Characteristics and prognosis of mucinous gastric carcinoma

Abstract

Abstract. Mucinous gastric carcinoma (MGC) is a rare histological subtype of undifferentiated gastric carcinoma, accounting for ~2.6-6.6% of all gastric cancer cases. The clinicopathological characteristics and prognosis of MGC are controversial. The present study aimed to determine the clinicopathological characteristics and prognosis of patients with MGC. We retrospectively compared the characteristics and postoperative survival of 70 patients with MGC and 2,492 non-MGC (NMGC) cases who underwent surgical resection between 1990 and 2010. MGC was characterised by larger tumor size, macroscopic Borrmann type 2 and 3, T4 invasion of the gastric wall, positive N2 and N3 lymph node metastasis, positive lymphatic vessel invasion, positive venous invasion, peritoneal metastasis and advanced tumor stage III and IV. The prognosis of MGC patients was worse compared to that of NMGC patients, as the former group consisted of more advanced-stage cases. When patients with similar disease stages were compared, the incidence of peritoneal metastasis was significantly higher among MGC patients. However, hepatic metastasis was found significantly more often in NMGC patients. Otherwise, the prognosis of MGC and NMGC patients with similar disease stages was not significantly different. Therefore, our findings indicated that, although MGC is more rare and mostly detected at an advanced stage, the diagnosis of the mucinous histological subtype was not an independent prognostic factor.

Clinical Outcomes of Mucinous Gastric Carcinomas Compared with Non-mucinous and Signet Ring Cell Carcinomas

“…MGC is often found in a more advanced stage than NMGC, 7,16,17 which was also found in the present study. MGC is found mainly in advanced stages and is believed to be related to the characteristics of MGC.…”

“…The proportion of the initial pT4, M1 stage was also the highest in the MGC group. The MGC group had a significantly higher recurrence rate than the NMGC and SRC groups (37.3% in MGC vs. 16.8%…”

“…Second, as the tumor invades the gastric wall, mucin could not be excreted into the lumen, but deposited in the intramural area. 16,20 The pathogenesis of MGC is also believed to contribute to the diagnosis of MGC in advanced stages.…”

Prognostic significance of mucinous component in gastric adenocarcinoma after radical D2 gastrectomy

“…Lots of studies have reported on the clinical–pathological characteristics and prognosis of MGC, 4 , 6 , 7 , 18 but few have focused on the prognostic significance of mucinous component in gastric adenocarcinoma, even though the coexistence of mucinous component and gastric adenocarcinoma is observed frequently. Kim et al 19 revealed there were some differences in several clinicopathological features of signet-ring cell, mucinous (MGC), papillary, and lymphoepithelioma-like subtypes of advanced gastric cancer, and no statistical differences in survival were found among these after R0 gastrectomy.…”

“… 3 – 5 Tang et al 6 found that MGC was an aggressive malignancy with unique clinicopathological features in 244 MGC patients who underwent radical gastrectomy with D2 lymphadenectomy. In Isobe et al’s study, 7 70 MGC patients were compared with 2,492 non-MGC (NMGC) patients, and although MGC is rarer and mostly detected at an advanced stage, the diagnosis of the mucinous histological subtype was not an independent prognostic factor. Zhao et al’s results showed MGC was more likely to have large tumors and more advanced tumor stage (II and III) than NMGC, and the thicker gastric wall, layered enhancement pattern, and calcification were highly suggestive computed tomography features for differentiating MGC from NMGC.…”