Is histologic differentiation a prognostic indicator for gastric carcinoma patients with curative resection.

BACKGROUND: The prognostic relevance of histologic differentiation in gastric carcinoma patients with curative resection is unclear. We analyzed the clinicopathologic features of gastric carcinoma patients with curative resection according to the histologic differentiation and evaluated surgical outcome. MATERIALS AND METHODS: Of 1198 gastric carcinoma patients with curative resection (American joint committee on cancer, Stages I‑III), 274 (22.9%) had well‑differentiated, 331 (27.6%) had moderately differentiated and 593 (49.5%) had poorly differentiated gastric carcinomas. RESULTS: Patients with the poorly differentiated type had more prominent serosal invasion, much more lymph node involvement and more advanced stage than patients with the well‑differentiated type. The overall survival rate was higher for patients with a well‑differentiated gastric carcinoma than for patients with a poorly differentiated type. Using Cox’s proportional hazard regression model, histologic differentiation was found to be a statistically significant prognostic parameter (risk ratio, 1.41; 95% confidence interval, 1.028‑1.922; P < 0.05). CONCLUSION: Our results suggest that patients with a well‑differentiated gastric carcinoma have a good prognosis compared with those with a poorly differentiated type. Therefore, histologic differentiation can be used as a prognostic indicator in gastric carcinoma patients with curative resection.