A new staging system based on tumor volume in gastric cancer

Background: Development of a more appropriate staging system for gastric cancer may prove useful in clinical practice. Materials and Methods: A total of 171 patients with solitary carcinoma of the stomach (112 males and 59 females, age range, 20 to 84 years; mean, 57.7 years) who underwent curative surgery were examined. The volume of each tumor was measured from serial tumor tissue sections using a computer software program. The utility of a new staging system based on tumor volume was assessed with respect to patient survival in comparison with other clinicopathological factors and conventional staging. Results: Significant differences in survival time were found for depth of invasion (TI vs T2 or T3; p = 0.008), nodal status (n0 vs n1 or n2; p = 0.032), tumor volume (less than or equal to 2000 mm(3) vs > 2000 mm(3); p < 0.001) and stage (stage I vs stage II, III or IV; p = 0.003). However, multivariate analysis only identified tumor volume as a significant prognostic factor in the present study (p < 0.001; relative risk 10.351). Conclusion: The above findings suggest that a new staging system based on tumor volume may have advantages over the conventional staging system in the assessment of gastric cancer.