A cohort study and meta-analysis between histopathological classification and prognosis of gastric carcinoma

To determine the correlation of histopathological classification and patient outcomes, we performed a meta-analysis of histological subtypes on postoperative survival in gastric cancer.

A dataset composed of 11073 gastric cancers from 21 publications, combined with our cohort was included in the metaanalysis. We evaluated the association between the 5-year survival rate and the subtypes of gastric cancer based on histological grading or Lauren classification. All literatures were from Pubmed and Embase (up to December 2011).

In our cohort from Shanghai Ruijin Hospital, the differentiated gastric cancer revealed a significantly higher accumulative 5-year survival rate, compared to that in poor-differentiated cases (62.6% vs 44.8%, P < 0.001). Intestinal-type gastric cancer shown a higher accumulative 5-year survival rate, compared to that in diffuse-type cases (61.7% vs 41.1%, P < 0.001). In overall meta-analysis, the poordifferentiated gastric cancer significantly increased the postoperative 5-year death risk, compared to the differentiated cases (OR=1.24, 95% CI 1.13-1.36, P < 0.001). The 5-year death risk was increased in the diffuse-type cases relative to the intestinal-type cases (OR=1.29, 95% CI 1.11-1.49, P < 0.001).

Gastric cancer with a differentiated histology or intestinal-type shows a better prognosis than individual with a poordifferentiated histology or a diffuse-type. Accurate histologic classification is desirable for gastric cancer handling.