Abstract
Simple SummaryBorrmann classification is widely used for advanced gastric cancer (GC). Most studies on the clinicopathological impact of this classification have been performed in Asian countries, and almost all authors analyzed only type IV tumors. We assessed the clinicopathological, molecular features and the prognostic value of Borrmann types in all patients with advanced GC resected in a Western institution (n = 260). We observed a significant relationship between Borrmann types and several clinicopathological and molecular features, including age at diagnosis, systemic symptoms, tumor size, Laurén subtype, presence of signet-ring cells, infiltrative pattern, high grade, necrosis, size of the largest lymph node metastasis, HERCEPTEST positivity, microsatellite instability and molecular subtypes. No association was found between Borrmann classification and prognosis. According to our results, Borrmann types may represent distinct clinicopathological and biological entities. Further studies should be performed to confirm the role of Borrmann classification in the stratification of patients with advanced GC.Most studies on the clinicopathological impact of Borrmann classification for gastric cancer (GC) have been performed in Asian patients with type IV tumors, and immunohistochemical features of Borrmann types have scarcely been analyzed. We assessed the clinicopathological, molecular features and prognostic value of Borrmann types in all patients with advanced GC resected in a Western institution (n = 260). We observed a significant relationship between Borrmann types and age, systemic symptoms, tumor size, Laurén subtype, presence of signet-ring cells, infiltrative growth, high grade, tumor necrosis, HERCEPTEST positivity, microsatellite instability (MSI) and molecular subtypes. Polypoid GC showed systemic symptoms, intestinal-type histology, low grade, expansive growth and HERCEPTEST positivity. Fungating GC occurred in symptomatic older patients. It presented intestinal-type histology, infiltrative growth and necrosis. Ulcerated GC showed smaller size, intestinal-type histology, high grade and infiltrative growth. Most polypoid and ulcerated tumors were stable-p53-not overexpressed or microsatellite unstable. Flat lesions were high-grade diffuse tumors with no MSI, and occurred in younger and less symptomatic patients. No association was found between Borrmann classification and prognosis. According to our results, Borrmann types may represent distinct clinicopathological and biological entities. Further research should be conducted to confirm the role of Borrmann classification in the stratification of patients with advanced GC.
Highlights
Gastric cancer (GC) is the fifth most frequent tumor worldwide and the third most common cause of cancer-related deaths [1]
gastric cancer (GC) cases were divided into molecular subgroups depending on the classification of the ACRG, as we described in a previous study [16]
We found that Borrmann types were significantly related to different clinicopathological features: age at diagnosis, systemic symptoms, tumor size, Laurén subtype, presence of signet-ring cells, infiltrative growth pattern, high grade, tumor necrosis and size of the largest lymph node metastasis (Figure 1)
Summary
Gastric cancer (GC) is the fifth most frequent tumor worldwide and the third most common cause of cancer-related deaths [1]. Five-year survival rates are estimated to be as low as 30% in Western countries [2]. It can be classified according to diverse features: location, gross morphology, microscopy or molecular alterations [5]. Several molecular classifications have been proposed, including The Cancer Genome Atlas and the. Asian Cancer Research Group (ACRG) systems [6,7]. These classifications have not yet been translated into clinical practice [8,9,10]
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