Clinicopathologic Characteristics of Gastric Cancer according to Histologic Type

Kwon, Sung Joon

Abstract

PURPOSE: The aim of this study was to determine the clinico-pathologic characteristics of gastric cancer according to histologic type, and prognosis.
METHODS
The distribution of various clinico-pathologic profiles and the outcomes of 819 gastric cancer patients who had received curative surgery were analyzed according to histologic type, which was divided into differentiated and undifferentiated carcinoma. Differentiated carcinoma (DC) included papillary adenocarcinoma, well differentiated and moderately differentiated tubular adenocarcinoma, whereas undifferentiated carcinoma (UDC) included poorly differentiated carcinoma, mucinous carcinoma, and signet ring cell carcinoma.
RESULTS
Patients with DC were characterized by: old age, male predominance, tumor located in the lower third of the stomach, small tumor size, early stage, and frequent liver metastasis in recurred cases; Patients with UDC were characterized by: youthfulness, advanced stage, large tumor size, lymphatic permeation, macroscopic depressed type or diffusely infiltrative pattern, and frequent peritoneal dissemination in recurred cases. The overall 5-year survival rate for patients with DC was higher than that for patients with UDC (78% vs. 69%; P=0.0045). The 5-year survival rate for patients who were treated in the early-stage of the disease was higher in DC patients than in UDC patients (98% vs. 91%; P=0.0261), and the 5-year survival rate for tumors located in the lower third of the stomach was lower in UDC patients than in DC patients (67% vs. 81%; P=0.0012).
CONCLUSION
In addition to the depth of gastric wall invasion and the status of lymph node metastasis, histologic type is also important in estimating tumor progression and outcome for patients with gastric carcinoma. In spite of curative surgery, it is important to consider postoperative adjuvant treatment and a close follow-up, especially in patients with differentiated early gastric carcinoma.