1 Jan 2000Article
PROGNOSTIC VALUE OF LAUREN’S HISTOLOGICAL TYPE IN PATIENTS WHO UNDERWENT CURATIVE SURGERY FOR GASTRIC CANCER ITALIAN MULTICENTRIC STUDY
G. MANZONI 1F. ROVIELLO 2D. MARRELLI 2P. MORGAGNI 3A. LEO 1L. SARAGONI 4A. STEFANO 2F. BAZZOCCHI 3E. PINTO 2
Affiliations
Article Info
1 Istituto di Semeiotica Chirurgica, I Divisione Clinicizzata di Chirurgia Generale, Università di Verona
2 Istituto di Scienze Chirurgiche, U.O. di Chirurgia Oncologica, Università di Siena
3 Divisione di Chirurgia Generale I, Ospedale di Forlì
4 Servizio di Anatomia Patologica, Ospedale di Forlì
Ann. Ital. Chir., 2001, 72(1), 13-18;
Published: 1 Jan 2000
Copyright © 2000 Annali Italiani di Chirurgia
This work is licensed under a Creative Commons Attribution 4.0 International License.
Abstract
Background. The prognostic significance of the histological type in gastric cancer is still debated. The correlation between intestinal-diffuse type and tumor recurrence was investigated in a prospective multicentric study which collects the cases from three surgical Departments of Italy. Patients and Metheds. Four-hundred and twelve patients who underwent a potentially curative resection between 1988 and 1995 were considered; 273 cases were classified as intestinal type (group A), and 139 cases as diffuse type (group B). Mixed cases were excluded from the study. All patients were included in a complete follow-up program for the early diagnosis of recurrence. Clinical, histopathological and surgical factors were examined for their influence on tumor recurrence by univariate and multivariate analysis. Results. Recurrence rate was 41.4% in intestinal type, and 65.5% in diffuse type cases (p<0.0001). In group A, multivariate analysis identified nodal status (p<0.0001), depth of invasion (p<0.005), lymph node dis section (D1 vs. D2-D4, p<0.01), advanced age (p<0.01) and male sex (p<0.05) as significant prognostic factors. In group B, depth of invasion (p<0.0005), lymph node dis section (p<0.005), tumor size (p<0.01) and nodal status (p<0.05) resulted as significant variables; no preventive effect on tumor recurrence was found for D2 vs. D1 lymphadenectomy. Multivariate analysis performed on the totality of the cases demonstrated diffuse type as an independent predictor of poor prognosis (relative risk: 1.67, p<0.001). Conclusions. Diffuse type of gastric cancer is an independent risk factor for tumor recurrence as compared with intestinal type; clinical and pathological variables play a different role as prognostic factors in the two histotypes.
Keywords
- gastric cancer
- surgical therapy
- R0-resection