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Pathology and prognosis of gastric carcinoma: well versus poorly differentiated type.
Cancer. 2000 Oct 01; 89(7):1418-24.C

Abstract

BACKGROUND

The most important parameters predicting outcome of patients with gastric carcinoma are the depth of wall invasion and the status of lymph node metastasis, but the prognostic significance of histologic type is unclear. The aim of this study was to clarify the prognostic value of two major histologic types of gastric carcinoma, that is well and poorly differentiated types.

METHODS

Histopathologic findings and outcomes of 504 patients with gastric carcinoma were evaluated by well and poorly differentiated types. Well differentiated gastric carcinoma (WGC) included papillary and tubular adenocarcinomas, poorly differentiated medullary carcinoma, and well differentiated mucinous carcinoma; whereas poorly differentiated gastric carcinoma (PGC) included poorly differentiated scirrhous carcinoma, signet ring cell carcinoma, and poorly differentiated mucinous carcinoma.

RESULTS

Patients with WGC were characterized by old age, male predominance, tumor location in the lower third of the stomach, small tumor size, and liver metastasis; whereas patients with PGC were distinguished by their tumor location in the middle third of the stomach, serosal invasion, lymph node metastasis, advanced stage, and peritoneal dissemination. The overall 5-year survival rate for patients with WGC was higher than that for patients with PGC (76% vs. 67%; P = 0.058), especially for patients with >/= 10 cm tumors (42% vs. 14%; P = 0.017). The 5-year survival rate for patients with serosa positive but node negative tumors was higher in WGC patients than in PGC patients (83% vs. 59%; P = 0.086); whereas the 5-year survival rate for patients with serosa negative but node positive tumors was lower in WGC patients than in PGC patients (63% vs. 88%; P = 0.008). Multivariate analysis indicated that among pathologic variables of the tumor, histologic type (WGC vs. PGC) was one of the independent prognostic factors.

CONCLUSIONS

Histologic type is important for estimating the tumor progression and outcomes of patients with gastric carcinoma. In addition to the depth of wall invasion and status of lymph node metastasis, histologic type, including well or poorly differentiated type, should be evaluated in the management of gastric cancer.

Authors+Show Affiliations

Adachi Y
First Department of Surgery, Oita Medical University, Oita, Japan.
Yasuda K
No affiliation info available
Inomata M
No affiliation info available
Sato K
No affiliation info available
Shiraishi N
No affiliation info available
Kitano S
No affiliation info available

MeSH

AdenocarcinomaAdenocarcinoma, MucinousAdultAgedCarcinoma, MedullaryDisease ProgressionFemaleHumansLymphatic MetastasisMaleMiddle AgedNeoplasm InvasivenessPrognosisRetrospective StudiesStomach Neoplasms

Pub Type(s)

Journal Article

Language

eng

PubMed ID

11013353

Citation

Adachi, Y, et al. "Pathology and Prognosis of Gastric Carcinoma: Well Versus Poorly Differentiated Type." Cancer, vol. 89, no. 7, 2000, pp. 1418-24.
Adachi Y, Yasuda K, Inomata M, et al. Pathology and prognosis of gastric carcinoma: well versus poorly differentiated type. Cancer. 2000;89(7):1418-24.
Adachi, Y., Yasuda, K., Inomata, M., Sato, K., Shiraishi, N., & Kitano, S. (2000). Pathology and prognosis of gastric carcinoma: well versus poorly differentiated type. Cancer, 89(7), 1418-24.
Adachi Y, et al. Pathology and Prognosis of Gastric Carcinoma: Well Versus Poorly Differentiated Type. Cancer. 2000 Oct 1;89(7):1418-24. PubMed PMID: 11013353.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Pathology and prognosis of gastric carcinoma: well versus poorly differentiated type. AU - Adachi,Y, AU - Yasuda,K, AU - Inomata,M, AU - Sato,K, AU - Shiraishi,N, AU - Kitano,S, PY - 2000/10/3/pubmed PY - 2000/10/21/medline PY - 2000/10/3/entrez SP - 1418 EP - 24 JF - Cancer JO - Cancer VL - 89 IS - 7 N2 - BACKGROUND: The most important parameters predicting outcome of patients with gastric carcinoma are the depth of wall invasion and the status of lymph node metastasis, but the prognostic significance of histologic type is unclear. The aim of this study was to clarify the prognostic value of two major histologic types of gastric carcinoma, that is well and poorly differentiated types. METHODS: Histopathologic findings and outcomes of 504 patients with gastric carcinoma were evaluated by well and poorly differentiated types. Well differentiated gastric carcinoma (WGC) included papillary and tubular adenocarcinomas, poorly differentiated medullary carcinoma, and well differentiated mucinous carcinoma; whereas poorly differentiated gastric carcinoma (PGC) included poorly differentiated scirrhous carcinoma, signet ring cell carcinoma, and poorly differentiated mucinous carcinoma. RESULTS: Patients with WGC were characterized by old age, male predominance, tumor location in the lower third of the stomach, small tumor size, and liver metastasis; whereas patients with PGC were distinguished by their tumor location in the middle third of the stomach, serosal invasion, lymph node metastasis, advanced stage, and peritoneal dissemination. The overall 5-year survival rate for patients with WGC was higher than that for patients with PGC (76% vs. 67%; P = 0.058), especially for patients with >/= 10 cm tumors (42% vs. 14%; P = 0.017). The 5-year survival rate for patients with serosa positive but node negative tumors was higher in WGC patients than in PGC patients (83% vs. 59%; P = 0.086); whereas the 5-year survival rate for patients with serosa negative but node positive tumors was lower in WGC patients than in PGC patients (63% vs. 88%; P = 0.008). Multivariate analysis indicated that among pathologic variables of the tumor, histologic type (WGC vs. PGC) was one of the independent prognostic factors. CONCLUSIONS: Histologic type is important for estimating the tumor progression and outcomes of patients with gastric carcinoma. In addition to the depth of wall invasion and status of lymph node metastasis, histologic type, including well or poorly differentiated type, should be evaluated in the management of gastric cancer. SN - 0008-543X UR - https://www.unboundmedicine.com/medline/citation/11013353/Pathology_and_prognosis_of_gastric_carcinoma:_well_versus_poorly_differentiated_type_ DB - PRIME DP - Unbound Medicine ER -