location and prognosis

Aim - To evaluate the prognostic impact of different histological classifications of gastric adenocarcinoma.Methods - Between 1993-2000, 94 patients with gastric odenocarcinoma were studied. Tumors were classified according to TNM staging, WHO, Lauren and Goseki classifications. Twenty five patients (27%) hod a proximal tumor and 69 (73%) a distal tumor. Intestinal type according to Lauren were more often observed among the proximal carcinomas (19/25) than in distal ones (32/69) (P = 0.01). According to Goseki, lymph node metastasis were less frequently found in group III (5/13) than in other groups (64/81) (P = 0.033). The mean follow-up was 23 months. Survical was not influenced by WHO, Lauren, and Goseki classifications. Survival significantly varied according to the different groups of the TNM classification. The proximal location of the tumor was associated with poorer prognosis than distal location (P = 0.0373). Number of lymph nodes, invasion of perineurium, and Vascular invasion had significant prognostic value in proximal carcinomas.Conclusion - The results of this study suggest that gastric carcinomas should be divided into proximal and distal tumors using the Goseki classification in addition to the Lauren classification because the Goseki classification recognizes tumor groups with different dissemination routes