Background/aim: Macroscopic features and age may be important prognostic factors that discriminate survival among clinical conditions requiring different therapeutic strategies of advanced gastric cancer (AGC), and this study aimed to identify their clinical relevance.
Methodology: A total of 232 AGC patients who had Surgical T2b or beyond was enrolled to identify clinical indicators, including macroscopic features in combination with age.
Results: Macroscopic features were divided into 3 categories (types I/II/V, III, and IV), which included stage IV in 24%, 53%, and 72% (P < 0.0001), respectively. Macroscopic features (P < 0.0001), histological features (P = 0.025), and pathological infiltration type (P = 0.0003) were all univariate prognostic factors, as well as stage (P < 0.0001) and age (P = 0.009). However, the multivariate proportional hazards model found that macroscopic features (P = 0.0013) and age (P = 0.0091) were the only factors independent of stage (P <0.0001). Both factors clearly classified the patients into 4 groups (young type 1/II/V (group 1), elderly type I/II/V (group 2), type III and young type IV (group 3), and elderly type IV (group 4) with different prognoses.
Conclusions: Macroscopic features and age were simple indicators of prognosis in AGC. Both factors may have great potential to develop prognostic categories that effectively classify AGC into categories requiring different therapeutic strategies.