Early Gastric Cancer Exfoliating into Gastric Lavage (GL1 EGC) Shows a More Aggressive Behavior and Poorer Survival Compared to the Non-Exfoliative Counterpart (GL0 EGC)

Anticancer Res. 2017 Aug;37(8):4199-4203. doi: 10.21873/anticanres.11810.

Abstract

Background/aim: Early gastric cancer (EGC) is usually associated with excellent prognosis. Some cases, however, entail a poorer survival. Our aim was to assess if EGC exfoliating into gastric lavage (GL) has a more aggressive behavior than the non-exfoliative counterpart.

Patients and methods: Between April 2012 and April 2017, 96 gastric cancer patients were prospectively submitted to preoperative GL to detect the presence (GL1) or absence (GL0) of exfoliated malignant cells.

Results: A total of 16 patients had EGC. T1b cases had significantly poorer overall (OS), progression-free (PFS) and disease-free survival (DFS) than their GL0 counterpart (16.3 vs. 61 months, p=0.0032). Similarly, the entire T1 class (T1a plus T1b EGCs) showed worse OS, PFS, DFS (15.5 vs. 61 months, p=0.0008) and time-to-tumor progression (17 vs. 61 months, p=0.0103).

Conclusion: In the case of EGC, the GL0-GL1 classification should become a routine clinical practice to identify the aggressive tumor phenotypes requiring for closer follow-up or additional treatment.

Keywords: EGC; Early gastric cancer; gastric cancer cytopathology; gastric cancer oncology; gastric lavage.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Disease-Free Survival
  • Early Detection of Cancer
  • Female
  • Gastrectomy
  • Gastric Lavage / methods*
  • Humans
  • Lymphatic Metastasis
  • Male
  • Middle Aged
  • Prognosis*
  • Stomach Neoplasms / diagnosis*
  • Stomach Neoplasms / drug therapy
  • Stomach Neoplasms / pathology*