A Study of Clinicopathological Findings and Postoperative Survival of Poorly Differentiated Adenocarcinoma of the Stomach in View of Amount of Interstitial Connective Tissue

Shiro Kawamura, Michio Kato, Tohru Morishita, Masakazu Ohno, Masato Funasaka, Takeshi Nakamura, Yoichi Saitoh

First Department of Surgery, Kobe University School of Medicine

A total of 511 patients with poorly differentiated adenocarcinoma of the stomach were histologically classified into medullary type (91 cases), intermediate type (148 cases), and scirrhous type (272 cases) based on the amount of interstitial connective tissue. Among them, the medullary and scirrhous types were compard with regard to clinicopathological findings and prognosis of the patients. Patients with the medullary type were also studied with regard to postoperative survival correlating to the degree of lymphocytic infiltration. Our results indicated that the patients with the medullary type tended to be older and to be male, and the tumor tended to be located in the lower third of the stomach and to be Borrmann type 1 and 2, ps (-), n₄, and stage I. Patients with the scirrhous type tended to be younger and to be female, and the tumor tended to show whole stomach extension and to be Borrmann type 3 and 4, ps (-), and stage III. On the other hand, there was no significant difference between the two types in terms of macroscopic peritoneal dissemination and liver metastasis. The postoperative survival rates for the two types were not significantly different according to histological staging (stage) and prognostic serosal factor (ps). Likewise, the amount of interstitial connective tissue did not appear to affect prognosis. In the medullary type, however, the patients with lymphocytic infiltration tended to have a better prognosis than those without lymphocytic infiltration.

Key words
medullary type of gastric carcinoma, scirrhous type of gastric carcinoma, lymphocytic infiltration

Reprint requests
Shiro Kawamura First Department of Surgery, Kobe University School of Medicine
7-5-2 Kusunoki-cho, Chuo-ku, Kobe, 650 JAPAN

Accepted
March 3, 1993

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