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CURRENT THOUGHTS ON FACTORS THAT INFLUENCE PROGNOSIS OF GASTRIC CANCER
Author(s) -
Thomas E.
Publication year - 1973
Publication title -
medical journal of australia
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.904
H-Index - 131
eISSN - 1326-5377
pISSN - 0025-729X
DOI - 10.5694/j.1326-5377.1973.tb129785.x
Subject(s) - medicine , grading (engineering) , stomach , gastrectomy , lymph node , lymph , cancer , infiltration (hvac) , stroma , pathology , radiology , oncology , biology , immunohistochemistry , ecology , physics , thermodynamics
A large number of factors influence the prognosis of gastric cancer. In individual cases, prognostication is difficult unless all these factors are assessed adequately. The presence of distant metastases indicates an extremely poor outcome. In resectable cases, prognosis varies not only with the presence or absence of regional lymph node involvement, but also with the number of nodes involved. The extent of involvement of the stomach wall by the tumour is very important; prognosis worsens as the tumour invades beyond the muscularis and the serosa. Another important factor affecting prognosis is the intensity of lymphocytic infiltration of the stroma of the tumour; the greater the infiltration, the better the prognosis. Mucus production by the tumour cells is an ominous sign. Tumours situated proximally, especially in the cardiaic and fundic regions of the stomach, have a worse outlook than those situated more distally; the prognosis progressively improves with the distance of the lesion from the cardia. The role of other factors, such as duration of symptoms, size, macroscopic appearance and histological grading, is discussed. A partial gastrectomy with removal of regional lymph nodes rather than total gastrectomy is the operation of choice, except under exceptional circumstances. Adequate assessment of all prognostic indicators can be achieved only by the combined efforts of the surgeon and pathologist.