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Recurrence in node-negative advanced gastric cancer:Novel findings from an in-depth pathological analysis of prognostic factors from a multicentric series

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World Journal of Gastroenterology 2017年第45期23卷 8000-8007页

作者： Gian Luca Baiocchi Sarah Molfino Carla Baronchelli Simone Giacopuzzi Daniele Marrelli Paolo Morgagni Maria Bencivenga Luca Saragoni Carla Vindigni Nazario Portolani maristella botticini Giovanni De Manzoni Department of Clinical and Experimental Sciences University of Brescia Department of Pathology Spedali Civili di Brescia 1st Department of General Surgery Borgo Trento HospitalUniversity of Verona Department of Human Pathology and Oncology Surgical OncologyUniversity of Siena Department of General Surgery Morgagni-Pierantoni Hospital Department of Pathology Morgagni-Pierantoni Hospital Department of Pathology Azienda Ospedaliera Universitaria Senese IGIER Università Bocconi

AIM To analyze the clinicopathological characteristics of patients with both node-negative gastric carcinoma and diagnosis of recurrence during follow-up. METHODS We enrolled 41 patients treated with curative gastrectomy for p T2-4 a N0 gastric carcinoma between 1992 and 2010,who developed recurrence(Group 1). We retrospectively selected this group from the prospectively collected database of 4 centers belonging to the Italian Research Group for Gastric Cancer,and compared them with 437 p T2-4 a N0 patients without recurrence(Group 2). We analyzed lymphatic embolization,microvascular infiltration,perineural infiltration,and immunohistochemical determination of p53,Ki67,and HER2 in Group 1 and in a subgroup of Group 2(Group 2 bis) of 41 cases matched with Group 1 according to demographic and pathological characteristics. RESULTS T4 a stage and diffuse histotype were associated with recurrence in the group of p N0 patients. In-depth pathological analysis of two homogenous groups of p N0 patients,with and without recurrence during longterm follow-up(groups 1 and 2 bis),revealed two striking patterns: lymphatic embolization and perineural infiltration(two parameters that pathologists can easily report),and p53 and Ki67,represent significant factors for *** The reported pathological features should be considered predictive factors for recurrence and could be useful to stratify node-negative gastric cancer patients for adjuvant treatment and tailored follow-up.

关键词： N0 gastric cancer Recurrence Prognostic factors Pathological analysis Lymphatic embolization Perineural infiltration p53 Ki67

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