Prognostic impact of tumor size in early gastric cancer        LU Jun, HUANG Chang-ming,  ZHENG Chao-Hui,  et al. Department of Stomach, Fujian Medical University Union Hospital, Fuzhou 350001, China.
Corresponding author: HUANG Chang-ming, E-mail: hcmlr2002@163.com
Abstract    Objective    To investigate the impact of tumor size in the prognosis of early gastric cancer. Methods    In Fujian Medical University Union Hospital,a total of 159 patients with early gastric cancer(EGC), underwent curative gastrectomy during April,1995 to July,2006 were retrospectively analyzed.The best cut-off point depending on tumor size was selected by ROC curve. Both univariate and multivariate analysis were used to analyze the prognosis of this group. The independent prognostic factors of patients were performed subgroup analysis. Results    Receiver operating characteristics (ROC) analysis showed that the most sounded cut-off point for tumor size was 23 small-size  tumors  (SST, ＜23 mm)  and large-size tumors (LST, ≥23 mm). The 5-year survival rates were 98.8% and 80.6% of SST and LST patients respectively,and the differences was statistically significant (P<0.01). COX proportional hazards regression model indicated that the tumor size , submucosal invasion,lymph node metastasis were independent  prognostic  factors affecting the whole group（P<0.05）. Further stratified analysis indicated, that the 5-year survival rate of LST was significantly lower than that of SST in EGC patients without lymph node metastasis or submucosal invasion (P<0.01).Conclusions    Tumor size  cut-off point of 23 mm can exert significant impact on the prognosis of EGC patients without lymph node metastasis or submucosal invasion.