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Analysis of the Survival Period in Resectable Stage IV Gastric Cancer

From the Departments of Surgery II (ST, TN, RK, TS, YU) and Pathology I (SY), Oita Medical University, Japan.

Correspondence: Address correspondence and reprint requests to: Shinsuke Takeno, MD, PhD, Department of Surgery II, Oita Medical University, Idaigaoka 1-1, Hasama-machi, Oita 879-5593, Japan; Fax: 81-97-549-4449.

Background: Patients with stage IV gastric cancer usually have a poor prognosis, but some patients with resectable cancer survive for more than 5 years. We aimed to study the correlation of protein expression and survival in resectable stage IV gastric cancer.

Patients and Methods: Tissue samples of 42 patients with resectable stage IV gastric cancer were stained immunohistochemically for the mutant p53 protein and heat shock protein-27 (hsp27). The correlation between protein expression and clinicopathological factors was investigated. Furthermore, prognostic value of each factor was analyzed.

Results: Univariate analysis showed that pN factors (Japanese classification, P = .028; International Union Against Cancer classification, P = .024), blood vessel invasion (P = .043), hsp27 overexpression (P = .019), and the index of p53 and hsp27 overexpression (P = .0026) had a prognostic influence. Only Lauren classification, however, revealed the prognostic influence in multivariate analysis (P = .046).

Conclusions: These results suggest that immunostaining of tumor specimens for p53 and hsp27 and clinicopathological analysis may help predict the survival of patients with resectable stage IV gastric cancer.

Key Words: hsp27 • p53 • Resectable stage IV gastric cancer • Lymph node metastasis

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