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Updated: Apr 18, 2026
Author Spotlight: Advancing Early Detection and Treatment of Gastrointestinal Tumors
Published on: February 16, 2024
Histological mixed-type as an independent prognostic factor in stage I gastric carcinoma
Shuhei Komatsu1, Daisuke Ichikawa1, Mahito Miyamae1
1Shuhei Komatsu, Daisuke Ichikawa, Mahito Miyamae, Hiroki Shimizu, Hirotaka Konishi, Atsushi Shiozaki, Hitoshi Fujiwara, Kazuma Okamoto, Mitsuo Kishimoto, Eigo Otsuji, Division of Digestive Surgery, Department of Surgery, Kyoto Prefectural University of Medicine, Kyoto 602-8566, Japan.
Aim:
To evaluate the clinicopathological features of mixed-type gastric cancer and their influence on prognosis of mixed-type stage I gastric cancer.
Methods:
We analyzed 446 patients who underwent curative gastrectomy for stage I gastric cancer between 1999 and 2009. The patients were divided into two groups: those with differentiated or undifferentiated cancer (non-mixed-type, n = 333) and those with a mixture of differentiated and undifferentiated cancers (mixed-type, n = 113).
Results:
The overall prevalence of mixed-type gastric cancer was 25.3% (113/446). Compared with patients with non-mixed-type gastric cancer, those with mixed-type gastric cancer tended to be older at onset (P = 0.1252) and have a higher incidence of lymph node metastasis (P = 0.1476). They also had significantly larger tumors (P < 0.0001), more aggressive lymphatic invasion (P = 0.0011), and deeper tumor invasion (P < 0.0001). In addition, they exhibited significantly worse overall survival rates than did patients with non-mixed-type gastric cancer (P = 0.0026). Furthermore, mixed-type gastric cancer was independently associated with a worse outcome in multivariate analysis [P = 0.0300, hazard ratio = 11.4 (1.265-102.7)].
Conclusion:
Histological mixed-type of gastric cancer contributes to malignant outcomes and highlight its usefulness as a prognostic indicator in stage I gastric cancer.
