DNA Ploidy and Tumor Invasion in Human Gastric Cancer

Korenaga, Daisuke; Haraguchi, Masanobu; Okamura, Tomonori; Baba, Hideo; Saito, Atsushi; Sugimachi, Keizō

doi:10.1001/archsurg.1989.01410030064011

Cited by 61 publications

(30 citation statements)

References 19 publications

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“…These observations are in agreement to the results of other studies demonstrating that the outcome for gastric carcinoma patients is mainly dependent on the stage [13, 23, 26]. The prognostic value of venous invasion is also in agreement to other reports [16, 26, 35]. Cox regression further identified age as a prognostic factor for cardia carcinoma cases and tumor size for fundus/body carcinoma cases.…”

Section: Discussionsupporting

confidence: 92%

Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

et al. 2001

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Background/Aims: The putative influence of tumor location on the biologic behavior of gastric carcinomas remains controversial. The aim of this study was to investigate if carcinomas arising in the three types of gastric mucosa (cardia, fundus/body and antrum) have different clinical and pathologic profiles and carry a different prognosis. Methods: Three hundred and two patients with cardia or gastric carcinoma resected between 1984 and 1996 were retrospectively studied. Cases were divided in three groups according to tumor location: cardia (n = 80); fundus/body (n = 60); antrum (n = 162). The three groups were crosstabulated with clinic and pathologic parameters, such as age, sex, macroscopy, histology, desmoplasia, tumor size, depth of tumor wall penetration, nodal status, venous invasion and stage. Survival rates were calculated for the three locations according to the aforementioned parameters. Univariate survival analysis and Cox regression were performed for each location. Results: Cases from the cardia and fundus/body were similar and distinct from antrum cases according to macroscopy, tumor size, depth of wall penetration, venous invasion, nodal status and stage. Cases from fundus/body were similar to antrum cases and distinct from cardia cases according to gender and Laurén’s classification. An overall difference in survival between the three locations was observed (p = 0.006). Cumulative survival was better for patients with carcinomas in the antrum than in the cardia (p = 0.04) and in the fundus/body (p = 0.003); no significant differences were observed in survival between cardia and fundus/body carcinoma cases. Cox regression identified stage and venous invasion as prognostic factors for patients with carcinomas in the three locations. In the group of cardia tumors, older patients had a worse outcome and in the group of fundus/body carcinomas, large tumors were associated with a poorer survival. Conclusions: Our results show that cardia carcinoma and antrum carcinoma are distinct gastric carcinoma entities whereas fundus/body carcinoma shares some characteristics from both entities.

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Section: Discussionsupporting

confidence: 92%

Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

et al. 2001

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“…This is in accordance with many authors who have found a significant gain in overall survival associated with a female sex. 22,23 However, the sex influence on gastric cancer patientsÕ prognosis is controversial, and although various hypotheses have been proposed, ranging from genetic to hormonal factors, 24-26 the precise mechanisms for such association remain unknown.…”

Section: Discussionmentioning

confidence: 99%

Prognostic Score in Gastric Cancer: The Importance of a Conjoint Analysis of Clinical, Pathologic, and Therapeutic Factors

et al. 2006

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Background: This study was designed to establish a prognostic score for gastric cancer that takes into account factors related to the tumor, the patient, and the treatment.Methods: Two hundred thirty patients with gastric adenocarcinoma admitted to the Department of Abdominal Surgery at Hospital do Caˆncer A. C. Camargo (Sa˜o Paulo) and treated by gastrectomy from January 1992 until December 1996 were included in this retrospective cohort. The prognostic score was created according to the variables identified in the multivariate analysis and by using the regression coefficients generated by the Cox regression.Results: The 5-year overall survival rate was 44.5%. The final multivariate model identified six variables with a significant and independent effect on survival: sex, weight loss, lymphocyte count, tumor-node-metastasis staging, lymphadenectomy, and lymph node ratio. Patients were divided into four groups according to their scores, as follows: group 1, 0 to 3.0; group 2, 3.5 to 5.5; group 3, 6.0 to 8.5; and group 4, 9.0 to 14.0. The 5-year survival rates were 91.5%, 49.3%, 20.3%, and .0% for the score groups 1, 2, 3, and 4, respectively (P < .001). The score was superior in the assessment of prognosis when compared with tumor-node-metastasis staging alone.Conclusions: It is possible to create a prognostic score that simultaneously includes factors related to the tumor, patient, and treatment, thus generating a more effective system in predicting the prognosis than the morphology-based staging systems.

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“…Therefore, the DNA ploidy correlated better with the growth pattern than with the histologic type. In cases of gastric cancer, cell nuclear DNA ploidy correlates well with the malignant potential and prognosis [29, 30, 31, 32]. DNA aneuploidy is closely linked to tumor invasion, lymph node metastasis and a poorer prognosis for gastric cancer.…”

Section: Dna Ploidy and Growth Patternmentioning

confidence: 99%

Tumor Growth Patterns and Biological Characteristics of Early Gastric Carcinoma

et al. 2001

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Gastric cancer is a major malignant disease. The development of new diagnostic techniques and mass screening have led to increased detection rates of patients with early-stage gastric cancer in Japan. However, after curative resection of early gastric cancer, there are various types of recurrences, and residual occult disease and distant micrometastasis precede death. The growth and metastatic potential of cancer cells are closely related to the postoperative outcome, and patients at risk for cancer-related death after surgery have to be closely monitored to prevent tumor recurrence. The biological behavior of cancer cells should be determined in patients with early gastric cancer and with a less favorable prognosis to detect potential early recurrences in the liver. Two types of growth patterns have been found in early gastric cancer: the superficially spreading (Super) type and the penetrating (Pen) type, and the clinicopathological and biological characteristics of each type have been extensively determined. A subtype of the Pen-type gastric cancer, which is progressing expansively with complete destruction of the muscularis mucosae (Pen A type) has a less favorable prognosis due to early recurrences in the liver. These clinical cancer types are closely related to chromosomal instability in DNA aneuploidy and p53 overexpression, and vascular endothelial growth factor activation induced tumor angiogenesis, vascular invasion and hematogenous metastasis. Thus, patients with Pen-A-type cancer showing expansive tumor growth had a poorer postoperative outcome and a hematogenous-related recurrence of the cancer. Antiangiogenic approaches in a postoperative setting may prove to be effective in preventing tumor recurrence and improving the prognosis for these patients.

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DNA Ploidy and Tumor Invasion in Human Gastric Cancer

Cited by 61 publications

References 19 publications

Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

Clinicopathologic Profiles and Prognosis of Gastric Carcinomas from the Cardia, Fundus/Body and Antrum

Prognostic Score in Gastric Cancer: The Importance of a Conjoint Analysis of Clinical, Pathologic, and Therapeutic Factors

Tumor Growth Patterns and Biological Characteristics of Early Gastric Carcinoma

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