Yıl: 2022 Cilt: 38 Sayı: 1 Sayfa Aralığı: 5 - 13 Metin Dili: İngilizce DOI: 10.4274/eamr.galenos.2020.86648 İndeks Tarihi: 25-06-2022

Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology

Öz:
Objective: Gastric cancer consists of many histological subtypes. The prognostic value of histological types in stomach cancer is not well defined. In this study, we investigated the effects of different histological types on surgical and oncological outcomes in stomach cancer. Methods: Patients with a histology of undifferentiated carcinoma, neuroendocrine tumors, and gastrointestinal stromal tumors were included in the study of 1,060 patients who underwent gastrectomy for gastric cancer between 2010 and 2019. They were divided into three groups as group 1 (undifferentiated tumor), group 2 (neuroendocrine tumor), and group 3 (gastrointestinal stromal tumor). Demographic and clinical features, operative and oncological outcomes, and survival were compared between the groups. Results: Of a sample group that included 1,060 diseases, 53 patients (5%) were included in the study. Group 1 consisted of 24 patients, group 2 consisted of 10 patients, and group 3 consisted of 19 patients. Average age (p=0.591), was similar across all groups. Tumors were most frequently located in the corpus (41.7% vs. 80% vs. 42%, respectively) (p=0.283). Patients in group 1 and group 2 underwent total gastrectomy at a higher rate, with 79.2% and 60%, respectively, whereas in group 3, subtotal gastrectomy was performed on 63.2% of the patients. The number of lymph nodes dissected was highest in group 1 (24.25 vs. 13.70 vs. 9.52, p=0.00). The anastomosis leak (p=0.285) and post-operative 90-day mortality (p=0.285) were similar in each group. Local recurrence was most frequent in group 1 (50% vs. 40% vs. 10.5%, p=0.023). Total survival time was shortest in group 1 (31 months vs. 78 months vs. 99 months, p=0.005). Conclusion: While demographic characteristics, clinical features, and surgical results were not affected by tumor histology, oncological results (overall survey and local recurrence) were associated with tumor histology. Undifferentiated carcinoma showed an oncologically aggressive course compared to other histological types.
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  • 1. Jemal A, Bray F, Center MM, Ferlay J, Ward E, Forman D. Global cancer statistics. CA Cancer J Clin 2011;61:69-90. Erratum in: CA Cancer J Clin 2011;61:134.
  • 2. 2-Türkiye’de Kanser istatistikleri. Available at: https://hsgm.saglik.gov.tr/ depo/birimler/kanser-db/istatistik/Turkiye_Kanser_Istatistikleri_2015. pdf acces date 15.04.2020
  • 3. Lauwers GY, Carneiro F, Graham DY, Curado MP. Gastric Carcinoma. In: Bosman FT, Carneiro F, Hruban RH, Theise ND, eds. WHO Classification of Tumours of the Digestive System. IARC, Lyon; 2010.p.48-58.
  • 4. Nagtegaal ID, Odze RD, Klimstra D, Paradis V, Rugge M, Schirmacher P, et al. The 2019 WHO classification of tumours of the digestive system. Histopathology 2020;76:182-8.
  • 5. Japanese Gastric Cancer Association. Japanese classification of gastric carcinoma: 3rd English edition. Gastric Cancer 2011;14:101-12.
  • 6. Endo S, Nishikawa K, Yamada T, Nakagawa T, Fushimi H, Chihara T, et al. Our experience of treating undifferentiated gastric carcinoma: report of four cases. Surg Today 2015;45:235-40.
  • 7. Corey B, Chen H. Neuroendocrine tumors of the stomach. Surg Clin North Am 2017;97:333-43.
  • 8. Gupta SK, Rateria N. Gastrointestinal stromal tumors (GIST): an overview. Indian J Surg 2020;83:647-53.
  • 9. Yalav O, Topal U, Unal AG. Clinical value of neutrophil/lymphocyte ratio in predicting postoperative complications, lymph node positivity and prognosis in gastric cancer patients who underwent curative surgical resection. Ann Med Res 2019;26:2513-9.
  • 10. Iwatsuki M, Yamamoto H, Miyata H, Kakeji Y, Yoshida K, Konno H, et al. Effect of hospital and surgeon volume on postoperative outcomes after distal gastrectomy for gastric cancer based on data from 145,523 Japanese patients collected from a nationwide web-based data entry system. Gastric Cancer 2019;22:190-201.
  • 11. Claassen YHM, van Amelsfoort RM, Hartgrink HH, Dikken JL, de Steur WO, van Sandick JW, et al. Effect of hospital volume with respect to performing gastric cancer resection on recurrence and survival: results from the CRITICS trial. Ann Surg 2019;270:1096-102. 12. Orman S, Cayci HM. Gastric cancer: factors affecting survival. Acta Chir Belg 2019;119:24-30.
  • 13. Lee HJ, Hyung WJ, Yang HK, Han SU, Park YK, An JY, et al. Short-term outcomes of a multicenter randomized controlled trial comparing laparoscopic distal gastrectomy with D2 lymphadenectomy to open distal gastrectomy for locally advanced gastric cancer (KLASS-02-RCT). Ann Surg 2019;270:983-91.
  • 14. Zheng HC, Zheng YS, Xia P, Xu XY, Xing YN, Takahashi H, et al. The pathobiological behaviors and prognosis associated with Japanese gastric adenocarcinomas of pure WHO histological subtypes. Histol Histopathol 2010;25:445-52.
  • 15. Su JS, Chen YT, Wang RC, Wu CY, Lee SW, Lee TY. Clinicopathological characteristics in the differential diagnosis of hepatoid adenocarcinoma: a literature review. World J Gastroenterol 2013;19:321-7.
  • 16. Berlth F, Bollschweiler E, Drebber U, Hoelscher AH, Moenig S. Pathohistological classification systems in gastric cancer: diagnostic relevance and prognostic value. World J Gastroenterol 2014;20:5679-84.
  • 17. Hamilton SR, Aaltonen LA. Pathology and genetics of tumours of the digestive system b2000 (volume 2). Lyon: IARC press.
  • 18. Horan TC, Gaynes RP, Martone WJ, Jarvis WR, Emori TG. CDC definitions of nosocomial surgical site infections, 1992: a modification of CDC definitions of surgical wound infections. Infect Control Hosp Epidemiol 1992;13:606-8.
  • 19. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. Acta Pathol Microbiol Scand 1965;64:31-49.
  • 20. Nakamura K, Sugano H, Takagi K. Carcinoma of the stomach in incipient phase: its histogenesis and histological appearances. Gan 1968;59:251- 8.
  • 21. Park JM, Jang YJ, Kim JH, Park SS, Park SH, Kim SJ, et al. Gastric cancer histology: clinicopathologic characteristics and prognostic value. J Surg Oncol 2008;98:520-5.
  • 22. Zu H, Wang H, Li C, Xue Y. Clinicopathologic characteristics and prognostic value of various histological types in advanced gastric cancer. Int J Clin Exp Pathol 2014;7:5692-700.
  • 23. Huang ZB, Zhou X, Xu J, Du YP, Zhu W, Wang J, et al. Prognostic value of preoperative serum tumor markers in gastric cancer. World J Clin Oncol 2014;5:170-6.
  • 24. Shimada H, Noie T, Ohashi M, Oba K, Takahashi Y. Clinical significance of serum tumor markers for gastric cancer: a systematic review of literature by the Task Force of the Japanese Gastric Cancer Association. Gastric Cancer 2014;17:26-33.
  • 25. Mattar R, Alves de Andrade CR, DiFavero GM, Gama-Rodrigues JJ, Laudanna AA. Preoperative serum levels of CA 72-4, CEA, CA 19-9, and alpha-fetoprotein in patients with gastric cancer. Rev Hosp Clin Fac Med Sao Paulo 2002;57:89-92.
  • 26. Ishigami S, Natsugoe S, Hokita S, Che X, Tokuda K, Nakajo A, et al. Clinical importance of preoperative carcinoembryonic antigen and carbohydrate antigen 19-9 levels in gastric cancer. J Clin Gastroenterol 2001;32:41-4.
  • 27. Makuuchi R, Irino T, Tanizawa Y, Bando E, Kawamura T, Terashima M. Esophagojejunal anastomotic leakage following gastrectomy for gastric cancer. Surg Today 2019;49:187-96.
  • 28. Russell MC, Mansfield PF. Surgical approaches to gastric cancer. J Surg Oncol 2013;107:250-8.
  • 29. Yalav O, Topal U. Risk factors for leakage after total gastrectomy. Ann Med Res 2020;27:174-80.
  • 30. Tsai TC, Joynt KE, Orav EJ, Gawande AA, Jha AK. Variation in surgicalreadmission rates and quality of hospital care. N Engl J Med 2013;369:1134-42.
  • 31. Merkow RP, Bilimoria KY, Cohen ME, Richards K, Ko CY, Hall BL. Variability in reoperation rates at 182 hospitals: a potential target for quality improvement. J Am Coll Surg 2009;209:557-64.
  • 32. Li SS, Costantino CL, Mullen JT. Morbidity and mortality of total gastrectomy: a comprehensive analysis of 90-day outcomes. J Gastrointest Surg 2019;23:1340-8.
  • 33. Xiao H, Wang Y, Quan H, Ouyang Y. Incidence, causes and risk factors for 30-day unplanned reoperation after gastrectomy for gastric cancer: experience of a high-volume center. Gastroenterology Res 2018;11:213- 20.
  • 34. Yalav O, Topal U. Predictive factors associated mortality after gastrectomy. Ann Med Res 2020;27:326-33.
  • 35. Ueda K, Yamazoe S, Kawazoe Y, Iwasaki Y, Naka T, Yamaue H, et al. Perforated undifferentiated gastric cancer with metastaticsmall intestinal tumors: a case report (in Japanese with English abstract). J Abdom Emerg Med 2010;30:937-40.
  • 36. Yamamoto M, Kobayashi Y, Ochiai M, Terasawa H, MizumotoY, Tsubota Y. A rapidly progressed case of undifferentiated gastric cancer (in Japanese with English abstract). J Jpn Surg Assoc 2012;73:2841-46. https://www. jstage.jst.go.jp/article/jjsa/73/11/73_2841/_pdf/-char/en
APA topal u, DAL F, Sözüer E, Akyuz M, İsaoğulları Ş, gök m, Deniz K (2022). Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. , 5 - 13. 10.4274/eamr.galenos.2020.86648
Chicago topal uğur,DAL Fatih,Sözüer Erdoğan Mütevelli,Akyuz Muhammet,İsaoğulları Şadi Yenel,gök mustafa,Deniz Kemal Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. (2022): 5 - 13. 10.4274/eamr.galenos.2020.86648
MLA topal uğur,DAL Fatih,Sözüer Erdoğan Mütevelli,Akyuz Muhammet,İsaoğulları Şadi Yenel,gök mustafa,Deniz Kemal Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. , 2022, ss.5 - 13. 10.4274/eamr.galenos.2020.86648
AMA topal u,DAL F,Sözüer E,Akyuz M,İsaoğulları Ş,gök m,Deniz K Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. . 2022; 5 - 13. 10.4274/eamr.galenos.2020.86648
Vancouver topal u,DAL F,Sözüer E,Akyuz M,İsaoğulları Ş,gök m,Deniz K Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. . 2022; 5 - 13. 10.4274/eamr.galenos.2020.86648
IEEE topal u,DAL F,Sözüer E,Akyuz M,İsaoğulları Ş,gök m,Deniz K "Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology." , ss.5 - 13, 2022. 10.4274/eamr.galenos.2020.86648
ISNAD topal, uğur vd. "Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology". (2022), 5-13. https://doi.org/10.4274/eamr.galenos.2020.86648
APA topal u, DAL F, Sözüer E, Akyuz M, İsaoğulları Ş, gök m, Deniz K (2022). Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. European Archives of Medical Research, 38(1), 5 - 13. 10.4274/eamr.galenos.2020.86648
Chicago topal uğur,DAL Fatih,Sözüer Erdoğan Mütevelli,Akyuz Muhammet,İsaoğulları Şadi Yenel,gök mustafa,Deniz Kemal Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. European Archives of Medical Research 38, no.1 (2022): 5 - 13. 10.4274/eamr.galenos.2020.86648
MLA topal uğur,DAL Fatih,Sözüer Erdoğan Mütevelli,Akyuz Muhammet,İsaoğulları Şadi Yenel,gök mustafa,Deniz Kemal Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. European Archives of Medical Research, vol.38, no.1, 2022, ss.5 - 13. 10.4274/eamr.galenos.2020.86648
AMA topal u,DAL F,Sözüer E,Akyuz M,İsaoğulları Ş,gök m,Deniz K Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. European Archives of Medical Research. 2022; 38(1): 5 - 13. 10.4274/eamr.galenos.2020.86648
Vancouver topal u,DAL F,Sözüer E,Akyuz M,İsaoğulları Ş,gök m,Deniz K Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology. European Archives of Medical Research. 2022; 38(1): 5 - 13. 10.4274/eamr.galenos.2020.86648
IEEE topal u,DAL F,Sözüer E,Akyuz M,İsaoğulları Ş,gök m,Deniz K "Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology." European Archives of Medical Research, 38, ss.5 - 13, 2022. 10.4274/eamr.galenos.2020.86648
ISNAD topal, uğur vd. "Clinicopathological Features and Surgical Outcomes in Patients Undergoing Radical Resection for Gastric Cancer with Undifferentiated Carcinoma, Neuroendocrine Tumor, and Gastrointestinal Stromal Tumor Histology". European Archives of Medical Research 38/1 (2022), 5-13. https://doi.org/10.4274/eamr.galenos.2020.86648