Clinicopathologic study of patients with Borrmann type iv gastric carcinoma

Kitamura, Kenichiro; Beppu, Richiko; Anai, Hideaki; Izutsu, Koji; Yakabe, Shigeru; Sugimachi, Keizō; Saku, Motonori

doi:10.1002/jso.2930580208

Cited by 47 publications

(56 citation statements)

References 15 publications

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“…In most of these works, such variables were analyzed in groups of patients undergoing any type of gastric resection, without distinguishing curative from palliative approaches 3,5,7,9,[14][15][16][17][18][19] , while a smaller number detained on the study of these factors solely in the curative operation 8,11,20 , similar to our series. Like our study, several others confirmed that the B IV was associated with known factors of poor [5][6][7]11,14,16 . Diagnosis in advanced stages, poorly differentiated histology, serosal invasion and high incidence of lymph node involvement are factors that directly influence the prognosis, causing lower rates of curative operations, which can vary between 31 and 52% 3,[5][6][7][8]20 and are in agreement with our data, which was 42.3% (52/123).…”

Section: Discussion Discussion Discussion Discussion Discussionsupporting

confidence: 88%

“…In 1858, Brinton coined the term linitis plastica 4 to describe the infiltrative gastric carcinoma occupying the entire stomach (diffuse form), also called cirrous carcinoma in English literature 3 . Approximately 10 to 15% of all gastric adenocarcinomas are classified as type B IV, and some studies show its association with factors known to be of poor prognosis [5][6][7] . Thus, despite advances in treatment of gastric cancer, the surgical results of the B IV remains poor, with lower rates of curative resection [5][6][7][8] and survival 6,7,9 in comparison with other types of gastric carcinomas.…”

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

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Adenocarcinoma gástrico Borrmann tipo IV: análise dos resultados da ressecção curativa

Accetta

Manso

Mello³

et al. 2011

Rev. Col. Bras. Cir.

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Results Results Results Results: Of the 123 patients studied, 68 underwent gastrectomy, 52 (42.3%) with curative intent and 16 (13%) palliative resection, while 55 (44.7%) had disease not subject to resection. Three postoperative deaths followed the curative resection, constituting a mortality rate of 5.76%. In nine (17.3%) patients there were technical complications, and esophagojejunal fistula seven cases, the most frequent. All technical complications and deaths occurred after total gastrectomy, which was the most commonly performed curative resection type in this series. The most common pattern of recurrence was peritoneal carcinomatosis. The location of the tumor, lymph node metastasis, lymphatic invasion and pathological staging were considered significant prognostic factors. The median survival time was 29 months, with a rate of five-year survival of 33% in patients undergoing curative resection. Conclusion Conclusion Conclusion Conclusion Conclusion: The curative resection of B IV gastric adenocarcinoma had a positive impact on survival of patients with the disease in stages IB, II and III, with up to 15 lymph nodes (pN2) and localized type.

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Section: Discussion Discussion Discussion Discussion Discussionsupporting

confidence: 88%

Section: Introduction Introduction Introduction Introduction Introducmentioning

confidence: 99%

Adenocarcinoma gástrico Borrmann tipo IV: análise dos resultados da ressecção curativa

Accetta

Manso

Mello³

et al. 2011

Rev. Col. Bras. Cir.

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“…SGC has been shown to possess unique clinicopathological characteristics and a poor survival outcome despite curative gastrectomy (10)(11)(12)(13)(14)(15)(16)(20)(21)(22)(23). One reason for the poor prognosis specific to SGC is the difficulty in early detection.…”

Section: A B C Discussionmentioning

confidence: 99%

“…By contrast, numerous studies have commented on the definition (1-4), incidence (10), significance (11), pathology (12), prognosis (10)(11)(12) and management strategy (13)(14)(15)(16) of SGC pertaining solely to the early and the final phase of the disease.…”

Section: Introductionmentioning

confidence: 99%

Biological significance of localized Type IV scirrhous gastric cancer

et al. 2011

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Abstract. The prognosis of type IV scirrhous gastric cancer (SGC) is extremely poor. Linitis plastica (LP), the so-called 'leather bottle stomach', is believed to be a typical case of SGC, which is usually diagnosed as a far-advanced gastric cancer. The pathogenesis of this disease remains unclear. Although typical SGC often invades the entire stomach, atypical cases show SGC localized to one region of the stomach. The aim of the present study was to investigate localized SGC (LSGC) and its biological significance. A total of 509 patients with advanced gastric cancer who underwent gastrectomy were evaluated. These patients were divided into three groups as follows: 19 patients with type IV scirrhous lesions invading the whole stomach (defined as LP), 60 patients with type IV scirrhous lesions localized in less than two thirds of the stomach (defined as LSGC) and the remaining 430 patients with all other types of gastric cancer (OGC), and then clinicopathologically compared. Results showed that LP had deeper invasion (p=0.006), more frequent peritoneal dissemination including positive cytology (p=0.01 and p=0.018) and lower curability (p=0.03) compared with LSGC, whereas LSGC showed a higher malignant potential in a number of clinicopathological factors compared with OGC. Univariate analysis showed that survival in patients with LP was significantly poorer than in those with LSGC (p=0.002) whose survival was, in turn, inferior to those with OGC. By contrast, LSGC was not a prognostic factor in SGC according to the multivariate analysis. The findings of this study suggested that the malignant status of LSGC differs from that of LP, and that curative gastrectomy is effective in improving the outcome for LSGC but not for LP, as LSGC may represent the prelinitis condition. IntroductionType IV scirrhous gastric cancer (SGC) is characterized by diffuse infiltration and proliferation of poorly differentiated gastric cancer cells accompanied by marked stromal fibrosis (1). Linitis plastica (LP), also known as leather bottle stomach, is believed to be a typical case of SGC, usually involving the whole stomach and characterized by a grossly thickened wall. Despite recent advances in the diagnosis and treatment of gastric cancer, the majority of cases of SGC are not detected at an early stage since tumor cells migrate throughout the submucosa without severely affecting the mucosal lining of the stomach. This causes difficulty in detecting cancer cells by gastrointestinal series or endoscopy (2-5).In LP, the cancer is poorly differentiated and originates in the gastric fundic gland area as a small IIc lesion, which shows extensive submucosal invasion without obvious concavities or recesses and a leather bottle-like appearance with giant folded walls. These walls are occasionally accompanied by peritoneal dissemination, considerable lymph node metastasis and direct invasion into the surrounding organs (6-8). Therefore, LP is recognized as a far-advanced gastric cancer in most cases, or as an early cancer that is accidentally ...

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“…Scirrhous carcinoma of the stomach is a poorly di erentiated adenocarcinoma typically characterized by growing vast ®brous stroma, and in®ltrative and rapid expansion (Sugimachi, 1993). It should be mentioned that the prognosis of scirrhous carcinoma is still poor, despite recent advances in the treatment of gastric carcinoma (Kitamura et al, 1995). Several peptide growth factors including epidermal growth factor (EGF) may be involved in its development and/or malignant progression.…”

Section: Introductionmentioning

confidence: 99%