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International Journal of Clinical Oncology

, Volume 24, Issue 12, pp 1565–1573 | Cite as

Gastrectomy for invasive micropapillary carcinoma is associated with poorer disease-free and disease-specific survival

  • Mikihiro KanoEmail author
  • Jun Hihara
  • Mayumi Kaneko
  • Kenichiro Uemura
  • Hiroki Ohge
  • Taijiro Sueda
Original Article
  • 65 Downloads

Abstract

Background

Invasive micropapillary carcinoma (IMPC) is a relatively rare subtype of gastric adenocarcinoma and has aggressive histopathologic characteristics, including lymphatic and vascular invasion. However, the associated long-term survival outcomes remain unclear. This study aimed to compare the clinicopathological characteristics and prognosis of gastric adenocarcinoma with and without IMPC using propensity score-matched (PSM) analysis.

Methods

Patients with gastric adenocarcinoma who underwent gastrectomy between 2006 and 2015 were included in the analysis. PSM analysis was performed to compensate for the background heterogeneity between the groups. The primary endpoint was disease-free survival (DFS) after gastrectomy, and the secondary endpoints were disease-specific survival (DSS) and recurrence pattern.

Results

Of 882 patients who underwent gastrectomy for gastric adenocarcinoma, with a follow-up duration greater than 36 months, 35 were diagnosed as having gastric adenocarcinoma with IMPC. After PSM, 70 patients, including 35 with IMPC and 35 without IMPC, were selected. Gastric adenocarcinoma with IMPC is characterized by lymphatic invasion (94% versus 69%, p = 0.012). Patients with IMPC had significantly poorer DFS than those without IMPC, with 3-year DFS rates of 62.2% and 93.4% (p = 0.003), respectively. Furthermore, a significant difference was also observed in DSS (p = 0.016); patients with IMPC more frequently developed liver metastasis (20%) than those without IMPC (3%, p = 0.006).

Conclusions

Resected gastric carcinoma with IMPC was associated with poorer DFS and DSS; furthermore, an increased rate of lymphatic invasion and liver metastasis was noted than in cases without IMPC.

Keywords

Invasive micropapillary carcinoma Gastric carcinoma Liver metastasis Prognosis Propensity score matching 

Notes

Acknowledgements

We would like to extend our appreciation to our staff members, who provided carefully considered feedback and valuable comments. Furthermore, we have had the support and encouragement of other two pathologists (Shinji Kimura and Hiroo Matsuura) of the department of Pathology in Hiroshima City Asa Citizens Hospital.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflicts of interest.

Ethical standards

All procedures followed were in accordance with the ethical standards of the responsible committee on human experimentation (institutional and national) and with the Helsinki Declaration of 1964 and later versions. This study is a retrospective observational study, carried out by the opt-out method of our hospital website.

Informed consent

For this type of study, formal consent is not required.

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Copyright information

© Japan Society of Clinical Oncology 2019

Authors and Affiliations

  1. 1.Department of SurgeryHiroshima City Asa Citizens HospitalHiroshimaJapan
  2. 2.Department of PathologyHiroshima City Asa Citizens HospitalHiroshimaJapan
  3. 3.Department of Surgery, Graduate School of Biomedical and Health SciencesHiroshima UniversityHiroshimaJapan

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