TY - JOUR AU - Luu, Carrie AU - Thapa, Ram AU - Woo, Katherine AU - Coppola, Domenico AU - Almhanna, Khaldoun AU - Pimiento, Jose M. AU - Chen, Dung-Tsa AU - Marquez, Daissy Dominguez AU - Hodul, Pamela J. PY - 2017 TI - Does histology really influence gastric cancer prognosis? JF - Journal of Gastrointestinal Oncology; Vol 8, No 6 (December 01, 2017): Journal of Gastrointestinal Oncology Y2 - 2017 KW - N2 - Background: Gastric cancer (GC) is associated with poor survival despite curative-intent surgical resection and systemic therapy. Our objective is to examine the impact of histology on prognosis as well as the impact of linitis plastica (LP) on survival. Methods: The GC database at a single institution was evaluated for patients who underwent resection from 2000 to 2015. Clinicopathologic characteristics were examined and descriptive statistics was used to analyze four groups of patients based on Lauren classification: intestinal (n=93), diffuse (n=20), diffuse with signetring cell features (n=57), and LP (n=40). LP patients had diffuse GC but also presented with circumferential infiltration of the gastric wall for at least a third of the stomach length on endoscopy or imaging. Fisher’s exact test was used to compare groups; Cox regression was used for multivariate analysis and Kaplan-Meier method for survival. Results: Of 210 patients who underwent gastric resection, 112 (53%) were male with mean age 65.3 years (SD ±14.6 years). Intestinal GC patients were older at diagnosis but other patient demographics were similar between all groups. LP patients had a higher rate of R1 resection despite higher rates of total gastrectomy (P Conclusions: Intestinal GC is thought to have a better prognosis. Interestingly, this study demonstrates similar outcomes in patients with intestinal, diffuse, and signet-ring cell GC. However, a subset of diffuse GC-LP was associated with an infiltrative pattern of disease characterized by PNI and LVI. Despite controlling for poor prognostic markers, LP was independently associated with a worse prognosis. More research is needed to identify methods of earlier diagnosis and effective systemic therapy to treat this aggressive disease. UR - https://jgo.amegroups.org/article/view/16909