Proliferation kinetics and prognosis in gastric cancer after resection

Eur J Cancer. 2001 Sep;37(13):1635-41. doi: 10.1016/s0959-8049(01)00186-1.

Abstract

The influence of proliferation and proliferation kinetics on prognosis in gastric 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-phase cells, BrdU labelling index (LI), DNA synthesis time (T(s)), potential tumour 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). Besides the established pathohistological prognostic factors, univariate analysis revealed a prognostic influence on survival for BrdU LI, T(pot) and the proportion of S-phase cells. By multivariate Cox analysis of the completely resected cases, only tumour stage and T(pot) had a significant, independent influence on survival. By classification and regression trees (CART) analysis, resection status, tumour stage and T(pot) defined risk groups with significantly different outcomes. A short T(pot) was a predictor of better survival in stage I, II and IIIA tumours. Ploidy and the other investigated proliferation-related parameters failed to demonstrate any influence on prognosis after resection of gastric cancer.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenocarcinoma / pathology*
  • Adenocarcinoma / surgery
  • Adult
  • Aged
  • Aged, 80 and over
  • Antimetabolites, Antineoplastic / administration & dosage
  • Bromodeoxyuridine / administration & dosage
  • Cell Division
  • DNA, Neoplasm / analysis
  • Female
  • Flow Cytometry
  • Humans
  • Infusions, Intravenous
  • Ki-67 Antigen / metabolism
  • Male
  • Middle Aged
  • Ploidies
  • Postoperative Care / methods
  • Preoperative Care / methods
  • Proliferating Cell Nuclear Antigen / metabolism
  • Regression Analysis
  • S Phase / physiology
  • Stomach Neoplasms / pathology*
  • Stomach Neoplasms / surgery
  • Survival Analysis

Substances

  • Antimetabolites, Antineoplastic
  • DNA, Neoplasm
  • Ki-67 Antigen
  • Proliferating Cell Nuclear Antigen
  • Bromodeoxyuridine