Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2025
Long-term prognosis of mixed histological-type gastric cancers cured by endoscopic resection: a multicenter prospective cohort study.
СтатьяМногоцентровое исследованиеНаблюдательное исследованиеПоддержка исследования: вне правительства СШАНазвание и аннотация: Перевод пока не подготовлен
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Horiuchi Yusuke, Hirasawa Toshiaki, Suzuki Haruhisa, Takizawa Kohei, Takeuchi Yoji, Ishido Kenji, Hoteya Shu, Yano Tomonori, Tanaka Shinji, Toya Yosuke, Nakagawa Masahiro, Yoshizaki Tetsuya, Yoshida Naohiro, Hirasawa Kingo, Matsuda Mitsuru, Yamamoto Hironori, Koizumi Shigeto, Hori Shinichiro, Tajika Masahiro, Hikichi Takuto, Yao Kenshi, Shimazu Taichi, Ono Hiroyuki, Tanabe Satoshi, Kondo Hitoshi, Iishi Hiroyasu, Ninomiya Motoki, Oda Ichiro, J-WEB/EGC group
Аннотация
BACKGROUND: Gastric cancer is divided into differentiated and undifferentiated types and sometimes exhibits mixed histology. However, the risk of gastric cancer-related death after curative endoscopic resection for mixed histology remains unknown. This study evaluated the long-term prognosis of mixed histological type gastric cancers treated with endoscopic resection.
METHODS: Data from a Japanese multicenter prospective cohort study were analyzed. Patients with single gastric cancer lesions who underwent curative endoscopic resection were included and divided into those with pure or mixed histological types. Patients with both types of gastric cancer were compared in terms of 5-year overall survival and 5-year disease-specific survival related to primary gastric cancers.
RESULTS: Pure histological type was observed in 6434 patients with 6434 lesions, and mixed histological type was observed in 161 patients with 161 lesions. Overall survival was not significantly different between patients with both types (p = 0.415). The 5-year disease-specific survival was lower in patients with mixed histological type than in those with pure histological type (p = 0.003). After stratification by curative endoscopic resection criteria, in cases of pT1a/M, differentiated-type dominance, tumor size ≤ 3 cm with ulcerative findings, no lymphovascular invasion, and R0 resection, the 5-year disease-specific survival was significantly lower in patients with mixed histological type than in those with pure type (p < 0.001).
CONCLUSIONS: The long-term prognosis in cured cases, including those with mixed histological type, was favorable. Stratification analysis showed that mixed histological types with ulcers were more likely to cause primary gastric cancer-related death than pure histological type and might need more careful surveillance.
CLINICAL TRIAL REGISTRATION: UMIN Clinical Trial Registry, UMIN000005871.
METHODS: Data from a Japanese multicenter prospective cohort study were analyzed. Patients with single gastric cancer lesions who underwent curative endoscopic resection were included and divided into those with pure or mixed histological types. Patients with both types of gastric cancer were compared in terms of 5-year overall survival and 5-year disease-specific survival related to primary gastric cancers.
RESULTS: Pure histological type was observed in 6434 patients with 6434 lesions, and mixed histological type was observed in 161 patients with 161 lesions. Overall survival was not significantly different between patients with both types (p = 0.415). The 5-year disease-specific survival was lower in patients with mixed histological type than in those with pure histological type (p = 0.003). After stratification by curative endoscopic resection criteria, in cases of pT1a/M, differentiated-type dominance, tumor size ≤ 3 cm with ulcerative findings, no lymphovascular invasion, and R0 resection, the 5-year disease-specific survival was significantly lower in patients with mixed histological type than in those with pure type (p < 0.001).
CONCLUSIONS: The long-term prognosis in cured cases, including those with mixed histological type, was favorable. Stratification analysis showed that mixed histological types with ulcers were more likely to cause primary gastric cancer-related death than pure histological type and might need more careful surveillance.
CLINICAL TRIAL REGISTRATION: UMIN Clinical Trial Registry, UMIN000005871.