Subclassification of Type 5 Cancer of the Stomach

Masao Kondo, Yukifumi Kondo*, Tsunemi Higashi*, Norimitsu Hasegawa*, Akira Miyauchi*, Hiroshi Shiroto, Junichi Uchino

First Department of Surgery, Hokkaido University School of Medicine
*Department of Surgery, Sapporo Kohsei Hospital

258 patients with type 5 cancer of the stomach were treated in our clinic from January 1980 to December 1989. These carcinomas were divided into three groups according to their gross appearance: 1. early-advanced cancer (53 cases)-preoperatively diagnosed as an early gastric cancer, but was pathologically advanced cancer; 2. IIc-advanced cancer (143 cases) preoperatively diagnosed as an advanced cancer, but macroscopically looked like an early IIc cancer; 3. unclassified cancer (62 cases) could not be assigned any type of gastric cancer. The average tumor size was largest in the unclassified cancers, 62.9 mm; 47.7 mm in IIc-advanced cancer and 39.1 mm in early advanced cancer. The early advanced cancer invading only the muscularis mucosa was 64.2% which was significantly higher than the other types (35.7% in IIc-advanced cancer, 32.8% in unclassified cancer) (p<0.01). In the early advanced cancer group, no evidence of histological lymph node metastasis was observed in 71.7% which was significantly higher than the others (p<0.01). And in the early advanced cancer group, lymphatic vessel invasion was observed at the low percentage of 30.2%. The frequency of microscopic vessel invasion was also low, 13.2%. Patients with the early advanced cancer and the IIc-advanced cancer had significantly better 5-year survival rates, 83.8% and 75.0%, respectively, compared with the unclassified group patients, 53.0% (p<0.05). These results suggest that type 5 cancer of the stomach includes various types of macroscopic findings and have different clinicopathological features. The classification into three groups may be useful for clinicopathological analysis

Key words
type 5 gastric cancer, unclassified gastric cancer, advanced gastric cancer

Reprint requests
Masao Kondo First Department of Surgery, Hokkaido University School of Medicine
N-15 W-7 Kita-ku, Sapporo, 060 JAPAN

Accepted
December 7, 1994

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