Validated prediction of clinical outcome in sarcomas and multiple types of cancer on the basis of a gene expression signature related to genome complexity.

Sarcomas are heterogeneous and aggressive mesenchymal tumors. Histological grading has so far been the best predictor for metastasis-free survival, but it has several limitations, such as moderate reproducibility and poor prognostic value for some histological types. To improve patient grading, we performed genomic and expression profiling in a training set of 183 sarcomas and established a prognostic gene expression signature, complexity index in sarcomas (CINSARC), composed of 67 genes related to mitosis and chromosome management. In a multivariate analysis, CINSARC predicts metastasis outcome in the training set and in an independent 127 sarcomas validation set. It is superior to the Fédération Francaise des Centres de Lutte Contre le Cancer grading system in determining metastatic outcome for sarcoma patients. Furthermore, it also predicts outcome for gastrointestinal stromal tumors (GISTs), breast carcinomas and lymphomas. Application of the signature will permit more selective use of adjuvant therapies for people with sarcomas, leading to decreased iatrogenic morbidity and improved outcomes for such individuals.

Some like it hot: temperature and acidification modulate larval development and settlement of the sea urchin Arbacia lixula

We studied the effects of temperature and pH on larval development, settlement and juvenile survival of a Mediterranean population of the sea urchin Arbacia lixula. Three temperatures (16, 17.5 and 19 °C) were tested at present pH conditions (pHT 8.1). At 19 °C, two pH levels were compared to reflect present average (pHT 8.1) and near-future average conditions (pHT 7.7, expected by 2100). Larvae were reared for 52-days to achieve the full larval development and complete the metamorphosis to the settler stage. We analyzed larval survival, growth, morphology and settlement success. We also tested the carry-over effect of acidification on juvenile survival after 3 days. Our results showed that larval survival and size significantly increased with temperature. Acidification resulted in higher survival rates and developmental delay. Larval morphology was significantly altered by low temperatures, which led to narrower larvae with relatively shorter skeletal rods, but larval morphology was only marginally affected by acidification. No carry-over effects between larvae and juveniles were detected in early settler survival, though settlers from larvae reared at pH 7.7 were significantly smaller than their counterparts developed at pH 8.1. These results suggest an overall positive effect of environmental parameters related to global change on the reproduction of A. lixula, and reinforce the concerns about the increasing negative impact on shallow Mediterranean ecosystems of this post-glacial colonizer.

Education Task Force Report, August 2008

The Rebuild Iowa Education Task Force is composed of Iowans with experience and expertise related to the impact of the tornadoes, storms, and floods of 2008 on the educational system in Iowa. The massive damage greatly impacted educational facilities and enrollment, resulting in thousands of displaced students and significant long-term rebuilding needs. In addition, the education system is a “community center,” and in many ways acts as a first responder to Iowans experiencing the disasters. It is important to also recognize this role and the need for “non-educational” (and often non-quantifiable) supports as a part of the overall recovery effort. There are a few parts of the state that sustained significant structural and other damage as a result of the disasters. However, many school districts and educational institutions throughout the state experienced damage that resulted in re-allocating building usage, enrollment issues (because of housing and relocation issues in the community), or use of school facilities to assist in the recovery efforts (by housing displaced community agencies and providing temporary shelter for displaced Iowans). At this time, damage estimates are only estimates and numbers are revised often. Estimates of damage are being developed by multiple agencies, including FEMA, the Iowa Department of Education, insurance companies, and schools themselves, since there are many different types of damage to be assessed and repaired. In addition to structural damage, educational institutions and communities are trying to find ways to quantify sometimes unquantifiable data, such as future revenue capabilities, population declines, and impact on mental health in the long-term. The data provided in this report is preliminary and as up to date as possible; information is updated on a regular basis as assessments continue and damage estimates are finalized.

Supplemental Information to the August 2008 Education Task Force Report, August 2008

The Rebuild Iowa Education Task Force is composed of Iowans with experience and expertise related to the impact of the tornadoes, storms, and floods of 2008 on the educational system in Iowa. The massive damage greatly impacted educational facilities and enrollment, resulting in thousands of displaced students and significant long-term rebuilding needs. In addition, the education system is a “community center,” and in many ways acts as a first responder to Iowans experiencing the disasters. It is important to also recognize this role and the need for “non-educational” (and often non-quantifiable) supports as a part of the overall recovery effort. There are a few parts of the state that sustained significant structural and other damage as a result of the disasters. However, many school districts and educational institutions throughout the state experienced damage that resulted in re-allocating building usage, enrollment issues (because of housing and relocation issues in the community), or use of school facilities to assist in the recovery efforts (by housing displaced community agencies and providing temporary shelter for displaced Iowans). At this time, damage estimates are only estimates and numbers are revised often. Estimates of damage are being developed by multiple agencies, including FEMA, the Iowa Department of Education, insurance companies, and schools themselves, since there are many different types of damage to be assessed and repaired. In addition to structural damage, educational institutions and communities are trying to find ways to quantify sometimes unquantifiable data, such as future revenue capabilities, population declines, and impact on mental health in the long-term. The data provided in this report is preliminary and as up to date as possible; information is updated on a regular basis as assessments continue and damage estimates are finalized. Supplemental Information to the August 2008 Education Task Force Report

Activation of peroxisome proliferator-activated receptor beta/delta inhibits lipopolysaccharide-induced cytokine production in adipocytes by lowering nuclear factor-kappaB activity via extracellular signal-related kinase 1/2.

OBJECTIVE: Chronic activation of the nuclear factor-kappaB (NF-kappaB) in white adipose tissue leads to increased production of pro-inflammatory cytokines, which are involved in the development of insulin resistance. It is presently unknown whether peroxisome proliferator-activated receptor (PPAR) beta/delta activation prevents inflammation in adipocytes. RESEARCH DESIGN AND METHODS AND RESULTS: First, we examined whether the PPARbeta/delta agonist GW501516 prevents lipopolysaccharide (LPS)-induced cytokine production in differentiated 3T3-L1 adipocytes. Treatment with GW501516 blocked LPS-induced IL-6 expression and secretion by adipocytes and the subsequent activation of the signal transducer and activator of transcription 3 (STAT3)-Suppressor of cytokine signaling 3 (SOCS3) pathway. This effect was associated with the capacity of GW501516 to impede LPS-induced NF-kappaB activation. Second, in in vivo studies, white adipose tissue from Zucker diabetic fatty (ZDF) rats, compared with that of lean rats, showed reduced PPARbeta/delta expression and PPAR DNA-binding activity, which was accompanied by enhanced IL-6 expression and NF-kappaB DNA-binding activity. Furthermore, IL-6 expression and NF-kappaB DNA-binding activity was higher in white adipose tissue from PPARbeta/delta-null mice than in wild-type mice. Because mitogen-activated protein kinase-extracellular signal-related kinase (ERK)1/2 (MEK1/2) is involved in LPS-induced NF-kappaB activation in adipocytes, we explored whether PPARbeta/delta prevented NF-kappaB activation by inhibiting this pathway. Interestingly, GW501516 prevented ERK1/2 phosphorylation by LPS. Furthermore, white adipose tissue from animal showing constitutively increased NF-kappaB activity, such as ZDF rats and PPARbeta/delta-null mice, also showed enhanced phospho-ERK1/2 levels. CONCLUSIONS: These findings indicate that activation of PPARbeta/delta inhibits enhanced cytokine production in adipocytes by preventing NF-kappaB activation via ERK1/2, an effect that may help prevent insulin resistance.

Leaf area of common bean genotypes during early pod filling as related to plant adaptation to limited phosphorus supply

Low phosphorus supply markedly limits leaf growth and genotypes able to maintain adequate leaf area at low P could adapt better to limited-P conditions. This work aimed to investigate the relationship between leaf area production of common bean (Phaseolus vulgaris) genotypes during early pod filling and plant adaptation to limited P supply. Twenty-four genotypes, comprised of the four growth habits in the species and two weedy accessions, were grown at two P level applied to the soil (20 and 80 mg kg-1) in 4 kg pots and harvested at two growth stages (pod setting and early pod filling). High P level markedly increased the leaf number and leaf size (leaf area per leaf), slightly increased specific leaf area but did not affect the net assimilation rate. At low P level most genotypic variation for plant dry mass was associated with leaf size, whereas at high P level this variation was associated primarily with the number of leaves and secondarily with leaf size, specific leaf area playing a minor role at both P level. Determinate bush genotypes presented a smaller leaf area, fewer but larger leaves with higher specific leaf area and lower net assimilation rate. Climbing genotypes showed numerous leaves, smaller and thicker leaves with a higher net assimilation rate. Indeterminate bush and indeterminate prostrate genotypes presented the highest leaf area, achieved through intermediate leaf number, leaf size and specific leaf area. The latter groups were better adapted to limited P. It is concluded that improved growth at low P during early pod filling was associated with common bean genotypes able to maintain leaf expansion through leaves with greater individual leaf area.

Evaluation of risk perception related to drug use during pregnancy: a Swiss survey

Introduction Health care professionals' perception of risk mayimpact on therapeutic management of women during pregnancy.Since the thalidomide tragedy, the use of drugs during pregnancygenerates fear. This concern might affect the estimation of the riskassociated with drug intake during pregnancy, leading to prematurediscontinuation of a required treatment, superfluous anxiety orpointless termination of a desired pregnancy. Although data regardingthe security of drugs during pregnancy are still scarce, a few specializedinformation sources exist providing reliable recommendationsfor daily practice. This study aimed at characterizing therisk perception associated with drugs during pregnancy in a sample ofSwiss health care professionals.Materials & Methods An online French and German survey was sentby email to the Swiss professional societies of Pharmacists, Gynecologists,Mid-wives and Pediatricians. The questionnaire wasconstructed to assess (a) the characteristics of the population and theopinion of the professionals regarding the medication use pattern intheir pregnant patients, (b) to evaluate the sources of information usedduring their practice and finally (c) to assess their risk perceptionassociated with drugs during pregnancy. Results were analyzed bydescriptive statistics.Results A total of 1,310 questionnaires were collected (18% responserate). Most health care professionals believe that 30-60% of theirpregnant patients are taking at least one treatment during their pregnancyand that 80% are adherent to it. A large majority think,however, that women are anxious when they must take their medication.More than 80% of health professionals commonly use theSwiss Drug Reference Book (Compendium) to assess the risk associatedwith drugs during pregnancy, despite the uniformly low levelof credibility and utility they express about this reference. Except forsome gynecologists, the majority of professionals are not aware of ordo not use specialized books. The majority of participants thinkwrongly that more than 30% of drugs are teratogenic. About 20% ofthem are not aware of the risk associated with paracetamol intakeduring pregnancy. More than 70% agree that phytotherapeutic mixturesare not safer than conventional drugs, with the exception of midwiveswho tend to overestimate the safety of such drugs. With thenotable exception of gynecologists, the risk related to drug intake wasoverall overestimated.Discussion & Conclusion Swiss professionals differ in their perceptionof the risk associated with drugs during pregnancy and tend tooverestimate it. The differences might be attributed to the level oftraining and awareness of specialized sources offering a realisticestimation of the risk. Further efforts are needed to expand thetraining and the tools for health care professionals to optimize druguse during pregnancy.

Uncertainties in the prediction of spatial variability of soil CO2 emissions and related properties

The soil CO2 emission has high spatial variability because it depends strongly on soil properties. The purpose of this study was to (i) characterize the spatial variability of soil respiration and related properties, (ii) evaluate the accuracy of results of the ordinary kriging method and sequential Gaussian simulation, and (iii) evaluate the uncertainty in predicting the spatial variability of soil CO2 emission and other properties using sequential Gaussian simulations. The study was conducted in a sugarcane area, using a regular sampling grid with 141 points, where soil CO2 emission, soil temperature, air-filled pore space, soil organic matter and soil bulk density were evaluated. All variables showed spatial dependence structure. The soil CO2 emission was positively correlated with organic matter (r = 0.25, p < 0.05) and air-filled pore space (r = 0.27, p < 0.01) and negatively with soil bulk density (r = -0.41, p < 0.01). However, when the estimated spatial values were considered, the air-filled pore space was the variable mainly responsible for the spatial characteristics of soil respiration, with a correlation of 0.26 (p < 0.01). For all variables, individual simulations represented the cumulative distribution functions and variograms better than ordinary kriging and E-type estimates. The greatest uncertainties in predicting soil CO2 emission were associated with areas with the highest estimated values, which produced estimates from 0.18 to 1.85 t CO2 ha-1, according to the different scenarios considered. The knowledge of the uncertainties generated by the different scenarios can be used in inventories of greenhouse gases, to provide conservative estimates of the potential emission of these gases.

Strategy of specification of management areas: rice grain yield as related to soil fertility

It is well-known nowadays that soil variability can influence crop yields. Therefore, to determine specific areas of soil management, we studied the Pearson and spatial correlations of rice grain yield with organic matter content and pH of an Oxisol (Typic Acrustox) under no- tillage, in the 2009/10 growing season, in Selvíria, State of Mato Grosso do Sul, in the Brazilian Cerrado (longitude 51º24' 21'' W, latitude 20º20' 56'' S). The upland rice cultivar IAC 202 was used as test plant. A geostatistical grid was installed for soil and plant data collection, with 120 sampling points in an area of 3.0 ha with a homogeneous slope of 0.055 m m-1. The properties rice grain yield and organic matter content, pH and potential acidity and aluminum content were analyzed in the 0-0.10 and 0.10-0.20 m soil layers. Spatially, two specific areas of agricultural land management were discriminated, differing in the value of organic matter and rice grain yield, respectively with fertilization at variable rates in the second zone, a substantial increase in agricultural productivity can be obtained. The organic matter content was confirmed as a good indicator of soil quality, when spatially correlated with rice grain yield.

Regulated exocytosis from astrocytes physiological and pathological related aspects.

Astrocytes have traditionally been considered ancillary, satellite cells of the nervous system. However, it is a very recent acquisition that glial cells generate signaling loops which are integral to the brain circuitry and participate, interactively with neuronal networks, in the processing of information. Such a conceptual breakthrough makes this field of investigation one of the hottest in neuroscience, as it calls for a revision of past theories of brain function as well as for new strategies of experimental exploration of brain function. Glial cells are electrically not excitable, and it was only the use of optical recording techniques together with calcium sensitive dyes, that allowed the chemical excitability of glial cells to become apparent. Studies using these new techniques have shown for the first time that glial cells are activated by surrounding synaptic activity and translate neuronal signals into their own calcium code. Intracellular calcium concentration([Ca2+]i) elevations in glial cells have then shown to underlie spatial transfer of information in the glial network, accompanied by release of chemical transmitters (gliotransmitters) such as glutamate and back-signaling to neurons. As a consequence, optical imaging techniques applied to cell cultures or intact tissue have become a state-of-the-art technology for studying glial cell signaling. The molecular mechanisms leading to release of "gliotransmitters," especially glutamate, from glia are under debate. Accumulating evidence clearly indicates that astrocytes secrete numerous transmitters by Ca(2+)-dependent exocytosis. This review will discuss the mechanisms underlying the release of chemical transmitters from astrocytes with a particular emphasis to the regulated exocytosis processes.

Patient-perceived health-related quality of life during recovery after total hip arthroplasty – a 6-month follow-up study

Potilaiden käsitys terveyteen liittyvästä elämänlaadusta lonkan tekonivelleikkauksen jälkeisenä toipumisaikana – kuuden kuukauden seurantatutkimus Tässä kaksivaiheisessa seurantatutkimuksessa tarkasteltiin potilaiden käsitystä terveyteen liittyvästä elämänlaadusta lonkan tekonivelleikkauksen jälkeisenä toipumisaikana. Tutkimuksen ensimmäisessä vaiheessa tarkoituksena oli sekä kuvailla potilaiden kokemuksia potilaana olosta, saamastaan hoidosta ja terveyspalveluorganisaatiosta että analysoida aikaisempien tutkimusten perusteella leikkauksen tuloksia potilaan kannalta. Toisessa vaiheessa tarkoituksena oli arvioida potilaiden kokemaa elämänlaatua leikkauksen jälkeen, ja sitä vaikuttivatko primaaritulokset (fyysinen toimintakyky, kipu, ahdistus) tai taloudelliset seuraukset (potilaiden itsensämaksamat kustannukset, palvelujen käyttö) terveyteen liittyvään elämänlaatuun. Tutkimuksen tavoitteena oli löytää mahdolliset kriittiset ajankohdat tai tekijät, jotka saattavat hidastaa toipumista ja siten huonontaa potilaiden elämänlaatua. Tätä tietoa voidaan käyttää hoitotyössä kun suunnitellaan sopivaa hoitoa ja tukea toipumisajalle. Tutkimuksen ensimmäisessä vaiheessa primaarileikkaukseen tulevat potilaat (n = 17) kuvailivat teemahaastatteluissa kokemuksiaan kahdesti leikkauksen jälkeen. Haastatteluaineisto analysoitiin induktiivisella sisällönanalyysilla. Lisäksi 17 tutkimusartikkelista analysoitiin deduktiivisella sisällönanalyysilla leikkauksen tuloksia potilaalle, tuloksiin vaikuttavia tekijöitä ja käytetyt tutkimusmetodit. Toisessa vaiheessa primaari- tai revisioleikkaukseen tulevat potilaat (n = 100) arvioivat leikkauksen tuloksia kuuden kuukauden ajan leikkauksen jälkeen: terveyteen liittyvää elämänlaatua, primaarituloksia ja taloudellisia seurauksia. Aineisto kerättiin erilaisilla mittareilla: Sickness Impact Profile, Finnish Version, Stait-Trait Anxiety Inventory, ja Numeric Rating Scale. Lisäksi käytettiin tätä tutkimusta varten tehtyjä kyselylomakkeita: Fyysinen toimintakyky-mittari, Palvelujen käyttö-mittari ja Kustannusmittari. Tutkimuksen toiseen vaiheen tulokset analysoitiin tilastollisilla menetelmillä. Potilaiden terveyteen liittyvä elämänlaatu parani ja kipu lievittyi leikkauksen jälkeen ja fyysinen toimintakyky lisääntyi toipumisaikana. Positiivisista muutoksista huolimatta potilaat kokivat ahdistusta samassa määrin kuin ennen leikkaustakin. Palvelujen käyttö vaihteli toipumisajan kuluessa ja potilaiden maksamissa kustannuksissa oli suuria vaihteluita. Fyysisen toimintakyvyn lisääntyminen ja kivun lieveneminen paransivat terveyteen liittyvää elämänlaatua. Sen sijaan huonompi elämänlaatu toipumisaikana oli yhteydessä suurempaan palvelujen käyttöön, kun taas kustannuksilla ei ollut yhteyttä elämänlaatuun. Potilaiden ominaispiirteet tulisi ottaa enemmän huomioon suunniteltaessa sopivaa leikkauksenjälkeistä hoitoa ja tukea. Potilaat tarvitsevat yksilöllisiä ohjeita, sillä monet taustatekijät (esim. ikä, sukupuoli, preoperatiivinen kipu, siviilisääty, ja leikkaustyyppi) vaikuttavat toipumiseen.

Intravitreal ranibizumab for age-related macular degeneration - optical coherence tomography guided retreatment intervals and their intra- and inter-individual variability

PURPOSE:To determine whether the need for retreatment after an initial loading phase of 3 monthly intravitreal injections of ranibizumab shows an intra-individual regular rhythm and to what degree it varies between different patients.SETTING:Prospective mono-centre cohort study.METHODS:Prospective study with 42 patients with exudative age-related macular degeneration (AMD), treatment na?ve, giving informed consent. Loading dose of 3 monthly doses of ranibizumab (0,5mg), followed by a 12 months pro re nata (PRN) regimen according to early exudative signs on spectral domain optical coherence tomography (HD-OCT Cirrus Zeiss?, cube 512x126). The follow-up visits were intensified (week 4, 5, 6, 7, 8, 10, 12, 14, 16, 20, 24, etc after each injection) in order to detect exudative recurrences early, and injection followed within 3 days in cases of subretinal fluid, or intraretinal cysts, or central thickness increase of >50?m. Intervals were calculated between injections and the following recurrence was calculated for the 12 month follow-up with PRN treatment. Variability was expressed as standard deviation (SD). RESULTS Visual acuity (VA) improved from a mean ETDRS letter score of 61.6 (SD 10.8) at baseline to 68.0 (SD 10.2, +6.4 letters) at month 3 and increased further to 74.7 (SD 9.0, +13.1 letters from baseline) at month 12. The 15 patients who have completed the study by October 2010 showed maintenance of the VA improvement. Retinal thickness of the central foveal subfield improved from a mean value of 366?m(baseline) to 253?m(month 3), well maintained thereafter. Mean number of injections was 8.8 (SD 3.5) per 12 months of follow-up (after 3 loading doses), ranging from 0 to 12, with mean individual treatment-recurrence intervals ranging from 28 to >365 days (mean 58 days). Intraindividual variability of treatment-recurrence intervals, measured as SD of the individual intervals, was 7.1days as a mean value(range 1.7 ? 22.6 days) for the 33 patients with more than 1 injection during follow-up. SD was higher for longer intervals of an individual patient. It ranged within 20% of the mean intra-individual interval for 30 patients(91%) and within 15% for 21 patients(64%). The first interval was within 1 week of the mean intra-individual interval in 64% of patients and within 2 weeks in 89% of patients.CONCLUSIONS:The majority of AMD patients showed a relatively stable rhythm for PRN injections of intravitreal ranibizumab after initial loading phase, associated with excellent functional and anatomical results. The initial interval between last loading dose and first recurrence may have a predictive value for further need of treatment, therefore potentially facilitating follow-up and patient care.

Quality of surface water related to land use: a case study in a catchment with small farms and intensive vegetable crop production in southern Brazil

Water degradation is strongly related to agricultural activity. The aim of this study was to evaluate the influence of land use and some environmental components on surface water quality in the Campestre catchment, located in Colombo, state of Parana, Brazil. Physical and chemical attributes were analyzed (total nitrogen, ammonium, nitrate, total phosphorus, electrical conductivity, pH, temperature, turbidity, total solids, biological oxygen demand, chemical oxygen demand and dissolved oxygen). Monthly samples of the river water were taken over one year at eight monitoring sites, distributed over three sub-basins. Overall, water quality was worse in the sub-basin with a higher percentage of agriculture, and was also affected by a lower percentage of native forest and permanent preservation area, and a larger drainage area. Water quality was also negatively affected by the presence of agriculture in the riparian zone. In the summer season, probably due to higher rainfall and intensive soil use, a higher concentration of total nitrogen and particulate nitrogen was observed, as well as higher electrical conductivity, pH and turbidity. All attributes, except for total phosphorus, were in compliance with Brazilian Conama Resolution Nº 357/2005 for freshwater class 1. However, it should be noted that these results referred to the base flow and did not represent a discharge condition since most of the water samples were not collected at or near the rainfall event.

Simultaneous coexpression of memory-related and effector-related genes by individual human CD8 T cells depends on antigen specificity and differentiation.

Phenotypic and functional cell properties are usually analyzed at the level of defined cell populations but not single cells. Yet, large differences between individual cells may have important functional consequences. It is likely that T-cell-mediated immunity depends on the polyfunctionality of individual T cells, rather than the sum of functions of responding T-cell subpopulations. We performed highly sensitive single-cell gene expression profiling, allowing the direct ex vivo characterization of individual virus-specific and tumor-specific T cells from healthy donors and melanoma patients. We have previously shown that vaccination with the natural tumor peptide Melan-A-induced T cells with superior effector functions as compared with vaccination with the analog peptide optimized for enhanced HLA-A*0201 binding. Here we found that natural peptide vaccination induced tumor-reactive CD8 T cells with frequent coexpression of both memory/homing-associated genes (CD27, IL7R, EOMES, CXCR3, and CCR5) and effector-related genes (IFNG, KLRD1, PRF1, and GZMB), comparable with protective Epstein-Barr virus-specific and cytomegalovirus-specific T cells. In contrast, memory/homing-associated and effector-associated genes were less frequently coexpressed after vaccination with the analog peptide. Remarkably, these findings reveal a previously unknown level of gene expression diversity among vaccine-specific and virus-specific T cells with the simultaneous coexpression of multiple memory/homing-related and effector-related genes by the same cell. Such broad functional gene expression signatures within antigen-specific T cells may be critical for mounting efficient responses to pathogens or tumors. In summary, direct ex vivo high-resolution molecular characterization of individual T cells provides key insights into the processes shaping the functional properties of tumor-specific and virus-specific T cells.

Time-related improvement of survival in resectable gastric cancer: the role of Japanese-style gastrectomy with D2 lymphadenectomy and adjuvant chemotherapy

Background: We investigated the change of prognosis in resected gastric cancer (RGC) patients and the role of radical surgery and adjuvant chemotherapy. Methods: We retrospectively analyze the outcome of 426 consecutive patients from 1975 to 2002, divided into 2 time-periods (TP) cohort: Before 1990 (TP1, n = 207) and 1990 or after (TP2; n= 219). Partial gastrectomy and D1-lymphadenetomy was predominant in TP1 and total gastrectomy with D2-lymphadenectomy it was in TP2. Adjuvant chemotherapy consisted of mitomycin C (MMC), 10¿20 mg/m2 iv 4 courses or MMC plus Tegafur 500 mg/m2 for 6 months. Results: Positive nodes were similar in TP2/TP1 patients with 56%/59% respectively. Total gastrectomy was done in 56%/45% of TP2/TP1 respectively. Two-drug adjuvant chemotherapy was administered in 65%/18% of TP2/TP1 respectively. Survival at 5 years was 66% for TP2 versus 42%for TP1 patients (p < 0.0001). Survival by stages II, IIIA y IIIB for TP2 versus TP1 patients was 70 vs. 51% (p = 0.0132); 57 vs. 22% (p = 0.0008) y 30 vs. 15% (p = 0.2315) respectively. Multivariate analysis showed that age, stage of disease and period of treatment were independent variables. Conclusion: The global prognosis and that of some stages have improved in recent years with case RGC patients treated with surgery and adjuvant chemotherapy.