Clinicopathological characteristics of stage 1 gastric cancer

Comparison of macroscopic and microscopic findings

Hideo Baba, Tatsuo Ohshiro, Manabu Yamamoto, Kazuya Endo, Eisuke Adachi, Yoshihiro Kakeji, Shunji Kohnoe, Yoshihiko Maehara, Keizo Sugimachi

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Background/Aims: Laparoscopic surgery or endoscopic mucosal resection. for early stages of gastric cancer have been, introduced recently in many regions. In such cases, a precise diagnosis is needed prior to treatment, since understaging of gastric cancer may lead to treatment failure and impairment of curability and prognosis. The clinicopathological features of understaged cases in macroscopic Stage 1 gastric cancer have not been clarified yet. Material and Methods: We examined 435 patients with intra-operative findings of macroscopic Stage 1 gastric cancer and compared clinicopathological features of 354 patients (Group A) with both macroscopic and histological stage 1 cancer and 81 patients (Group B) with macroscopic stage 1 but histologically proven to be more advanced cancer. Results: Among 435 patients with macroscopic Stage 1, there were 81 (18.6%) with histologically more advanced stages (44 of stage 2, 34 of stage 3, and 3 of stage 4). There were no statistical differences in age, sex, operative procedure, and extend of lymph node dissection between the groups. Carcinomas in the 81 Group B patients tended to have larger tumors (> 4 cm), located in, the middle third and along the Lesser curvature of the stomach, appeared to be Borrmann V type (unclassified type) and were histologically more often, associated with undifferentiated type, INF-γ, lymphovascular invasion, lymph node metastasis, and invasion into a layer deeper than submucosa, all of which resulted in significantly poorer prognosis. Conclusions: Pre-operative and intra-operative assessment of the stage for gastric cancer was not always accurate enough and about one fifth cases with macroscopic Stage 1 gastric cancer were understaged. Thus, we recommend gastrectomy plus radical lymphadenectomy (at least D2) for the treatment of choice, from the points of view of curability and prognosis when gastric carcinoma is associated with the above mentioned characteristics.

Original languageEnglish
Pages (from-to)554-558
Number of pages5
JournalHepato-gastroenterology
Volume44
Issue number14
Publication statusPublished - May 3 1997

Fingerprint

Stomach Neoplasms
Lymph Node Excision
Stomach
Carcinoma
Neoplasms
Operative Surgical Procedures
Gastrectomy
Treatment Failure
Laparoscopy
Lymph Nodes
Neoplasm Metastasis
Therapeutics

All Science Journal Classification (ASJC) codes

  • Hepatology
  • Gastroenterology

Cite this

Baba, H., Ohshiro, T., Yamamoto, M., Endo, K., Adachi, E., Kakeji, Y., ... Sugimachi, K. (1997). Clinicopathological characteristics of stage 1 gastric cancer: Comparison of macroscopic and microscopic findings. Hepato-gastroenterology, 44(14), 554-558.

Clinicopathological characteristics of stage 1 gastric cancer : Comparison of macroscopic and microscopic findings. / Baba, Hideo; Ohshiro, Tatsuo; Yamamoto, Manabu; Endo, Kazuya; Adachi, Eisuke; Kakeji, Yoshihiro; Kohnoe, Shunji; Maehara, Yoshihiko; Sugimachi, Keizo.

In: Hepato-gastroenterology, Vol. 44, No. 14, 03.05.1997, p. 554-558.

Research output: Contribution to journalArticle

Baba, H, Ohshiro, T, Yamamoto, M, Endo, K, Adachi, E, Kakeji, Y, Kohnoe, S, Maehara, Y & Sugimachi, K 1997, 'Clinicopathological characteristics of stage 1 gastric cancer: Comparison of macroscopic and microscopic findings', Hepato-gastroenterology, vol. 44, no. 14, pp. 554-558.
Baba H, Ohshiro T, Yamamoto M, Endo K, Adachi E, Kakeji Y et al. Clinicopathological characteristics of stage 1 gastric cancer: Comparison of macroscopic and microscopic findings. Hepato-gastroenterology. 1997 May 3;44(14):554-558.
Baba, Hideo ; Ohshiro, Tatsuo ; Yamamoto, Manabu ; Endo, Kazuya ; Adachi, Eisuke ; Kakeji, Yoshihiro ; Kohnoe, Shunji ; Maehara, Yoshihiko ; Sugimachi, Keizo. / Clinicopathological characteristics of stage 1 gastric cancer : Comparison of macroscopic and microscopic findings. In: Hepato-gastroenterology. 1997 ; Vol. 44, No. 14. pp. 554-558.
@article{f85d51c1698841b3b4689aea17ed5263,
title = "Clinicopathological characteristics of stage 1 gastric cancer: Comparison of macroscopic and microscopic findings",
abstract = "Background/Aims: Laparoscopic surgery or endoscopic mucosal resection. for early stages of gastric cancer have been, introduced recently in many regions. In such cases, a precise diagnosis is needed prior to treatment, since understaging of gastric cancer may lead to treatment failure and impairment of curability and prognosis. The clinicopathological features of understaged cases in macroscopic Stage 1 gastric cancer have not been clarified yet. Material and Methods: We examined 435 patients with intra-operative findings of macroscopic Stage 1 gastric cancer and compared clinicopathological features of 354 patients (Group A) with both macroscopic and histological stage 1 cancer and 81 patients (Group B) with macroscopic stage 1 but histologically proven to be more advanced cancer. Results: Among 435 patients with macroscopic Stage 1, there were 81 (18.6{\%}) with histologically more advanced stages (44 of stage 2, 34 of stage 3, and 3 of stage 4). There were no statistical differences in age, sex, operative procedure, and extend of lymph node dissection between the groups. Carcinomas in the 81 Group B patients tended to have larger tumors (> 4 cm), located in, the middle third and along the Lesser curvature of the stomach, appeared to be Borrmann V type (unclassified type) and were histologically more often, associated with undifferentiated type, INF-γ, lymphovascular invasion, lymph node metastasis, and invasion into a layer deeper than submucosa, all of which resulted in significantly poorer prognosis. Conclusions: Pre-operative and intra-operative assessment of the stage for gastric cancer was not always accurate enough and about one fifth cases with macroscopic Stage 1 gastric cancer were understaged. Thus, we recommend gastrectomy plus radical lymphadenectomy (at least D2) for the treatment of choice, from the points of view of curability and prognosis when gastric carcinoma is associated with the above mentioned characteristics.",
author = "Hideo Baba and Tatsuo Ohshiro and Manabu Yamamoto and Kazuya Endo and Eisuke Adachi and Yoshihiro Kakeji and Shunji Kohnoe and Yoshihiko Maehara and Keizo Sugimachi",
year = "1997",
month = "5",
day = "3",
language = "English",
volume = "44",
pages = "554--558",
journal = "Acta hepato-splenologica",
issn = "0172-6390",
publisher = "H.G.E. Update Medical Publishing Ltd.",
number = "14",

}

TY - JOUR

T1 - Clinicopathological characteristics of stage 1 gastric cancer

T2 - Comparison of macroscopic and microscopic findings

AU - Baba, Hideo

AU - Ohshiro, Tatsuo

AU - Yamamoto, Manabu

AU - Endo, Kazuya

AU - Adachi, Eisuke

AU - Kakeji, Yoshihiro

AU - Kohnoe, Shunji

AU - Maehara, Yoshihiko

AU - Sugimachi, Keizo

PY - 1997/5/3

Y1 - 1997/5/3

N2 - Background/Aims: Laparoscopic surgery or endoscopic mucosal resection. for early stages of gastric cancer have been, introduced recently in many regions. In such cases, a precise diagnosis is needed prior to treatment, since understaging of gastric cancer may lead to treatment failure and impairment of curability and prognosis. The clinicopathological features of understaged cases in macroscopic Stage 1 gastric cancer have not been clarified yet. Material and Methods: We examined 435 patients with intra-operative findings of macroscopic Stage 1 gastric cancer and compared clinicopathological features of 354 patients (Group A) with both macroscopic and histological stage 1 cancer and 81 patients (Group B) with macroscopic stage 1 but histologically proven to be more advanced cancer. Results: Among 435 patients with macroscopic Stage 1, there were 81 (18.6%) with histologically more advanced stages (44 of stage 2, 34 of stage 3, and 3 of stage 4). There were no statistical differences in age, sex, operative procedure, and extend of lymph node dissection between the groups. Carcinomas in the 81 Group B patients tended to have larger tumors (> 4 cm), located in, the middle third and along the Lesser curvature of the stomach, appeared to be Borrmann V type (unclassified type) and were histologically more often, associated with undifferentiated type, INF-γ, lymphovascular invasion, lymph node metastasis, and invasion into a layer deeper than submucosa, all of which resulted in significantly poorer prognosis. Conclusions: Pre-operative and intra-operative assessment of the stage for gastric cancer was not always accurate enough and about one fifth cases with macroscopic Stage 1 gastric cancer were understaged. Thus, we recommend gastrectomy plus radical lymphadenectomy (at least D2) for the treatment of choice, from the points of view of curability and prognosis when gastric carcinoma is associated with the above mentioned characteristics.

AB - Background/Aims: Laparoscopic surgery or endoscopic mucosal resection. for early stages of gastric cancer have been, introduced recently in many regions. In such cases, a precise diagnosis is needed prior to treatment, since understaging of gastric cancer may lead to treatment failure and impairment of curability and prognosis. The clinicopathological features of understaged cases in macroscopic Stage 1 gastric cancer have not been clarified yet. Material and Methods: We examined 435 patients with intra-operative findings of macroscopic Stage 1 gastric cancer and compared clinicopathological features of 354 patients (Group A) with both macroscopic and histological stage 1 cancer and 81 patients (Group B) with macroscopic stage 1 but histologically proven to be more advanced cancer. Results: Among 435 patients with macroscopic Stage 1, there were 81 (18.6%) with histologically more advanced stages (44 of stage 2, 34 of stage 3, and 3 of stage 4). There were no statistical differences in age, sex, operative procedure, and extend of lymph node dissection between the groups. Carcinomas in the 81 Group B patients tended to have larger tumors (> 4 cm), located in, the middle third and along the Lesser curvature of the stomach, appeared to be Borrmann V type (unclassified type) and were histologically more often, associated with undifferentiated type, INF-γ, lymphovascular invasion, lymph node metastasis, and invasion into a layer deeper than submucosa, all of which resulted in significantly poorer prognosis. Conclusions: Pre-operative and intra-operative assessment of the stage for gastric cancer was not always accurate enough and about one fifth cases with macroscopic Stage 1 gastric cancer were understaged. Thus, we recommend gastrectomy plus radical lymphadenectomy (at least D2) for the treatment of choice, from the points of view of curability and prognosis when gastric carcinoma is associated with the above mentioned characteristics.

UR - http://www.scopus.com/inward/record.url?scp=0030892227&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0030892227&partnerID=8YFLogxK

M3 - Article

VL - 44

SP - 554

EP - 558

JO - Acta hepato-splenologica

JF - Acta hepato-splenologica

SN - 0172-6390

IS - 14

ER -