Clinicopathological Features and Prognosis of Mixed-Type T1a Gastric Cancer Based on Lauren's Classification.
Recent studies have reported that mixed-type (MT) gastric cancer, as per Lauren's classification, exhibits aggressive behavior. However, the behavior of early gastric cancer is unclear. In this study, we addressed the influence of mucosa-confined MT gastric cancer, according to Lauren's classification, on lymph node metastasis (LNM) and long-term outcomes.



Among patients who underwent gastrectomy for gastric cancer from January 2000 to December 2012, 3170 had mucosa-confined gastric cancer. According to Lauren's classification, 1449 (45.7 %), 1528 (48.2 %), and 193 (6.1 %) patients had intestinal type (IT), diffuse type (DT), and MT cancer, respectively. Moreover, patients with MT cancer were histologically subdivided into IT-predominant MT (3.0 %) and DT-predominant MT (2.5 %) groups. We analyzed and compared the clinicopathological characteristics, incidence of LNM, overall survival, and recurrence-free survival between these groups.



Clinicopathological characteristics showed that mucosa-confined MT gastric cancer had larger size, deeper invasion, and more frequent lymphovascular invasion compared with IT or DT cancers. The LNM of MT lesions (4.7 %) was comparable with that of DT lesions (4.8 %), and multivariate logistic regression analysis indicated that Lauren's classification was a significant predictor for LNM (P < 0.001). However, the overall survival and recurrence-free survival of patients with MT lesions did not differ significantly (P = 0.506 and 0.359, respectively).



Thus, among patients with mucosa-confined gastric cancer, those with MT cancer as per Lauren's classification have aggressive clinical features and a risk of LNM. Hence, surgical treatment may be the preferred option in these patients.
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jeung Hui
JH
Pyo
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.|Department of Pathology, Ewha Womans University School of Medicine, Seoul, South Korea.
Soomin
S
Ahn
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. leehyuk@skku.edu.
Hyuk
0000-0003-4271-7205
H
Lee
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Byung-Hoon
BH
Min
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jun Haeng
JH
Lee
Department of Medicine, Samsung Changwon Hospital, Sungkyunkwan University School of Medicine, Changwon, South Korea.
Sang Goon
SG
Shim
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Min Gew
MG
Choi
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jun Ho
JH
Lee
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Tae Sung
TS
Sohn
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Jae Moon
JM
Bae
Department of Pathology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Kyoung-Mee
KM
Kim
Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Seungmin
S
Yeon
Biostatistics and Clinical Epidemiology Center, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.|Department of Biostatistics and Bioinformatics, Duke University, Durham, NC, USA.
Sin-Ho
SH
Jung
Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea. jjkim@skku.edu.
Jae J
JJ
Kim
Department of Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea.
Sung
S
Kim
D000328:Adult; D000368:Aged; D002277:Carcinoma / Q000145:classification* / Q000556:secondary* / Q000601:surgery; D018572:Disease-Free Survival; D005260:Female; D005743:Gastrectomy; D005753:Gastric Mucosa; D006801:Humans; D015182:Lymphatic Irradiation; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011379:Prognosis; D013274:Stomach Neoplasms / Q000145:classification* / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D047368:Tumor Burden