). Cox proportional hazards model showed that lymph node metastasis, tumor size, and Borrmann type were independent prognostic factors for the entire cohort. Borrmann type IIII( and N2-3 nodal metastasis were independent prognostic factors for the large size group. Lymph node metastasis was independent prognostic factor for the small size group.

CONCLUSIONSTumor size is an independent prognostic factor in patients with T3 gastric cancer. Lymph node metastasis is a significant predictor for the prognosis regardless of tumor size. Furthermore, Borrmann classification is associated with the prognosis in patients with tumor size ≥8 cm.