Fattori predittivi clinici ed anatomo-patologici: rilevanza prognostica nel tumore gastrico operato

Abstract

Background. Gastric cancer is one of the most common human cancers and it is the second most frequent cause of cancer-related death in the world. This study was conducted to investigate retrospectively the morphologic features of invaded tissues, histogical type, intra-tumour vascular composition, and their correlation with patients’ prognosis. Patients and Methods. We reviewed all gastric cancer cases in stage N+ after radically surgery in “Luigi Sacco” hospital in the last ten years. They were classified in two groups: Long Survivors (LS) (> 3 years survival) and Short Survivors (SS) (< 3 years survival). We evaluated their morphological features. The surgical specimens underwent examination to determine the stage, the differences in the way of development and the extent of infiltration, histological type, degree of invasion of microvessel and perineural spaces, degree of necrosis, presence of desmoplasia and number of positive resected node. Results. We reviewed 42 patients, 18 females and 24 males, median age 62 years, 23 were resected with total gastrectomy and 19 with subtotal one, but all underwent to completed lymphadenectomy. Twenty-one patients were SS and 21 were LS. All data are reported by SS/LS respectively. Median survival were 14/72 months, stages T3-4 were 9/5; growth pattern was infiltrative in 13/5 and invasive in 8/16, intestinal histologic type was 11/16 while diffuse type was 10/5; necrosis index was 47% vs 61%; desmoplasia was present in 61% vs 33% and positive node ratio was 43% vs 21%. Discussion. In our patients some morphological features have still an important role in influencing the prognosis and the treatment, expecially the microscopic infiltrative growth pattern type and the lymph node ratio that showed significant correlation with group of Long Survivors.