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The decision criterion of histological mixed type in “T1/T2” gastric carcinoma—comparison between TNM classification and Japanese classification of gastric cancer
Author(s) -
Shimizu Hiroki,
Ichikawa Daisuke,
Komatsu Shuhei,
Okamoto Kazuma,
Shiozaki Atsushi,
Fujiwara Hitoshi,
Murayama Yasutoshi,
Kuriu Yoshiaki,
Ikoma Hisashi,
Nakanishi Masayoshi,
Ochiai Toshiya,
Kokuba Yukihito,
Kishimoto Mitsuo,
Yanagisawa Akio,
Otsuji Eigo
Publication year - 2011
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.23010
Subject(s) - medicine , cancer , lymphovascular invasion , adenocarcinoma , gastrectomy , gastroenterology , gastric carcinoma , multivariate analysis , oncology , pathology , metastasis
Abstract Background This study was designed to evaluate the clinical significance of undifferentiated component in differentiated T1/T2 gastric adenocarcinoma. Methods Two hundred thirty‐one patients who underwent curative gastrectomy were diagnosed pathologically as differentiated type T1/T2 gastric cancer according to Japanese Classification of Gastric Carcinoma (JCGC). The patients were divided into subgroups, pure differentiated type (pure D group, 181 patients) and differentiated‐predominant mixed type (D > U group, 51 patients). The clinicopathological features of D > U group were compared with those of pure D group, and also those of undifferentiated‐predominant type (U > D group). Results Patients in D > U group were more likely to have larger and deeper tumors with lymphatic invasion and metastases than pure D group. However, there was no significant difference in clinicopathological factors between D > U and U > D groups, except for depth of tumor invasion. The postoperative 5‐year survival rate of D > U group was significantly poorer than that of pure D group (88% and 98%, P = 0.011). Multivariate analysis revealed the presence of undifferentiated component was an independent prognostic factor. Conclusions The presence of undifferentiated component in differentiated T1/T2 gastric cancer is associated with tumor progression. Therefore, the decision criterion of histological mixed type in TNM classification is better suited than JCGC in T1/T2 gastric cancer. J. Surg. Oncol. 2012; 105:800–804. © 2012 Wiley Periodicals, Inc.