Endoscopic prognosis in gastric cancer

Sixty-eight patients with gastric adenocarcinoma underwent upper gastrointestinal endoscopy from 1968 to 1975. Tumors were divided into two categories according to their gross characteristics at endoscopy (mass-ulcer or infiltrative), to try to correlate gross morphology and stage at presentation with survival. The median survival in the mass-ulcer group was 31 months, in the infiltrative group, 4.7 months. Mucosal biopsies were positive in 88% of the mass-ulcer group and in 64% of the infiltrative group. Ninety-four percent of patients with infiltrative lesions had stage III or IV disease (regional lymphatic or distant metastasis) at the time of diagnosis, compared to only 55% of the mass-ulcer patients. Endoscopic features consistent with an infiltrating tumor suggest an advanced stage of tumor with a poor prognosis.