Objective:
Gastric cancer consists of many histological subtypes. Prognostic value of histological types in gastric cancer has not been very well defined. In this study, we aimed to investigate the relationship between different histological types and clinicopathologic features and prognosis in gastric cancer.
Method:
Patients whose pathological diagnosis was adenosquamous carcinoma, hepatoid adenocarcinoma, lymphoepithelioma-like carcinoma, and papillary adenocarcinoma, among the 1060 patients who underwent gastrectomy for gastric cancer between 2010-2019, were included in the study. Demographic features, clinicopathological features, oncological follow-up results and survival of the patients were analyzed.
Results:
Group 1 (adenosquamous carcinoma) consisted of 3, Group 2 (hepatoid adenocarcinoma) of 3, Group 3 (lymphoepithelioma-like carcinoma) of 3, and Group 4 (papillary adenocarcinoma) consisted of 4 patients. The mean age of the patients included in the study was 63.3+11.76 (41-81) years. Tumors were more commonly located in the corpus in hepatoid adenocarcinoma and lymphoma-like carcinoma (67%) and in the antrum (75%) in papillary adenocarcinoma. Eight patients underwent total gastrectomy, four patients subtotal gastrectomy, and a patient with a tumor located at the gastroesophageal junction underwent proximal gastrectomy. Average tumor size (cm) was 5.11+2.23 (1.2-8) cm. Local recurrence occurred in two patients with adenosquamous carcinoma, two with hepatoid adenocarcinoma, and one with papillary adenocarcinoma. Two patients with adenosquamous carcinoma developed systemic metastasis (lung, liver), two patients with hepatoid adenocarcinoma developed peritoneal carcinomatosis, and a patient with papillary adenocarcinoma developed surrenal metastasis. Average survival was the shortest in hepatoid adenocarcinoma (17.50 months), and the longest in papillary adenocarcinoma (63 months). There was no statistical difference in survival between the groups (p: 0.445).
Conclusion:
Rare histological types of the stomach differed in terms of their locations and prognoses. Among the rare histological types, hepatoid adenocarcinoma exhibited the most aggressive biological behavior, while patients with papillary adenocarcinoma had longer survival times.
Keywords: gastric cancer, rare histological type, curative resection, prognosis