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

International Journal of Clinical Oncology volume 24, pages 1565–1573 (2019)Cite this article

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.

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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.

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Affiliations

  1. Department of Surgery, Hiroshima City Asa Citizens Hospital, Kabe-minami 2-1-1, Asakita-ku, Hiroshima, 731-0293, Japan

    Mikihiro Kano & Jun Hihara

  2. Department of Pathology, Hiroshima City Asa Citizens Hospital, Hiroshima, Japan

    Mayumi Kaneko

  3. Department of Surgery, Graduate School of Biomedical and Health Sciences, Hiroshima University, Hiroshima, Japan

    Kenichiro Uemura, Hiroki Ohge & Taijiro Sueda

Authors
  1. Mikihiro Kano
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  2. Jun Hihara
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  3. Mayumi Kaneko
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  4. Kenichiro Uemura
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  5. Hiroki Ohge
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  6. Taijiro Sueda
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Corresponding author

Correspondence to Mikihiro Kano.

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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.

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Kano, M., Hihara, J., Kaneko, M. et al. Gastrectomy for invasive micropapillary carcinoma is associated with poorer disease-free and disease-specific survival. Int J Clin Oncol 24, 1565–1573 (2019). https://doi.org/10.1007/s10147-019-01514-x

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  • DOI: https://doi.org/10.1007/s10147-019-01514-x

Keywords

  • Invasive micropapillary carcinoma
  • Gastric carcinoma
  • Liver metastasis
  • Prognosis
  • Propensity score matching