Poor prognostic factors in patients with stage I gastric cancer according to the seventh edition TNM classification: A comparative analysis of three subgroups

Background and Objectives The purpose of this study was to investigate the prognosis of stage I gastric cancer and to compare clinicopathologic characteristics by subgroup. Methods: Between January 2000 and December 2006, 384 patients with gastric cancer were reclassified as stage I according to the seventh edition classification. A comparative analysis was performed between three subgroups. Univariate and multivariate analyses were conducted. Results: The 5-year overall survival rates in T1N0, T1N1, and T2N0 were 98.8%, 94.1%, 91.1%, respectively (P = 0.009). In patients with T2N0 gastric cancer, tumors in the upper third and larger tumors were more common than in patients with T1N0 and T1N1 gastric cancer (P < 0.001). In patients with T1N1 and T2N0 gastric cancer, the presence of lymphatic and/or blood vessel invasion (LBVI) and perineural invasion (PNI) were more common than in patients with T1N0 gastric cancer (P < 0.001). Univariate analysis showed tumor stage, depth of invasion, LBVI, and PNI were significant prognostic factors. However, multivariate analysis demonstrated that only tumor stage, LBVI, and PNI were significant variables. Conclusions: Survival data support the accuracy of new TNM classification for stage I gastric cancer. Tumor stage, the presence of LBVI and PNI are important independent prognostic factors in stage I gastric cancer. J. Surg. Oncol. 2012;105:323-328. (C) 2011 Wiley Periodicals, Inc.