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Poorly differentiated Clusters (PDCs) of tumor cells composed of more than five elements have been recently described in gastrointestinal cancers and correlate with a worse prognosis. Our study aims to investigate PDC occurrence in a series of patients with gastric cancer and correlate it with lymph node status and clinical outcome. 50 patients were included in the study; PDCs count was graduated as G1, G2, and G3 according to Ueno classification (PDCs count at 20× &lt;5, 5–9 and ≥10 respectively). We collected several clinicopathologic variables such as tumor location, pTNM stage, vascular or perineural invasion, and lymph-node ratio for each case. The presence of PDCs was related to vascular invasion ( p  &lt; .013) and recurrence event ( p  &lt; .027). When the population was categorized according to the number of PDCs, a significant correlation was found with the presence of lymph node metastasis ( p  &lt; .000), the Lymph Node Ratio ( p  &lt; .002), WHO stage at the diagnosis ( p  &lt; .000) and vascular invasion ( p  &lt; .001). At the univariate and multivariate analysis, PDCs were found as an independent risk factor for recurrence (HR 1.94; CI 95% 1.209–3.121;  p  &lt; .006 and HR 0.401; CI 95% 0.187–0.862;  p  &lt; .017 respectively). The Kaplan–Meier curves for OS and DFS showed a significant association between PDCs and shorter time to recurrence or survival. PDC is a strong prognostic factor in gastric cancer, easily detectable, and feasible. As far as we know, this is the first report in Literature of a strong correlation between PDC and survival in patients with operated gastric cancer.

Role of poorly differentiated cluster in gastric cancer: is it a new prognosis factor?