Annals of Surgical Oncology

, Volume 18, Issue 5, pp 1274–1281 | Cite as

Transverse Mesocolon Invasion in Advanced Gastric Cancer: Should We Reconsider Current T Staging?

  • Jong Won Kim
  • Seong-Ho Kong
  • Min A Kim
  • Woo Ho Kim
  • Hyuk-Joon Lee
  • Kuhn Uk Lee
  • Han-Kwang Yang
Gastrointestinal Oncology

Abstract

Background

According to the AJCC/UICC TNM classification, T mesocolon invasion in AGC is classified as T2b or T3 according to the presence or the absence of serosa invasion. However, many authors have considered T mesocolon invasion in AGC as T4. This study was performed to evaluate the appropriate T stage for T mesocolon invasion in AGC.

Materials and Methods

From 1996 to 2008, 90 patients underwent curative gastrectomy with T mesocolon excision at the authors’ institute under the suspicion of T mesocolon invasion based on surgical findings and without pathologic invasion to any other organ. Histopathologic findings were reviewed to determine whether tumors had invaded the T mesocolon. Survival data of AGC patients registered in the SNUH database (N = 9998, from 1986 to 2007) was used as reference data for comparative purposes.

Results

A total of 27 patients (30%) had proven histopathological invasion of the T mesocolon, and a significant difference in survival rates was found between these 27 and the remaining 63 (P = .012). As compared with the SNUH database population, the survival rate of T mesocolon invasion patients differed from those of T2b (P < .001) and T3 (P = .043) patients, but was similar to that of T4 patients (P = .218). Furthermore, for N1 stage patients, the survival rate differed from those of T2b (P = .001) and T3 (P = .046) patients, but was similar to that of T4 patients (P = .744).

Conclusions

The T stage of T mesocolon invasion in AGC should be revised to AJCC/UICC stage T4, because the survival rate of T mesocolon invasion AGC is lower than that of stage T2b or T3.

Keywords

Gastric Cancer Survival Curve Gastric Cancer Patient Advanced Gastric Cancer Transverse Mesocolon 

Notes

Acknowledgment

This study was supported by a research fund, Seoul National University Hospital (04-2009-111-0).

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Copyright information

© Society of Surgical Oncology 2011

Authors and Affiliations

  • Jong Won Kim
    • 1
  • Seong-Ho Kong
    • 1
  • Min A Kim
    • 2
  • Woo Ho Kim
    • 3
  • Hyuk-Joon Lee
    • 4
  • Kuhn Uk Lee
    • 1
  • Han-Kwang Yang
    • 4
  1. 1.Department of SurgerySeoul National University College of MedicineSeoulKorea
  2. 2.Department of PathologySeoul National University College of MedicineSeoulKorea
  3. 3.Department of Pathology and Cancer Research InstituteSeoul National University College of MedicineSeoulKorea
  4. 4.Department of Surgery and Cancer Research InstituteSeoul National University College of MedicineSeoulKorea

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