Prognostic value of S-phase fraction in T3N0M0 gastric cancer. Implications for adjuvant chemotherapy

Introduction: The prognosis of patients with T3N0M0 gastric cancer is still unfavourable and the role of adjuvant chemotherapy is unclear. We addresse d this study to evaluate whether the analysis of the S-Phase Fraction (SPF) might have prognostic implications in serosa-positive, node-negative gastr ic cancer. Materials and Methods: Specimens of resected gastric cancer were studied by flow cytometry for SPF analysis. Consecutive patients with stag e pT3N0M0, adequate follow-up information and sufficient archival tumor tis sue were considered eligible for the study. The tumor SPF indices were rela ted to the timing of recurrences, the relapse rate and the disease-free sur vival of patients. Results: The analysis was carried out on samples of 137 patients with surgically-resected, stage pT3N0M0 gastric cancer. SPF result ed high and low in 39% and 61% of cases, respectively. Fifty-seven patients relapsed (42%) and early recurrences (within 18 months after surgery) occu rred more frequently among cases with high SPF (p<.03). Patients with high SPF tumors showed a worse relapse rate and disease-free survival than patie nts with low SPF tumors. (p<.005). Conclusion: The SPF analysis showed prog nostic differences among patients with stage pT3N0M0 gastric cancer These d ata may be of value;in the planning of future adjuvant chemotherapy trials in gastric cancer.