An aggressive early gastric cancer: Kodama's PenA type

GIRCG

Research output: Contribution to journalArticle

Abstract

Background: To investigate the role of Kodama PenA subtype in influencing survival in patients with early gastric cancer (EGC). Methods: All patients surgically treated for EGC at 7 Italian centers (Forlì Varese, Siena, Verona, Milan, Rome and Perugia) belonging to the Italian Research Group for Gastric Cancer (GIRCG) from January 1982 and December 2009 were included. Results: PenA patients were 230 (21.5%) while other types were 839 (78.5%). Nodal metastases were more common in PenA (30.7%) than non-PenA (10.4%) EGCs. Among preoperative variables, only age (OR 1.02; 95% CI 1.00–1.03, p = 0.009) and macrotype III (OR 1.95; 95% CI 1.39–2.75, p = 0.0001) were significantly associated with Pen A type. Survival analysis performed on N0 patients demonstrated that only size >2 cm (HR 1.85; 95% CI 1.12–3.05, p = 0.017) and age (HR 1.06; 95% CI 1.03–1.08, p < 0.0001) were independent poor prognostic factor. Among N+ patients age (HR 1.04; 95% CI 1.00–1.07, p = 0.048), number of positive lymph nodes (HR 1.13; 95% CI 1.05–1.20, p = 0.0002) and PenA (HR 4.23; 95% CI 1.70–10.55, p = 0.002) were significantly correlated with poor prognosis at multivariate analysis. Conclusions: Kodama PenA subtype was the most powerful independent prognostic factor in patients with nodal metastases. Its status should always be investigated in EGCs patients.

Original languageEnglish
Pages (from-to)1186-1190
Number of pages5
JournalEuropean Journal of Surgical Oncology
Volume44
Issue number8
DOIs
Publication statusPublished - Aug 1 2018

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Stomach Neoplasms
Neoplasm Metastasis
Survival Analysis
Multivariate Analysis
Lymph Nodes
Survival
Research

Keywords

  • Early gastric cancer
  • Histotype
  • Lymph node metastases
  • Prognosis
  • Prognostic factors

ASJC Scopus subject areas

  • Surgery
  • Oncology

Cite this

An aggressive early gastric cancer : Kodama's PenA type. / GIRCG.

In: European Journal of Surgical Oncology, Vol. 44, No. 8, 01.08.2018, p. 1186-1190.

Research output: Contribution to journalArticle

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title = "An aggressive early gastric cancer: Kodama's PenA type",
abstract = "Background: To investigate the role of Kodama PenA subtype in influencing survival in patients with early gastric cancer (EGC). Methods: All patients surgically treated for EGC at 7 Italian centers (Forl{\`i} Varese, Siena, Verona, Milan, Rome and Perugia) belonging to the Italian Research Group for Gastric Cancer (GIRCG) from January 1982 and December 2009 were included. Results: PenA patients were 230 (21.5{\%}) while other types were 839 (78.5{\%}). Nodal metastases were more common in PenA (30.7{\%}) than non-PenA (10.4{\%}) EGCs. Among preoperative variables, only age (OR 1.02; 95{\%} CI 1.00–1.03, p = 0.009) and macrotype III (OR 1.95; 95{\%} CI 1.39–2.75, p = 0.0001) were significantly associated with Pen A type. Survival analysis performed on N0 patients demonstrated that only size >2 cm (HR 1.85; 95{\%} CI 1.12–3.05, p = 0.017) and age (HR 1.06; 95{\%} CI 1.03–1.08, p < 0.0001) were independent poor prognostic factor. Among N+ patients age (HR 1.04; 95{\%} CI 1.00–1.07, p = 0.048), number of positive lymph nodes (HR 1.13; 95{\%} CI 1.05–1.20, p = 0.0002) and PenA (HR 4.23; 95{\%} CI 1.70–10.55, p = 0.002) were significantly correlated with poor prognosis at multivariate analysis. Conclusions: Kodama PenA subtype was the most powerful independent prognostic factor in patients with nodal metastases. Its status should always be investigated in EGCs patients.",
keywords = "Early gastric cancer, Histotype, Lymph node metastases, Prognosis, Prognostic factors",
author = "GIRCG and Paolo Morgagni and Leonardo Solaini and Luca Saragoni and Maria Bencivenga and Luigina Graziosi and Elisabetta Marino and Daniele Marrelli and Stefano Rausei and Fausto Rosa and Emanuela Scarpi and Anna Tomezzoli and Domenico Tringali and Carla Vindigni and Giovanni Vittimberga and Franco Roviello",
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T2 - Kodama's PenA type

AU - GIRCG

AU - Morgagni, Paolo

AU - Solaini, Leonardo

AU - Saragoni, Luca

AU - Bencivenga, Maria

AU - Graziosi, Luigina

AU - Marino, Elisabetta

AU - Marrelli, Daniele

AU - Rausei, Stefano

AU - Rosa, Fausto

AU - Scarpi, Emanuela

AU - Tomezzoli, Anna

AU - Tringali, Domenico

AU - Vindigni, Carla

AU - Vittimberga, Giovanni

AU - Roviello, Franco

PY - 2018/8/1

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N2 - Background: To investigate the role of Kodama PenA subtype in influencing survival in patients with early gastric cancer (EGC). Methods: All patients surgically treated for EGC at 7 Italian centers (Forlì Varese, Siena, Verona, Milan, Rome and Perugia) belonging to the Italian Research Group for Gastric Cancer (GIRCG) from January 1982 and December 2009 were included. Results: PenA patients were 230 (21.5%) while other types were 839 (78.5%). Nodal metastases were more common in PenA (30.7%) than non-PenA (10.4%) EGCs. Among preoperative variables, only age (OR 1.02; 95% CI 1.00–1.03, p = 0.009) and macrotype III (OR 1.95; 95% CI 1.39–2.75, p = 0.0001) were significantly associated with Pen A type. Survival analysis performed on N0 patients demonstrated that only size >2 cm (HR 1.85; 95% CI 1.12–3.05, p = 0.017) and age (HR 1.06; 95% CI 1.03–1.08, p < 0.0001) were independent poor prognostic factor. Among N+ patients age (HR 1.04; 95% CI 1.00–1.07, p = 0.048), number of positive lymph nodes (HR 1.13; 95% CI 1.05–1.20, p = 0.0002) and PenA (HR 4.23; 95% CI 1.70–10.55, p = 0.002) were significantly correlated with poor prognosis at multivariate analysis. Conclusions: Kodama PenA subtype was the most powerful independent prognostic factor in patients with nodal metastases. Its status should always be investigated in EGCs patients.

AB - Background: To investigate the role of Kodama PenA subtype in influencing survival in patients with early gastric cancer (EGC). Methods: All patients surgically treated for EGC at 7 Italian centers (Forlì Varese, Siena, Verona, Milan, Rome and Perugia) belonging to the Italian Research Group for Gastric Cancer (GIRCG) from January 1982 and December 2009 were included. Results: PenA patients were 230 (21.5%) while other types were 839 (78.5%). Nodal metastases were more common in PenA (30.7%) than non-PenA (10.4%) EGCs. Among preoperative variables, only age (OR 1.02; 95% CI 1.00–1.03, p = 0.009) and macrotype III (OR 1.95; 95% CI 1.39–2.75, p = 0.0001) were significantly associated with Pen A type. Survival analysis performed on N0 patients demonstrated that only size >2 cm (HR 1.85; 95% CI 1.12–3.05, p = 0.017) and age (HR 1.06; 95% CI 1.03–1.08, p < 0.0001) were independent poor prognostic factor. Among N+ patients age (HR 1.04; 95% CI 1.00–1.07, p = 0.048), number of positive lymph nodes (HR 1.13; 95% CI 1.05–1.20, p = 0.0002) and PenA (HR 4.23; 95% CI 1.70–10.55, p = 0.002) were significantly correlated with poor prognosis at multivariate analysis. Conclusions: Kodama PenA subtype was the most powerful independent prognostic factor in patients with nodal metastases. Its status should always be investigated in EGCs patients.

KW - Early gastric cancer

KW - Histotype

KW - Lymph node metastases

KW - Prognosis

KW - Prognostic factors

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