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Surgical treatment results of intestinal and diffuse type gastric cancer. Implications for a differentiated therapeutic approach?

J Stiekema ,
A Cats ,
A Kuijpers ,
F van Coevorden ,
H Boot ,
E P M Jansen ,
M Verheij ,
O Balague Ponz ,
M Hauptmann ,
J W van Sandick

Abstract

METHODS

All patients who underwent a potentially curative gastric resection between 1995 and 2011 in our institute were included. Patient, tumour and treatment characteristics were obtained retrospectively. Binary logistic and Cox regression models were used for multivariate analysis.

CONCLUSIONS

Striking differences were found between patients with diffuse type tumours and those with intestinal type tumours. These differences call for a differentiated approach in the potentially curative treatment of these two tumour types.

RESULTS

A consecutive series of 132 patients was included. Median follow-up was 53 months. There were no significant differences between patients with intestinal (N = 62) versus diffuse type (N = 70) gastric cancer with regard to the proportion of patients who underwent (neo)adjuvant treatment. Postoperative mortality was 2%. Pathological T- and N-stage were significantly more advanced for patients with diffuse type tumours. There was a significant difference in the percentage of microscopically irradical resections (2% versus 24%, p < 0.001) and median overall survival (129 versus 17 months, p < 0.001) between patients with intestinal type tumours and those with diffuse type tumours. On multivariate analysis, diffuse type histology was the only factor significantly associated with an R1 resection. In a multivariate Cox regression model, diffuse type histology was a significant adverse prognostic factor for overall survival.

AIM

To study the outcome of patients who were surgically treated for primary gastric cancer with specific attention to differences in treatment results for intestinal and diffuse type tumours.

More about this publication

European journal of surgical oncology : the journal of the European Society of Surgical Oncology and the British Association of Surgical Oncology

Volume 39
Issue nr. 7
Pages 686-93
Publication date 01-07-2013

Full text links

Publisher website (DOI) 10.1016/j.ejso.2013.02.026
Europe PubMed Central 23498364
Pubmed 23498364

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