Clinicopathological Study on Poorly Differentiated Adenocarcinoma of the Stomach with Medullary Growth Pattern

Hiroo Oshita, Sengai Tanaka, Daizou Fukata

Department of Surgery, Gifu City Hospital

Among patients with poorly differentiated adenocarcinoma of the stomach, 51 with the medullary type and 162 with the scirrhous type were compared with regard to clinicopathological findings. The percentages of patients with medullary and scirrhous types, among all patients with gastric cancer, were 6.3% and 20.1%, respectively. According to the classification of gross findings, medullary types 2 and 3, i.e., associated with ulcer formation, accounted for 62.7%, and the scirrhous type 4 accounted for 38.9%, of all cases. Many patients with both types showed depth of invasion as se and si (sei), and the incidence of early cancer was low in those patients. The incidence of liver metastasis in the patients with the medullary type (13.7%), was significantly higher than that (3.1%) in patients with the scirrhous type. However, the incidence of lymph node metastasis was high in patients with both types 82.0% for the medullary type and 80.2% for the scirrhous type. The rate of curative resection was low in both groups, 49.0% for the medullary type and 61.1% for the scirrhous type. The 5-year survival rates for patients who had undergone curative resection were 71.0% and 49.5% for the medullary and scirrhous types, respectively, showing that the prognosis for the medullary type is significantly better than that for the scirrhous type. Although the incidence of liver metastasis and lymph node metastasis are high in patients with the medullary type, the prognosis for those whose have undergone curative resection is good. Radical surgery should therefore be actively performed for the medullary type.

Key words
poorly differentiated adenocarcinoma of the stomach, medullary growth pattern, scirrhous growth pattern

Reprint requests
Hiroo Oshita Department of Surgery, Gifu City Hospital
7-1 Kashimacho, Gifu, 500 JAPAN

Accepted
November 20, 1991

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