Macroscopic appearance of Type IV and giant Type III is a high risk for a poor prognosis in pathological stage II/III advanced gastric cancer with postoperative adjuvant chemotherapy

Table 1 Univariate prognostic analysis in pathological stage II/III advanced gastric cancer

Clinicopaghological factors	Classification	Number	Univariate analysis (5-yr RFS)	Univariate analysis (P value)	5-yr OS	P value
Age	Young	74	77.40%	0.0082	82.30%	0.0024
	Elderly	98	56.90%		58.10%
Sex	Male	120	62.50%	0.018	63.50%	0.0054
	Female	52	81.90%		83.10%
Tumor location	Upper	54	59.60%	0.12	81.10%	0.027
	Middle	74	68.40%		76.10%
	Lower	44	80.50%		59.20%
Method	Total	100	67.40%	0.51	69.00%	0.18
	Distal	72	70.00%		76.00%
Lymphadenectomy	D1	10	68.60%	0.95	56.00%	0.53
	D1+	16	64.30%		79.60%
	D2	146	69.00%		72.20%
Laparoscopic	Yes	25	77.30%	0.16	77.30%	0.2
	No	147	67.00%		70.90%
Splenectomy	Yes	51	61.50%	0.2	65.80%	0.31
	No	121	71.50%		74.50%
Transfusion	Yes	23	63.90%	0.58	68.00%	0.37
	No	149	69.30%		72.70%
13th JGCA pT	T2	65	80.30%	0.019	83.00%	0.021
	T3	105	61.90%		65.80%
	T4	2	50.00%		50.00%
13th JGCA pN	N0	24	90.50%	0.0043	89.40%	0.022
	N1	82	74.00%		77.30%
	N2	66	54.30%		59.10%
13th JGCA pStage	II	57	92.10%	< 0.0001	86.80%	< 0.0001
	IIIA	79	63.90%		76.00%
	IIIB	36	43.00%		42.80%
Lauren histology	Intestinal	60	63.60%	0.23	68.30%	0.27
	Diffuse	112	71.30%		74.20%
INF	Alpha	13	76.90%	0.83	84.60%	0.53
	Beta	75	69.90%		77.50%
	Gamma	84	66.40%		67.50%
Lymphatic invasion	ly0	9	100.00%	0.2	100.00%
	ly1	45	74.80%		77.10%	0.19
	ly2	62	63.70%		71.20%
	ly3	56	63.90%		63.60%
Vascular invasion	v0	16	87.10%	0.055	85.60%	0.043
	v1	55	69.90%		65.20%
	v2	55	72.80%		83.50%
	v3	46	55.70%		62.70%
Macroscopic feature	High risk	18	35.70%	0.0003	34.00%	< 0.0001
	Average risk	154	72.60%		76.60%

JGCA: Japanese Gastric Cancer Association.

Table 2 Multivariate Cox proportional hazards model in pathological stage II/III advanced gastric cancer

Clinicopaghological factors	Classification	Number	Multivariate analysis for PFS (Hazard ratio)	Multivariate analysis for OS (95%CI)	P value	Hazard ratio	95%CI	P value
Age	Young	74	Reference		0.029	Reference		0.008
	Elderly	98	1.83	1.07-3.20		2.35	1.25-4.58
Sex	Male	120	Reference	1.06-4.34	0.031	Reference	0.87-4.91	0.11
	Female	52	2.05			1.93
Tumor location	Upper	54				2.84	1.24-7.19	0.013
	Middle	74				1.73	0.70-4.66	0.24
	Lower	44				Reference
13th JGCA pStage	II	57	Reference			Reference
	IIIA	79	6.17	2.42-20.83	< 0.0001	2.25	0.93-6.27	0.08
	IIIB	36	8.48	3.11-29.70	< 0.0001	4.81	1.79-14.72	0.002
Vascular invasion	v0	16				Reference
	v1	55				1.46	0.38-9.55	0.62
	v2	55				0.71	0.17-4.80	0.68
	v3	46				1.34	0.33-9.01	0.71
Macroscopic feature	High risk	18	2.29	1.06-4.63	0.036	2.74	1.17-6.15	0.021
	Average risk	154	Reference			Reference

JGCA: Japanese Gastric Cancer Association.

Table 3 Relations of high risk macroscopic features to prognsotic factors in pathological stage II/III advanced gastric cancer

Clinicopaghological factors	Classification	Number	High risk gastric cancer n = 18	Average risk gastric cancer n = 154	P value
Age	Young	74	8	66	0.26
	Elderly	98	10	88
Sex	Male	120	13	107	0.81
	Female	52	5	47
Lymphadenectomy	D1	26	4	22	0.37
	D2	146	14	132
Tumor location	Upper	54	3	51	0.32
	Middle	74	9	65
	Lower	44	6	38
13th JGCA pT	T2	65	1	64	0.0025
	T3	105	17	88
	T4	2	0	2
13th JGCA pN	N0	24	2	22	0.11
	N1	82	5	77
	N2	66	11	55
13th JGCA pStage	II	57	3	54	0.0004
	IIIA	79	4	76
	IIIB	36	11	25
7th UICC pT	T2	29	0	29	0.02
	T3	36	1	35
	T4a	105	17	88
	T4b	2	0	2
7th UICC pN	N0	24	2	22	0.08
	N1	45	1	44
	N2	40	4	36
	N3	63	11	52
7th UICC pStage	IIA	13	0	13	< 0.0001
	IIB	37	2	35
	IIIA	46	2	44
	IIIB	38	3	35
	IIIC	38	11	27
Vascular invasion	v0	16	1	15	0.94
	v1	55	6	49
	v2	55	6	49
	v3	46	5	41

JGCA: Japanese Gastric Cancer Association.

Table 4 Initial recurrent sites and RTKs expression in high risk gastric cancer with relapse

Case	Age	Sex	13th JGCA pT	13th JGCA pN	13th JGCA pStage	Macroscopic features	EGFR	HER2	HER3	IGF1R	EphA2	Initial recurrences
1	74	M	3	2	IIIB	Giant type III	2+	1+	2+	2+	1+	#16 LN
2	62	M	3	2	IIIB	Giant type III	2+	0+	1+	2+	0+	#20 LN
3	79	F	3	2	IIIB	Giant type III	2+	1+	1+	0+	1+	#13 LN
4	68	M	3	2	IIIB	Giant type III	3+	1+	1+	1+	0+	#16,13
5	68	M	3	2	IIIB	Giant type III	3+	0+	1+	1+	1+	#13 LN
6	45	M	3	2	IIIB	Giant type III	2+	3+	2+	0+	2+	#13 LN
7	69	M	3	2	IIIB	Giant type III	3+	3+	1+	1+	2+	liver
8	71	M	3	1	IIIA	Type IV	2+	0+	1+	1+	0+	#13 LN
9	69	F	3	1	IIIA	Type IV	2+	0+	2+	1+	0+	Peritoneum
10	69	M	3	1	IIIA	Type IV	1+	2+	0+	1+	1+	Peritoneum
11	59	F	3	2	IIIB	Type IV	1+	1+	1+	1+	0+	Peritoneum

JGCA: Japanese Gastric Cancer Association; M: Male; F: Female; EGFR: Epidermal growth factor receptor; HER2: Human epidermalgrowth factor receptor-2; IGF1R: Insulin-like growth factor 1.