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Clinicopathological Features and Prognosis of Mixed-Type T1a Gastric Cancer Based on Lauren’s Classification

  • Gastrointestinal Oncology
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Recent studies have reported that mixed-type (MT) gastric cancer, as per Lauren’s classification, exhibits aggressive behavior. However, the behavior of early gastric cancer is unclear. In this study, we addressed the influence of mucosa-confined MT gastric cancer, according to Lauren’s classification, on lymph node metastasis (LNM) and long-term outcomes.

Methods

Among patients who underwent gastrectomy for gastric cancer from January 2000 to December 2012, 3170 had mucosa-confined gastric cancer. According to Lauren’s classification, 1449 (45.7 %), 1528 (48.2 %), and 193 (6.1 %) patients had intestinal type (IT), diffuse type (DT), and MT cancer, respectively. Moreover, patients with MT cancer were histologically subdivided into IT-predominant MT (3.0 %) and DT-predominant MT (2.5 %) groups. We analyzed and compared the clinicopathological characteristics, incidence of LNM, overall survival, and recurrence-free survival between these groups.

Results

Clinicopathological characteristics showed that mucosa-confined MT gastric cancer had larger size, deeper invasion, and more frequent lymphovascular invasion compared with IT or DT cancers. The LNM of MT lesions (4.7 %) was comparable with that of DT lesions (4.8 %), and multivariate logistic regression analysis indicated that Lauren’s classification was a significant predictor for LNM (P < 0.001). However, the overall survival and recurrence-free survival of patients with MT lesions did not differ significantly (P = 0.506 and 0.359, respectively).

Conclusions

Thus, among patients with mucosa-confined gastric cancer, those with MT cancer as per Lauren’s classification have aggressive clinical features and a risk of LNM. Hence, surgical treatment may be the preferred option in these patients.

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Disclosure

No external sources of funding were received for this study. All authors declare no conflicts of interest.

Author information

Author notes

  1. Soomin Ahn MD

    Present address: Department of Pathology, Ewha Womans University School of Medicine, Seoul, South Korea

Authors and Affiliations

  1. Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Jeung Hui Pyo MD, Hyuk Lee MD, PhD, Byung-Hoon Min MD, PhD, Jun Haeng Lee MD, PhD & Jae J. Kim MD, PhD

  2. Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Soomin Ahn MD & Kyoung-Mee Kim MD, PhD

  3. Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea

    Sang Goon Shim MD

  4. Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Min Gew Choi MD, PhD, Jun Ho Lee MD, PhD, Tae Sung Sohn MD, PhD, Jae Moon Bae MD, PhD & Sung Kim MD, PhD

  5. Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea

    Seungmin Yeon MS & Sin-Ho Jung PhD

  6. Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA

    Sin-Ho Jung PhD

Authors
  1. Jeung Hui Pyo MD
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  2. Soomin Ahn MD
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  4. Byung-Hoon Min MD, PhD
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  5. Jun Haeng Lee MD, PhD
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  7. Min Gew Choi MD, PhD
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  10. Jae Moon Bae MD, PhD
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  11. Kyoung-Mee Kim MD, PhD
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  12. Seungmin Yeon MS
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  14. Jae J. Kim MD, PhD
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  15. Sung Kim MD, PhD
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Corresponding authors

Correspondence to Hyuk Lee MD, PhD or Jae J. Kim MD, PhD.

Additional information

Jeung Hui Pyo and Soomin Ahn have contributed equally to this work.

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Pyo, J.H., Ahn, S., Lee, H. et al. Clinicopathological Features and Prognosis of Mixed-Type T1a Gastric Cancer Based on Lauren’s Classification. Ann Surg Oncol 23 (Suppl 5), 784–791 (2016). https://doi.org/10.1245/s10434-016-5549-9

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  • DOI: https://doi.org/10.1245/s10434-016-5549-9

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