Proliferation kinetics and prognosis in gastric cancer after resection

The influence of proliferation and proliferation kinetics on prognosis in g astric cancer after complete resection are controversial. In a prospective study we investigated the tumour specimens of 111 patients after resection of gastric cancer, who received 200 mg intravenous (i.v.) bromodeoxyuridine (BrdU) pre-operatively. The following biological parameters were analysed in the tumour tissue using flow-cytometry: DNA ploidy, proportion of S-phas e cells, BrdU labelling index (LI), DNA synthesis time (Ts), potential tumo ur doubling time (T-pot), proliferating cell nuclear antigen (PCNA) and Ki- 67 LI. The median follow-up time was 40 months (range 19-62 months). Beside s the established pathohistological prognostic factors, univariate analysis revealed a prognostic influence on survival for BrdU LI, Tpot and the prop ortion of S-phase cells. By multivariate Cox analysis of the completely res ected cases, only tumour stage and Tpot had a significant, independent infl uence on survival. By classification and regression trees (CART) analysis, resection status, tumour stage and Tpot defined risk groups with significan tly different outcomes. A short Tpot was a predictor of better survival in stage I, II and IIIA tumours. Ploidy and the other investigated proliferati on-related parameters failed to demonstrate any influence on prognosis afte r resection of gastric cancer. (C) 2001 Elsevier Science Ltd. All rights re served.