Clinicopathologic Characteristics and Prognosis of Advanced Gastric Cancer Simulating Early Gastric Cancer

Background

Although the clinicopathologic features and prognosis of Borrmann type advanced gastric cancerhas been well characterized, those of advanced gastric cancer simulating early gastric cancer(AGC simulating EGC) still remains unclear.

Methods

We reviewed 1985 gastric cancer patients who had undergone gastrectomy at our hospital todetermine the clinicopathologic characteristics, susceptible sites for lymph node metastasis, andprognosis of AGC simulating EGC in comparison with Borrmann type advanced gastric cancer.

Results

Among 102 patients with AGC simulating EGC, 100 patients (98%) had tumors with depressed typeappearance. The frequencies of serosal invasion, lymph node metastasis, lymphatic vessel invasion,blood vessel invasion, and liver metastasis were significantly lower in AGC simulating EGC than inBorrmann type tumors. The prognosis of AGC simulating EGC was significantly better than that of theBorrmann type tumors. Multivariate analysis indicated that the gross appearance was an independentprognostic factor. In patients with AGC simulating EGC which invaded to the the muscularis propria(MP), most lymph node metastasis was restricted with the perigastric lymph nodes (1st-titer lymphnodes) and lymph node metastasis to 2nd-titer lymph nodes was only observed at station 8a.

Conclusion

AGC simulating EGC is less advanced in comparison with Borrmann type advanced gastric cancer.Based on the results of susceptible sites for lymph node metastasis in the current study, limitedlymph node dissection could be indicated for AGC simulating EGC whose depth of invasion isMP.