Parietal cell carcinoma of the stomach: association with long-term survival after curative resection

Following the recent identification of gastric parietal cell carcinoma (Capella et al., 1984), a histological and clinical review of 125 consecutive cases of gastric cancers treated surgically during a 9-year period was undertaken. The pathology was reviewed blind and in addition to H & E sections, staining with Luxol Fast Blue, phosphotungstic acid haematoxylin and E-M studies were performed to identify parietal cell differentiation. The surgical procedures performed were curative R2 gastrectomy (n = 56), palliative resection (n = 30), gastro-enterostomy (n = 25) and intubation (n = 14). The 30-day operative mortality was 12/125 (10%) overall and 4/56 (7%) in the curative resection group. Two parietal cell cancers were identified and a further 4 tumours showed areas of parietal cell differentiation. All occurred in male patients (mean age 55 years, range 43-62). Sixteen patients out of the 56 patients (29%) who underwent curative R2 resection have survived long-term (mean 5.5 years, range 2.5-11): 4/5 mucosal/submucosal cancers (T1N0), 5/29 intestinal cancers (T2N0-2) 2/16 diffuse cancers (T2N1) and 5/6 with parietal cell cancer/differentiation (T2-3N0-2). There were no survivors beyond 14 months in the patients who were treated by palliative resection, bypass or intubation irrespective of histology. This study suggests that gastric parietal cell carcinoma carries a good prognosis after curative resection despite the advanced stage at presentation.