Journal of Gastric Cancer

The Korean Gastric Cancer Association (대한위암학회)
권호 표지
DOI QR코드

DOI QR Code

Clinicopathological Features of Upper Third Gastric Cancer during a 21-Year Period (Single Center Analysis)

  • Jang, Je-Ho (Department of Surgery, Seoul National University College of Medicine) ;
  • Beron, Reinaldo Isaacs (Department of Surgery, Federal University of Sao Paulo) ;
  • Ahn, Hye-Seong (Department of Surgery, Seoul National University College of Medicine) ;
  • Kong, Seong-Ho (Department of Surgery, Seoul National University College of Medicine) ;
  • Lee, Hyuk-Joon (Department of Surgery, Seoul National University College of Medicine) ;
  • Kim, Woo-Ho (Cancer Research Institute, Seoul National University College of Medicine) ;
  • Lee, Kuhn-Uk (Department of Surgery, Seoul National University College of Medicine) ;
  • Yang, Han-Kwang (Department of Surgery, Seoul National University College of Medicine)
  • Received : 2010.07.21
  • Accepted : 2010.10.12
  • Published : 2010.12.30
Download PDF
⟨ Previous Next ⟩

Abstract

Purpose: The aim of this study was to determine proportions of upper third gastric cancer (UTG) among all gastric cancers and analyze clinicopathological features of the disease. Materials and Methods: The medical records of 12,300 patients who underwent gastric surgery between 1986 and 2006 at Seoul National University Hospital (SNUH) were retrospectively reviewed. Clinicopathological features of 1,260 patients with UTG and 9,929 patients with middle or lower third gastric cancer (MLG) were compared, and annual proportions of UTG were evaluated. Results: The proportion of patients with UTG rapidly increased from 2.6% in 1986 to 12.5% in 1992. However, linear regression analysis showed that the rate of increase was reduced (0.21%/year) after 1992 (12.5% to 14.2% from 1992 to 2006). Compared with the MLG group, the UTG group had a lower proportion of (22.3% vs. 39.7%, P<0.001) and a greater proportion of stage III/IV disease (39.4% vs. 31.7%, P<0.001). The UTG group also had larger tumors than the MLG group in stages I/II and III (3.5 cm/5.3 cm/6.5 cm vs. 3.2 cm/5.0 cm/5.8 cm, P=0.020/0.028 /<0.001), a higher proportion of undifferentiated cancer (63.1% vs. 53.7%, P<0.001), and less intestinal Lauren's type (38.8% vs. 47.4%, P<0.001). The 5-year survival rate of the UTG group was significantly lower than that of the MLG group in stages I/II and III (85.6%/63.1%/34.2% vs. 91.6%/ 69.2%/44.7%, P<0.001/0.028/0.006). Conclusions: The proportion of UTGs has increased over the last two decades at SNUH, but the rate of increase has been greatly reduced since 1992. The UTG group showed a poorer prognosis compared with the MLG group in stages I/II and III.

Keywords

References

  1. Parkin DM, Bray F, Ferlay J, Pisani P. Global cancer statistics, 2002. CA Cancer. J Clin 2005;55:74-108. https://doi.org/10.3322/canjclin.55.2.74
  2. Hassan HA, Sharma VK, Raufman JP. Changing trends in gastric carcinoma at a university medical center: a twelve-year retrospective analysis. J Clin Gastroenterol 2001;32:37-40. https://doi.org/10.1097/00004836-200101000-00009
  3. Blaser MJ, Saito D. Trends in reported adenocarcinomas of the oesophagus and gastric cardia in Japan. Eur J Gastroenterol Hepatol 2002;14:107-113. https://doi.org/10.1097/00042737-200202000-00003
  4. Zhou Y, Zhang Z, Zhang Z, Wu J, Ren D, Yan X, et al. A rising trend of gastric cardia cancer in Gansu Province of China. Cancer Lett 2008;269:18-25. https://doi.org/10.1016/j.canlet.2008.04.013
  5. Ryu KW, Kim CS, Goo BH. Clinicopathologic characteristics of and prognosis for proximal gastric carcinomas. J Korean Surg Soc 2000;59:223-228.
  6. Park MW, Bae JM, Kim SW, Kim SW, Song SK. Annual change of clinicopathologic characteristics aft er radical gas-trectomy due to gastric cancer. J Korean Surg Soc 2009;77:88-95. https://doi.org/10.4174/jkss.2009.77.2.88
  7. Yang HK, Th e Information Committee of the Korean Gastric Cancer Association. Current status of clinical practice for gastric cancer patients in Korea. J Korean Gastric Cancer Assoc 2004;4:95-108. https://doi.org/10.5230/jkgca.2004.4.2.95
  8. Bruno L, Nesi G, Montinaro F, Carassale G, Lassig R, Boddi V, et al. Clinicopathologic fi ndings and results of surgical treatment in cardiac adenocarcinoma. J Surg Oncol 2000;74:33-35. https://doi.org/10.1002/1096-9098(200005)74:1<33::AID-JSO8>3.0.CO;2-R
  9. Talamonti MS, Kim SP, Yao KA, Wayne JD, Feinglass J, Bennett CL, et al. Surgical outcomes of patients with gastric carcinoma: the importance of primary tumor location and microvessel invasion. Surgery 2003;134:720-727. https://doi.org/10.1016/S0039-6060(03)00337-4
  10. Kim DY, Joo JK, Ryu SY, Park YK, Kim YJ, Kim SK. Clinicopathological characteristics and prognosis of carcinoma of the gastric cardia. Dig Surg 2006;23:313-318. https://doi.org/10.1159/000097895
  11. Kunisaki C, Akiyama H, Nomura M, Matsuda G, Otsuka Y, Ono H, et al. Surgical outcomes for early gastric cancer in the upper third of the stomach. J Am Coll Surg 2005;200:15-19. https://doi.org/10.1016/j.jamcollsurg.2004.09.015
  12. Kim WH, Park CK, Kim YB, Kim YW, Kim HG, Bae HI, et al. A standardized pathology report for gastric cancer. Korean J Pathol 2005;39:106-113.
  13. Nakamura K, Sugano H, Takagi K. Carcinoma of the stomach in incipient phase: its histogenesis and histological appearances. Gann 1968;59:251-258.
  14. Lauren P. The two histological main types of gastric carcinoma: diffuse and so-called intestinal-type carcinoma. an attempt at a histo-clinical classifi cation. Acta Pathol Microbiol Scand 1965;64:31-49. https://doi.org/10.1111/apm.1965.64.1.31
  15. Tamura G, Sato K, Akiyama S, Tsuchiya T, Endoh Y, Usuba O, et al. Molecular characterization of undiff erentiated-type gastric carcinoma. Lab Invest 2001;81:593-598. https://doi.org/10.1038/labinvest.3780268
  16. Frederick LG, Charles MB, David IP, Daniel GH, Irvin DF, Monica M, April GF, eds. AJCC Cancer Staging Manual. Vol 1. 6th ed. New York: Springer-Verlag, 2002.
  17. The Information Committee of the Korean Gastric Cancer Association. 2004 nationwide gastric cancer report in Korea. J Korean Gastric Cancer Assoc 2007;7:47-54. https://doi.org/10.5230/jkgca.2007.7.1.47
  18. http://www.kgca-i-or.kr/Accessed September 1, 2010
  19. Sasako M, Sano T, Yamamoto S, Sairenji M, Arai K, Kinoshita T, et al. Left thoracoabdominal approach versus abdominaltranshiatal approach for gastric cancer of the cardia or subcardia: a randomised controlled trial. Lancet Oncol 2006;7:644-651. https://doi.org/10.1016/S1470-2045(06)70766-5
  20. Piso P, Werner U, Lang H, Mirena P, Klempnauer J. Proximal versus distal gastric carcinoma--what are the diff erences? Ann Surg Oncol 2000;7:520-525. https://doi.org/10.1007/s10434-000-0520-0
  21. Maeda H, Okabayashi T, Nishimori I, Sugimoto T, Namikawa T, Dabanaka K, et al. Clinicopathologic features of adenocarcinoma at the gastric cardia: is it diff erent from distal cancer of the stomach? J Am Coll Surg 2008;206:306-310. https://doi.org/10.1016/j.jamcollsurg.2007.06.306
  22. McColl KE. Cancer of the gastric cardia. Best Pract Res Clin Gastroenterol 2006;20:687-696. https://doi.org/10.1016/j.bpg.2006.03.005
  23. Hamilton SR, Aaltonen LA: World Health Organization Classification of Tumours, eds. Pathology and Genetics of Tumours of the Digestive System. 1st ed. Lyon: IARCPress, 2000:281-292.
  24. Ectors N, Driessen A, De Hertog G, Lerut T, Geboes K. Is adenocarcinoma of the esophagogastric junction or cardia different from Barrett adenocarcinoma? Arch Pathol Lab Med 2005;129:183-185.
  25. Sakaguchi T, Watanabe A, Sawada H, Yamada Y, Tatsumi M, Fujimoto H, et al. Characteristics and clinical outcome of proximal-third gastric cancer. J Am Coll Surg 1998;187:352-357. https://doi.org/10.1016/S1072-7515(98)00191-4
  26. Yokoi C, Gotoda T, Hamanaka H, Oda I. Endoscopic submucosal dissection allows curative resection of locally recurrent early gastric cancer aft er prior endoscopic mucosal resection. Gastrointest Endosc 2006;64:212-218. https://doi.org/10.1016/j.gie.2005.10.038

Cited by

  1. Evaluation of the 7th UICC TNM Staging System of Gastric Cancer vol.11, pp.2, 2010, https://doi.org/10.5230/jgc.2011.11.2.78
  2. Comparison on Clinicopathological Features and Prognosis Between Esophagogastric Junctional Adenocarcinoma (Siewert II/III Types) and Distal Gastric Adenocarcinoma: Retrospective Cohort Study, a Singl vol.94, pp.34, 2010, https://doi.org/10.1097/md.0000000000001386
  3. Clinical, Histological and Prognosis Correlations in Diagnosis and Treatment of Gastric Cancer vol.42, pp.3, 2010, https://doi.org/10.12865/chsj.42.03.04
  4. Clinical Outcomes and Evaluation of Laparoscopic Proximal Gastrectomy with Double-Flap Technique for Early Gastric Cancer in the Upper Third of the Stomach vol.24, pp.6, 2010, https://doi.org/10.1245/s10434-017-5782-x
  5. Clinicopathologic characteristics in patients with upper third gastric cancer following radical surgical treatment : A retrospective cohort study vol.97, pp.45, 2010, https://doi.org/10.1097/md.0000000000013017
  6. Characteristics of proximal early gastric cancer differentiating distal early gastric cancer vol.14, pp.9, 2010, https://doi.org/10.1371/journal.pone.0223284
  7. Comparison of clinicopathologic profiles and prognosis of gastric cancer in the upper, middle and lower third of the stomach : A retrospective cohort study vol.99, pp.30, 2010, https://doi.org/10.1097/md.0000000000021261
  8. Shorter Survival of Patients with Upper-Third Gastric Cancer Preoperatively Diagnosed as Stage IA Compared with Those with Middle to Lower Lesions vol.27, pp.1, 2010, https://doi.org/10.1245/s10434-019-07782-1
  9. Spatially Distinct Reprogramming of the Tumor Microenvironment Based On Tumor Invasion in Diffuse-Type Gastric Cancers vol.27, pp.23, 2010, https://doi.org/10.1158/1078-0432.ccr-21-0792