Early gastric cancer with a mixed-type Lauren classification is more aggressive and exhibits greater lymph node metastasis
- 583 Downloads
The clinicopathological features of mixed-type (MT) early gastric cancer (EGC) according to Lauren’s classification remain uninvestigated. This study aimed to clarify the clinicopathological features of MT EGC, particularly in relation to lymph node metastasis (LNM) and long-term survival.
This study included 5309 patients who underwent gastrectomy for EGC. The clinicopathological features, LNM, and long-term outcomes of patients with MT carcinomas were compared with those of patients with intestinal-type (IT) and diffuse-type (DT) cancers. Furthermore, we evaluated the predictors of LNM in each Lauren classification subgroup.
Patients with MT carcinomas were likelier to have larger tumors, submucosal invasion, lymphovascular invasion, and LNM than those with IT or DT carcinomas. Multivariate logistic regression analysis revealed that the Lauren classification was a significant predictor of LNM (P < 0.001). The significant predictors of LNM in MT carcinomas were female sex, greater tumor size, presence of submucosal invasion, and lymphovascular invasion. However, the overall survival of patients with MT carcinoma was not significantly different from that of patients with IT or DT carcinomas (P = 0.104).
The presence of MT EGC carries a higher risk of LNM compared with the presence of IT or DT carcinomas. Therefore, MT carcinomas should be managed with gastrectomy that includes lymph node dissection instead of endoscopic resection.
KeywordsLauren’s classification Mixed type Early gastric cancer Lymph node metastasis
Compliance with ethical standards
Conflict of interest
The authors declare that they have no conflict of interest.
- 10.Bowman FT, Carneiro F, Hruban RH, editors. Classification of tumours of the digestive system. Lyon: International Agency for Research on Cancer; 2010.Google Scholar
- 11.Edge SB, Byrd DR, Compton CC, Fritz AG, Greene FL, Trotti A III, editors. AJCC cancer staging manual. 7th ed. New York: Springer; 2010.Google Scholar
- 21.Pyo JH, Shin CM, Lee H, et al. A risk-prediction model based on lymph-node metastasis for incorporation into a treatment algorithm for signet ring cell-type intramucosal gastric cancer. Ann Surg. 2016. doi: 10.1097/SLA.0000000000001602.
- 23.Tahara E. Genetic pathways of two types of gastric cancer. IARC Sci Publ. 2004:327–49.Google Scholar