Aneuploidy of tumor cells in cases of gastric cancer with esophageal invasion: another indicator of poor prognosis.
The prognosis of patients with gastric cancer with esophageal invasion is extremely poor. To evaluate factors related to this poor prognosis, we analyzed 200 patients with gastric cancer located in the upper third of the stomach. These patients underwent gastrectomy and were divided into two groups in terms of the presence (E[+] group; n = 62) or absence (E[-] group; n = 138) of histological evidence of esophageal invasion. Even when apparently curative surgery was performed, the 5-year survival rate of patients with E[+] gastric cancer (45.8%) was significantly lower than of patients with E[-] gastric cancer (71.6%). In the E[+] group, the 5-year survival rate of patients who had tumors with infiltrative growth and DNA aneuploidy was only 10.0%. These patients had a high frequency of peritoneal metastasis at operation (5/16; 31.3%); even when apparently curative operations were performed, 50% of these patients died from peritoneal metastatic recurrence within 2 years after surgery. Gastric adenocarcinoma with esophageal invasion accompanied by infiltrative growth and DNA aneuploidy had a high potential for peritoneal metastasis. This combination is associated with the most pessimistic prognosis for patients with gastric cancer with esophageal invasion.
Department of Surgery I, Faculty of Medicine, Tottori University, Yonago, Japan.
M
M
Ikeguchi
S
S
Ohfuji
A
A
Oka
S
S
Tsujitani
M
M
Maeta
N
N
Kaibara
D000230:Adenocarcinoma / Q000235:genetics / Q000473:pathology* / Q000556:secondary; D000782:Aneuploidy; D004273:DNA, Neoplasm / Q000032:analysis; D004938:Esophageal Neoplasms / Q000473:pathology*; D005260:Female; D005434:Flow Cytometry; D005743:Gastrectomy / Q000401:mortality; D006801:Humans; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D013274:Stomach Neoplasms / Q000235:genetics / Q000473:pathology*; D015996:Survival Rate
D004273:DNA, Neoplasm