Micropapillary Carcinoma Predicts Recurrence in Patients with Stage II Gastric Cancer and Treated with Surgery Only
Ingu Do, Jeeyun Lee, Sung Kim, Kyoung-Mee Kim. Samsung Medical Center, Seoul, Korea
Background: Micropapillary carcinoma (MPC) of the stomach is a rare, newly recognized entity, and only few case series have been reported. Moreover, clinical significance of MPC in the stomach has yet to be established. The aim of the study is to identify prognostic significance of MPC for patients diagnosed with stage II gastric cancer and treated with surgery only.
Design: The eligible patients are those who received gastrectomy at Samsung Medical Center between the years 2000 to 2010, and diagnosed with stage II gastric cancer, and have not received any adjuvant chemotherapy, and have all tumor slides available for review. A detailed morphologic review was performed in all 432 cases and cut-off value of micropapillary pattern for the diagnosis of MPC was 5%, which is similar to prior reports of MPC in other organs. The primary end point was disease free survival (DFS), which was defined as time to first documented recurrence of gastric cancer or death from the date of surgery.
Results: MPC was observed in 17 cases (4%). During follow up, recurrence was observed in 177 patients (41%). In univariate analyses, pT stage (1b+2a vs 2b+3) (p=0.0003), host cellular immune reaction (p=0.0135), pN stage (0 vs 1+2) (p=0.0107) and MPC (p=0.0010) were significantly associated with DFS. However, Lauren type, WHO histologic grade, mucin contents, lymphovascular invasion and positive lymph node ratio were not significant. In multivariate Cox regression analyses with confounding factors with p-value <0.05, pT stage, host cellular immune reaction, pN stage, and MPC were significant (p<0.04). In multivariate Cox regression analyses with confounding factors with p-value <0.01, only pT stage (p=0.004) and micropapillary feature (p=0.007) remained significant.
Conclusions: In patients diagnosed with stage II gastric cancer and have not received any adjuvant chemotherapy, MPC is an independent prognostic factor to predict recurrence.
Monday, March 19, 2012 1:00 PM
Poster Session II # 93, Monday Afternoon