ORIGINAL SCIENTIFIC REPORT The Correlation Between RhoA Expression and Clinicopathological Characteristics in Gastric Cancer Patients After Curative Surgery Kuo-Hung Huang 1,2,3 • Yuan-Tzu Lan 2,4 • Ming-Huang Chen 2,5 • Yee Chao 2,5 • Su-Shun Lo 2,6 • Anna Fen-Yau Li 2,7 • Chew-Wun Wu 1,2 • Shih-Hwa Chiou 3,8,9 • Muh-Hwa Yang 3,5 • Yi-Ming Shyr 1,2 • Wen-Liang Fang 1,2 Published online: 27 May 2015 Ó Socie ´te ´ Internationale de Chirurgie 2015 Abstract Background The expression of RhoA, a member of the ras homologue family, is reported to be involved in tumorigenesis in some cancers; however, its prognostic value in gastric cancer is controversial. Methods Between April 1988 and January 2005, a total of 206 gastric cancer patients receiving curative surgery were enrolled in this study. Immunohistochemical staining of the RhoA protein was performed, and the clinico- pathological characteristics and initial recurrence patterns were compared between low RhoA expression (n = 55) and high RhoA expression (n = 151) gastric cancer patients. Results For intestinal-type (n = 134) gastric cancer, there is no significant difference between the clinicopatho- logical characteristics and RhoA expression. However, for diffuse-type (n = 82) gastric cancer, high RhoA ex- pression was associated with more advanced pathological N category compared to low RhoA expression. A multivariate analysis revealed that age, pathological T and N categories, and RhoA expression were independent prognostic factors for overall survival after curative surgery. For all patients, the five-year overall survival rates and disease-free survival rates were higher in patients with low RhoA expression compared to those with high RhoA expression, which was observed in diffuse-type gastric cancer, not in intestinal-type gastric cancer. With regard to the initial recurrence pattern, patients with high RhoA expression had more distant metastasis compared to those with low RhoA expression, especially more liver metastasis. Conclusions RhoA expression is an independent prognostic factor for gastric cancer, especially for diffuse-type. We should be aware of liver metastasis during the follow-up of gastric cancer with high RhoA expression. & Wen-Liang Fang s821094@hotmail.com 1 Division of General Surgery, Department of Surgery, Taipei Veterans General Hospital, No. 201, Sec. 2, Shipai Rd., Beitou District, Taipei City 11217, Taiwan 2 School of Medicine, National Yang-Ming University, Taipei City, Taiwan 3 Institute of Clinical Medicine, School of Medicine, National Yang-Ming University, Taipei City, Taiwan 4 Division of Colon & Rectal Surgery, Department of Surgery, Taipei Veterans General Hospital, Taipei City, Taiwan 5 Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei City, Taiwan 6 National Yang-Ming University Hospital, Yilan City, Taiwan 7 Department of Pathology, Taipei Veterans General Hospital, Taipei City, Taiwan 8 Department of Medical Research and Education, Taipei Veterans General Hospital, Taipei City, Taiwan 9 Institute of Pharmacology, National Yang-Ming University, Taipei City, Taiwan 123 World J Surg (2015) 39:2289–2299 DOI 10.1007/s00268-015-3095-4