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Annals of Surgical Oncology
Published in: Annals of Surgical Oncology 6/2016

01-06-2016 | Gastrointestinal Oncology

Tumor Infiltrative Pattern Predicts Sites of Recurrence After Curative Gastrectomy for Stages 2 and 3 Gastric Cancer

Authors: Mitsuro Kanda, MD, PhD, FACS, Akira Mizuno, MD, Tsutomu Fujii, MD, PhD, FACS, Yoshie Shimoyama, MD, PhD, Suguru Yamada, MD, PhD, FACS, Chie Tanaka, MD, PhD, Daisuke Kobayashi, MD, PhD, Masahiko Koike, MD, PhD, Naoki Iwata, MD, PhD, Yukiko Niwa, MD, PhD, Masamichi Hayashi, MD, PhD, Hideki Takami, MD, PhD, Goro Nakayama, MD, PhD, Hiroyuki Sugimoto, MD, PhD, Michitaka Fujiwara, MD, PhD, Yasuhiro Kodera, MD, PhD, FACS

Published in: Annals of Surgical Oncology | Issue 6/2016

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Abstract

Background

In East Asia, the tumor infiltrative pattern (INF) has been routinely evaluated by hematoxylin and eosin-stained sections as a pathologic characteristic of surgically resected specimens.

Methods

The infiltrative pattern of gastric cancer (GC) has been histopathologically classified as INFa (expansive growth), INFb (intermediate type) and INFc (infiltrative growth) according to the Japanese Classification of Gastric Carcinoma. The prognostic value and characteristics of the disease recurrence pattern for each INF type were assessed in 785 patients with various stages of GC and also in 243 patients with stages 2 and 3 GC.

Results

Comparison of the overall survival experienced by patients independently of stage showed that INF was significantly associated with prognosis. Specifically, peritoneal metastasis was present in 91 % of stage 4 patients in the INFc group, whereas hepatic metastasis was present in 39 % of stage 4 patients in the INFa and INFb group. After curative gastrectomy of patients with stages 2 or 3 GC, INF was not significantly associated with survival. The prevalence of peritoneal recurrence was significantly higher in the INFc group than in the INFa and INFb group, whereas the prevalence of hepatic recurrence was significantly higher in the INFa and INFb group than in the INFc group. Multivariate analysis identified INFc as an independent risk factor for peritoneal recurrence after curative gastrectomy. The association of the INF type with the incidence of peritoneal recurrence was observed with all disease stages regardless whether the patient was given adjuvant chemotherapy or not.

Conclusions

Evaluation of the INF type shows promise for its role as a predictor of postoperative recurrence sites in patients with GC.
Appendix
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Metadata
Title
Tumor Infiltrative Pattern Predicts Sites of Recurrence After Curative Gastrectomy for Stages 2 and 3 Gastric Cancer
Authors
Mitsuro Kanda, MD, PhD, FACS
Akira Mizuno, MD
Tsutomu Fujii, MD, PhD, FACS
Yoshie Shimoyama, MD, PhD
Suguru Yamada, MD, PhD, FACS
Chie Tanaka, MD, PhD
Daisuke Kobayashi, MD, PhD
Masahiko Koike, MD, PhD
Naoki Iwata, MD, PhD
Yukiko Niwa, MD, PhD
Masamichi Hayashi, MD, PhD
Hideki Takami, MD, PhD
Goro Nakayama, MD, PhD
Hiroyuki Sugimoto, MD, PhD
Michitaka Fujiwara, MD, PhD
Yasuhiro Kodera, MD, PhD, FACS
Publication date
01-06-2016
Publisher
Springer International Publishing
Published in
Annals of Surgical Oncology / Issue 6/2016
Print ISSN: 1068-9265
Electronic ISSN: 1534-4681
DOI
https://doi.org/10.1245/s10434-016-5102-x

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