Clinicopathological characteristics of gastric cancer in the elderly

Kitamura, Kazuya; Yamaguchi, Toshiharu; Taniguchi, Hiroki; Hagiwara, Akeo; Yamane, Toshimi; Sawai, Kiyoshi; Takahashi, Toshio

doi:10.1038/bjc.1996.139

Cited by 102 publications

(94 citation statements)

References 13 publications

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“…Several reports have indicated that differentiatedtype or intestinal-type carcinomas are more common in older patients than in younger patients [3,[5][6][7][8][14][15][16]18,19]. Our study demonstrated that this tendency was clear, especially in early-stage cancer.…”

Section: Discussionsupporting

confidence: 63%

“…The characteristic features of gastric carcinoma in elderly people have been reported by several investigators [3][4][5][6][7][8][9]. Previous studies have shown that gastric cancer involving the lower third of the stomach and histopathologically well-differentiated adenocarcinoma was significantly more prevalent in elderly patients [6,8,10].…”

Section: Introductionmentioning

confidence: 78%

“…Previous studies have shown that gastric cancer involving the lower third of the stomach and histopathologically well-differentiated adenocarcinoma was significantly more prevalent in elderly patients [6,8,10]. It is also reported that the frequency of advanced cancer in the elderly is higher than in young people [7], and multiple and metastatic cancers are more common in aged people [5,11]. However, only a few reports, using a relatively small number of cases, have examined the clinicopathologic features of gastric carcinoma in very old people.…”

Section: Introductionmentioning

confidence: 99%

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Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Arai

Esaki²,

Inoshita

et al. 2004

Gastric Cancer

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Background. The clinicopathologic features of gastric carcinoma in elderly people have been reported previously. The present study examined the patterns and distribution of gastric carcinomas in the elderly, especially in patients aged 85 and older. Methods. A retrospective study of 994 consecutive Japanese patients aged 65 years or older was performed. In this group, a total of 1147 lesions were analyzed. Pathological findings in the very old group (older than 85 years; n ‫؍‬ 126) were compared with those in younger groups (65-74 years [young-old group]; n ‫؍‬ 356) and (75-84 years [middle-old group]; n ‫؍‬ 512). Results. While the male-to-female ratio significantly decreased with advancing age, the relative odds of gastric cancer in men were higher than those in women in all age groups. In the very old group, cancer of the lower third of the stomach tended to increase with advancing age, and accounted for 43.7% of cases. In the population overall, differentiated-type adenocarcinoma accounted for 89.6% in the early cancers and 50.3% in the advanced cancers. The proportion of cases involving differentiated-type carcinoma significantly increased with advancing age in early cancer and female advanced cancer cases, whereas no significant change was found in male advanced-cancer patients. In the very old group, lymph node metastasis was found in 5.4% of early cancers and 72.7% in advanced cancers. Multiple cancers significantly increased with advancing age (P < 0.05; 10.7% in the younger-old group, 12.7% in the middle-old group, and 19.0% in the very old group). Conclusion. These results indicate that, in the very old group, gastric cancers showed a distal shift with predominantly differentiated-type carcinoma in the early stages and increased undifferentiated-type carcinomas in advanced stages. These results suggest increased histologic diversity with tumor growth. These findings have important implications for the screening and diagnosis of gastric cancer in the elderly. Offprint requests to: T. Arai

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Section: Discussionsupporting

confidence: 63%

Section: Introductionmentioning

confidence: 78%

Section: Introductionmentioning

confidence: 99%

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Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Arai

Esaki²,

Inoshita

et al. 2004

Gastric Cancer

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“…As these incidences have increased, the clinicopathological features of EGCs have been gradually elucidated by various authors (Mori et al, 1985;Ohta et al, 1987;Moreaux et al, 1993). The accumulation of patients with EGCs has allowed the investigation of atypical EGCs (Noguchi et al, 1985;Ichiyoshi et al, 1990; Kitamura et al, 1996a); early gastric cancers mimicking advanced gastric cancers (EGC mimicking AGC) is one such variant.…”

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confidence: 99%

Early gastric cancer mimicking advanced gastric cancer

Kitamura

Yamaguchi²,

Nishida³

et al. 1997

Br J Cancer

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Summary The clinicopathological features of 37 early gastric cancers mimicking advanced gastric cancer were reviewed retrospectively, and were compared with 596 other early gastric cancers and 126 mp gastric cancers, defined as gastric cancer invading the muscularis propria of the stomach. A greater tumour size (P < 0.005), submucosal invasion (P < 0.005), lymph node and lymph vessel invasion (P < 0.005) and vascular invasion (P < 0.025) were found more frequently in early gastric cancers mimicking advanced gastric cancers than in other early gastric cancers. There were no significant differences in the clinicopathological findings between early gastric cancers mimicking advanced gastric cancers and mp gastric cancers. Patients with early gastric cancers mimicking advanced gastric cancers showed a lower survival rate than patients with other early gastric cancers, but a higher survival than those with mp gastric cancers. The macroscopic appearance of an advanced gastric cancer was an indicator of massive submucosal invasion and lymph node metastasis in early gastric cancer. As early gastric cancers mimicking advanced gastric cancers showed similar clinicopathological findings to mp gastric cancers, these cancers should be treated as mp gastric cancers.

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“…In literature, controversy remains about the influence of chronologic age on the nodal status in gastric carcinoma. Most previous reports have negated a significant difference in the rates of LN metastasis between younger and elderly patients [37][38][39][40], whereas in cases of early gastric cancer several authors have reported a higher prevalence of LN involvement for elderly patients [41,42].…”

Section: Survival Analysismentioning

confidence: 95%

Gastric carcinoma: stage migration by immunohistochemically detected lymph node micrometastases

Jeuck

Wittekind

2014

Gastric Cancer

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Background Immunohistochemically detected micrometastases of the regional lymph nodes in previously pN0-classified gastric cancer have been incorporated in the TNM staging system. This study aims to determine the incidence of such micrometastases in gastric carcinoma and to investigate their impact on stage grouping and prognosis. Methods Ninety-five patients with gastric carcinoma classified as pN0 by conventional histological examination were enrolled. All patients underwent gastric resection with regional lymphadenectomy between 2006 and 2010. A total of 2018 lymph nodes was obtained (median, 20 Lymph nodes) and immunohistostained with anti-pan cytokeratin antibody (KL1). Results Micrometastases were detected in regional lymph nodes by immunohistostaining in 16 out of all 95 patients. Fourteen patients were upstaged by micrometastasis-positive regional lymph nodes. Three patients demonstrated lymph nodes with isolated tumor cells alone. A significantly higher incidence of micrometastases was observed in patients with diffuse histologic type (p = 0.007) and total gastrectomy (p = 0.007). When isolated tumor cells were also regarded as lymph node involvement, the recurrence rate was significantly higher for node-positive than for node-negative patients and for those younger than 70 years (33.3 and 6.7 %, respectively; p = 0.026; n = 39). Overall survival analysis revealed no significant difference between micrometastasis-positive and micrometastasis-negative patients. ConclusionImmunohistostaining of regional lymph nodes in node-negative gastric carcinoma patients leads to an increased detection of micrometastases with significant implications for the staging system. Although no impact on survival time was shown, the higher recurrence rate for node-positive patients younger than 70 years indicates a prognostic value of immunohistochemically detectable micrometastases.

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Clinicopathological characteristics of gastric cancer in the elderly

Cited by 102 publications

References 13 publications

Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Pathologic characteristics of gastric cancer in the elderly: a retrospective study of 994 surgical patients

Early gastric cancer mimicking advanced gastric cancer

Gastric carcinoma: stage migration by immunohistochemically detected lymph node micrometastases

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