Comparison of relapse-free survival in gastric neuroendocrine carcinoma (WHO grade 3) and gastric carcinoma

Background: We compared relapse-free survival (RFS) in gastric neuroendocrine carcinoma (WHO grade 3) and gastric carcinoma (GC). This is one of very few studies that compare the prognosis of poorly differentiated neuroendocrine carcinoma (WHO grade 3, G3 NEC) with that of GC. Methods: Between 1996 and 2014, 63 patients were diagnosed with G3 NEC of the stomach and 56 with gastric neuroendocrine tumors (NETs) with GC at Asan Medical Center in Seoul, Korea. We also randomly selected 762 patients diagnosed with GC between 1999 and 2008. Results: Patients with G3 NEC tumors that invaded the muscularis propria or shallower had poorer RFS than those with GC of the same type, while G3 NEC that invaded the subserosa or deeper had similar RFS to GC of that type. Patients diagnosed with G3 NEC with N0 or N2 had poorer RFS than the corresponding patients with GC, while those who had G3 NEC with N1 or N3 had similar RFS to the corresponding patients with GC. G3 NEC patients had poorer RFS than well-differentiated, moderately differentiated and poorly differentiated GC patients, while G3 NEC patients had similar RFS to that of those with signet ring cell carcinoma (SRC). In addition, patients with G3 NEC of stages I or IIa had poorer RFS than those with corresponding GC, while G3 NEC stage IIb or greater had similar RFS to the corresponding GC. Conclusions: Non-advanced G3 NEC showed poorer RFS than GC excluding SRC, while advanced G3 NEC has a similar RFS to that of GC without SRC. Therefore, we recommend that patients with non-advanced G3 NEC of the stomach be given a more aggressive treatment and surveillance than those with non-advanced GC excluding SRC

Differences in the prognosis of early gastric cancer according to sex and age

Background: Few studies have compared early gastric cancer (EGC) outcomes according to sex and age. Methods: We retrospectively reviewed 2085 patients who underwent curative gastrectomy for EGC between 1989 and 2000. Prognosis and risk factors for nodal involvement were evaluated according to sex and age. Results: Male sex and age were independent prognostic factors for overall survival (OS) but not relapse-free survival (RFS). In young (⩽55 years) patients, there were no significant differences in RFS and OS between men and women. However, older (>55 years) men had a poorer OS and older women had a poorer RFS. Young female patients had a higher proportion of gastric cancer-related death than young male patients. Female sex was an independent risk factor for nodal involvement in younger patients. Conclusions: Young women with EGC should be more intensively treated and monitored than other patient groups and should not be treated by endoscopic resection

Additional file 1: Table S1. of Mediastinal lymph node dissection and distal esophagectomy is not essential in early esophagogastric junction adenocarcinoma

Prognostic factors for disease-free survival of adenocarcinoma in of the EGJ and the upper third of the stomach in multivariable analysis. aLVI refers to lymphovascular invasion. (DOC 30 kb