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 addressed this study to evaluate whether the analysis of the S-Phase Fraction (SPF) might have prognostic implications in serosa-positive, node-negative gastric cancer. Materials and Methods: Specimens of resected gastric cancer were studied by flow cytometry for SPF analysis. Consecutive patients with stage pT3N0M0, adequate follow-up information and sufficient archival tumor tissue were considered eligible for the study. The tumor SPF indices were related to the timing of recurrences, the relapse rate and the disease-free survival of patients. Results: The analysis was carried out on samples of 137 patients with surgically-resected, stage pT3N0M0 gastric cancer. SPF resulted high and low in 39% and 61% of cases, respectively. Fifty-seven patients relapsed (42%) and early recurrences (within 18 months after surgery) occurred more frequently among cases with high SPF (p<.03). Patients with high SPF tumors showed a worse relapse rate and disease-free survival than patients with low SPF tumors. (p<.005). Conclusion: The SPF analysis showed prognostic differences among patients with stage pT3N0M0 gastric cancer These data may be of value;in the planning of future adjuvant chemotherapy trials in gastric cancer.